Multiple Chemical Sensitivity: A 1999 consensus

The Archives of Environmental Health announces publication of the first consensus definition of the controversial syndrome known as multiple chemical sensitivity (MCS). The 1999 Consensus on MCS, signed by 34 medical researchers and clinicians from the United States and Canada, appears in the May/June 1999 issue (volume 54, number 3). It defines MCS according to six criteria, the first five of which were identified in a survey of 89 clinicians representing a diverse range of medical specialties and opinions that the Archives published in 1993 (see Nethercott JR, Davidoff LL, Curbow B and Abbey H. 1993. Multiple chemical sensitivities syndrome: toward a working case definition. Arch Environ Health 48: 1926.) 1999 Consensus Criteria for Multiple Chemical Sensitivity

  1. The symptoms are reproducible with repeated [chemical] exposure.

  2. The condition is chronic.

  3. Low levels of exposure [lower than previously or commonly tolerated] result in manifestations of the syndrome.

  4. The symptoms improve or resolve when the incitants are removed.

  5. Responses occur to multiple chemically unrelated substances.

  6. Symptoms involve multiple organ systems.

The prior lack of any consensus definition has been a significant obstacle to the diagnosis of MCS in clinical practice. This definition is published with the hope that it may standardize the diagnosis of MCS in both clinical and research settings. According to epidemiological surveys conducted by the New Mexico Department of Health and California Department of Health Services, one sixth of randomly selected adults are adversely affected by chemical sensitivity to some degree, while 2% (in NM) to 8% in CA) say they have already been diagnosed with MCS by a medical professional. Dr. Kaye Kilburn, editor of the Archives of Environmental Health and one of the authors of the consensus, hailed the new MCS definition as a practical and orderly step that was overdue. Altho

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