An increasingly common described entity, multiple chemical sensitivity syndrome (MCS) is a chronic, recurring problem generally caused by an individual’s inability to tolerate any one or many of the multiple chemical exposures found in the environment.  It appears to be triggered slowly by low level contact with offending chemical substances, and can disable those who are severely affected, both at work and in many external situations.

Although much research in the last 10-15 years has been done on MCS, there is still no one accepted etiology of why the syndrome occurs.  Multiple chemical sensitivity occurs more commonly in women than men, and those who have chronic fatigue syndrome or fibromyalgia report it much more frequently than the general population.  Many physicians believe than MCS is a type of allergic reaction, with repeated exposure bringing on the symptoms.  Some feel the disease is psychological in nature, similar to an anxiety reaction or panic attack in social situations.  Yet others believe it is a malfunction of the immune system which causes reproducible results regardless of the amount or degree of exposure.

An article by MC Cullen in the Journal of Occupational Medicine (1987;2:655-61) basically describes MCS as having four main elements.  First, it is acquired after a documentable environmental exposure that causes objective evidence of health effects.  Second, there is multiple organ system involvement which is predictable after exposure to known environmental chemicals.  Third, the exposure levels of these chemicals are not enough to cause toxic health problems in a normal individual. Fourth, no objective evidence of organ damage is found.   The definition unfortunately omits a mechanism of disease while describing the common tenets of symptoms.

What are the commonest triggers for MCS?  Aerosols of any type, after shave lotions and perfumes, cigar or cigarette smoke, occupational and cleaning fluid chemicals, deodorizers, and any industrial solvents seem to head the list.  Alcohol and drugs, caffeine and food additives, furniture and carpet odors, and any pesticides are likewise commonly implicated.  In other words, most detectible smells and chemical odors that are encountered in daily life, undistinguishable or tolerable by the majority of people, can set off MCS in an affected individual. 

The commonest symptoms of MCS are shortness of breath, fatigue, nausea, trembling, chest pain, and a rapid heart rate.  Many of these signs coincide with those of anxiety or panic attacks.  Difficulty concentrating or performing in a work environment, cough, and dizziness are also commonly described.  Doctors make the diagnosis when exposure to a certain environmental offender reproduces the symptoms on a constant basis, subside when the substance is withdrawn, and is generally present in lower amounts than would cause a normal person to be affected, certainly in non-toxic levels to body organs.  Blood and allergy testing is generally unhelpful in supporting the diagnosis.

MCS in the workplace is a particularly difficult situation for both worker and employer.  Creating an “MCS free” work zone is practically impossible, and unenforceable because of the chaos and personality conflicts that predominate, even amongst sympathetic co-workers.   MCS can be disabling enough for the affected individual not to want to leave home or enter any social situation where everyday chemical offenders will be present.  The thought that the disease has a strong psychosomatic component also makes it less socially acceptable in common surroundings. 

Is there a treatment for MCS?  The biggest problem occurs in not having a recognized physiologic cause.  Removal of offending chemical irritants and limited exposure to known toxins appears to be the most effective treatment.  While psychotherapy often helps, the use of antidepressants and psychological medications has not been shown to be of any consistent help, and some feel it invalidates their suffering from a legitimate illness.  Creation of a work environment than minimizes exposure to offending chemicals is very rewarding, and in fact many affected individuals successfully work from home and are quite productive in a chemical free environment.  Accepting and dealing with the consequences of exposure, which while very uncomfortable does not cause toxic body or organ damage, is also helpful and reassuring.

The information contained on this page is not intended to provide medical advice, which should be obtained directly from your physician.