title: Multiple Chemical Sensitivity (MCS) - Scientific and Public-Health Aspects.
abstract: Multiple Chemical Sensitivity (MCS) is a phenomenon which the ENT-doctor should be familiar with. It has its roots in the description of a syndrome in 1987. A worker spilled chemicals at his workplace and from then on he reacted highly sensitive to chemicals. Today, there are many people who explain their complaints with self-suspected MCS. Various pathopysiological models have been proposed, including toxicological, immunological or behaviorial models. But no-one could be proved so far. Since controlled provocation tests have also provided unclear results, an increasing number of doctors assumes today, that MCS reflects a psychic condition. In 1996, an expert team of the WHO has suggested the renaming of MCS to "idiopathic environmental illness" (IEI). However, other doctors still assume a chemical cause. Since there are neither straightforward diagnostic methods to proof MCS, nor reliable therapeutic concepts, treatment of MCS-patients is usually difficult. The MCS-debate (somatic vs psychic causes) seems to reflect the dilemma of the medical profession today, that somatic disorders of known origin can be well treated, whereas the increasing number of psychosomatic/ somatoform disorders is often resistant to medical help. The ENT-doctor should pay attention to changes of the nasal mucous membrane, nasal resistance and the sense of smell. Moreover he should know about the peculiarities of MCS-patients. The manuscript describes the present knowledge and state of discussion with special regard to the situation in Germany.
authors.affiliation: State Public Health Department, Stuttgart, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Schwenk
references.citation: J Occup Environ Med. 2002 Nov;44(11):1012-7
references.pmid: 12448352
references.citation: Regul Toxicol Pharmacol. 1996 Aug;24(1 Pt 2):S96-110
references.pmid: 8921563
references.citation: Environ Health Perspect. 1997 Mar;105 Suppl 2:531-7
references.pmid: 9167992
references.citation: Regul Toxicol Pharmacol. 1993 Aug;18(1):61-78
references.pmid: 7901876
references.citation: JAMA. 1992 Dec 23-30;268(24):3465-7
references.pmid: 1460738
references.citation: Regul Toxicol Pharmacol. 1996 Aug;24(1 Pt 2):S116-8
references.pmid: 8921565
references.citation: J Allergy Clin Immunol. 1994 Jun;93(6):953-4
references.pmid: 8006316
references.citation: Arch Environ Health. 2002 May-Jun;57(3):247-54
references.pmid: 12507179
references.citation: J Intern Med. 2001 Oct;250(4):309-21
references.pmid: 11576318
references.citation: Psychol Med. 2002 Nov;32(8):1387-94
references.pmid: 12455937
references.citation: J Toxicol Clin Toxicol. 1995;33(2):101-5
references.pmid: 7897746
references.citation: Regul Toxicol Pharmacol. 1996 Aug;24(1 Pt 2):S129-38
references.pmid: 8921568
references.citation: Psychosom Med. 1997 Jan-Feb;59(1):13-23
references.pmid: 9021862
references.citation: Scand J Work Environ Health. 2003 Apr;29(2):143-51
references.pmid: 12718500
references.citation: Regul Toxicol Pharmacol. 1996 Aug;24(1 Pt 2):S8-15
references.pmid: 8921550
references.citation: Regul Toxicol Pharmacol. 1993 Aug;18(1):2-12
references.pmid: 8234915
references.citation: Toxicol Lett. 2002 Mar 10;128(1-3):99-106
references.pmid: 11869821
references.citation: Ann N Y Acad Sci. 2001 Mar;933:278-90
references.pmid: 12000028
references.citation: Toxicol Lett. 2002 Mar 10;128(1-3):85-97
references.pmid: 11869820
references.citation: Toxicol Ind Health. 1994 Jul-Oct;10(4-5):587-96
references.pmid: 7778117
references.citation: Gesundheitswesen. 1995 Oct;57(10):661-6
references.pmid: 8527883
references.citation: Ann Intern Med. 1989 Jul 15;111(2):168-78
references.pmid: 2662850
references.citation: Ann N Y Acad Sci. 2001 Mar;933:24-37
references.pmid: 12000025
references.citation: MMW Fortschr Med. 2003 Aug 21;145(33-34):31-4
references.pmid: 14526571
references.citation: Occup Med. 1987 Oct-Dec;2(4):801-4
references.pmid: 3313773
references.citation: Arch Environ Health. 1999 May-Jun;54(3):147-9
references.pmid: 10444033
references.citation: Scand J Psychol. 2002 Apr;43(2):161-7
references.pmid: 12004954
references.citation: Curr Opin Neurol. 2003 Jun;16(3):351-7
references.pmid: 12858073
references.citation: J Occup Med. 1992 May;34(5):529-38
references.pmid: 1593293
references.citation: J Toxicol Clin Toxicol. 1995;33(2):111-3
references.pmid: 7897748
references.citation: Toxicol Ind Health. 1999 Apr-Jun;15(3-4):432-7
references.pmid: 10416297
references.citation: Toxicology. 1996 Jul 17;111(1-3):69-86
references.pmid: 8711750
references.citation: Neurotoxicology. 2003 Mar;24(2):179-86
references.pmid: 12606290
references.citation: Toxicol Ind Health. 1994 Jul-Oct;10(4-5):359-68
references.pmid: 7539950
references.citation: Arch Environ Health. 1999 Sep-Oct;54(5):309-11
references.pmid: 10501144
references.citation: Environ Health Perspect. 1997 Mar;105 Suppl 2:527-9
references.pmid: 9167991
references.citation: Fortschr Neurol Psychiatr. 2002 Nov;70(11):570-82
references.pmid: 12410427
references.citation: Mil Med. 1998 Nov;163(11):725-32
references.pmid: 9819530
references.citation: Occup Med. 1987 Oct-Dec;2(4):655-61
references.pmid: 3313760
references.citation: Regul Toxicol Pharmacol. 1993 Aug;18(1):44-53
references.pmid: 8234918
references.citation: Nuklearmedizin. 1999;38(7):297-301
references.pmid: 10599070
references.citation: Ann N Y Acad Sci. 2001 Mar;933:291-309
references.pmid: 12000029
references.citation: Ann N Y Acad Sci. 2001 Mar;933:1-23
references.pmid: 12000012
references.citation: Arch Environ Health. 1997 Jan-Feb;52(1):6-17
references.pmid: 9039852
references.citation: Environ Health Perspect. 2002 Aug;110 Suppl 4:591-5
references.pmid: 12194891
references.citation: Perspect Biol Med. 1991 Spring;34(3):355-64
references.pmid: 2067931
references.citation: Toxicol Ind Health. 1994 Jul-Oct;10(4-5):573-7
references.pmid: 7778115
references.citation: Occup Environ Med. 1999 May;56(5):295-301
references.pmid: 10472302
references.citation: Toxicol Ind Health. 1999 Apr-Jun;15(3-4):331-8
references.pmid: 10416285
references.citation: Arch Environ Health. 1993 Jan-Feb;48(1):14-8
references.pmid: 8452394
references.citation: Biol Psychiatry. 1992 Aug 1;32(3):218-42
references.pmid: 1420641