A Report on Multiple Chemical Sensitivity (MCS)

The Interagency Workgroup on
Multiple Chemical Sensitivity


August 24, 1998

 Predecisional Draft

Foreword

Table of Contents

  1. Background and Historical Review
  2. Epidemiologic Considerations
  3. Theories of Causation and Mechanisms
  4. Potential Tools for Future Research Studies 9
  5. Public Health Issues in Medical Evaluation and Care of MCS Patients
  6. Organizational Statements Relating to MCS
  7. Key Panels, Workshops, and Reports: Recommendations
  8. Federal Actions
  9. Findings and Recommendations
  10. References
  11. Abbreviations
  12. Annex of Research Suggested by Expert Reviewers
  13. Workgroup Members
  14. Workgroup Staff Members, Editorial Support, Consultation

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TABLE OF CONTENTS

Foreword

Executive Summary

I. Background and Historical Review

Introduction and History
Terminology
Definitions
Government Interest

II. Epidemiologic Considerations

Prevalence Studies
Descriptive Epidemiologic Studies
Summary Comments on Epidemiology

III. Theories of Causation and Mechanisms

Introduction
Immune Mechanisms
Inflammation
Neurologic Mechanisms Including Altered Sense of Smell
Psychological Mechanisms
Other Syndromes
Clinical Ecology Approach
Summary of Mechanisms

IV. Potential Tools for Future Research Studies

Use of Biomarkers in Studying MCS
Environmental Control Units
Survey Instruments

V. Public Health Issues in Medical Evaluation and Care of MCS Patients

Medical Evaluation
Treatment

VI. Organizational Statements Relating to MCS

VII. Key Panels, Workshops, and Reports: Recommendations

NRC Workshop on Multiple Chemical Sensitivities, 1991
AOEC Workshop on Multiple Chemical Sensitivity, 1991
Report on Biologic Markers in Immunotoxicology, 1992
ATSDR Expert Panel on Multiple Chemical Sensitivity, 1993
Chemicals and Neurobiologic Sensitivity, 1994
California Department of Health Services, 1994
NIEHS, MCS: Controlled Exposure Studies, 1995
EOHSI/NIEHS Conference, 1996
DHHS Report to Congress, 1998
Summary

VIII. Federal Actions

Agency for Toxic Substances and Disease Registry
Department of Defense
Department of Energy
Department of Veterans Affairs
National Center for Environmental Health, CDC
National Institute of Environmental Health Sciences, NIH
National Institute for Occupational Safety and Health, CDC
U.S. Environmental Protection Agency
Summary of Federal Actions

IX. Findings and Recommendations

Overview
MCS as a Public Health Priority

X. References

XI. Abbreviations

XII. Annex of Research Suggested by Expert Reviewers

XIII. Workgroup Members

XIV. Workgroup Staff Members, Editorial Support, Consultation

 

List of Tables

  1. Proposed Definitions for Multiple Chemical Sensitivity (MCS) since 1985
  2. Elements Common to Proposed Definitions for MCS since 1985
  3. Selected Legal and Government Actions Relating to MCS, 1979-1996
  4. Commonly Reported MCS Symptoms
  5. Recommendations from Selected Meetings about MCS