According to the National Academy of Sciences, 15% of the American people--some 37 million individuals--may experience "increased allergic sensitivity" to chemicals. A recent report, CHEMICAL SENSITIVITY, issued in 1990 by the New Jersey State Department of Health, concludes "that chemical sensitivity does exist as a serious health and environmental problem and that public and private sector action is warranted at both the state and federal levels.... Our review of the existing evidence suggests that chemical sensitivity is increasing and could become a large problem with significant economic consequences related to the disablement of productive members of society."

The New Jersey report, by chemist and lawyer Nicholas Ashford of the Massachusetts Institute of Technology and by physician Claudia Miller of the University of Texas, had two aims: (1) to clarify the nature of chemical sensitivity, and (2) to identify ways the New Jersey Department of Health can assist those who are affected.

Different people who suffer from multiple chemical sensitivity exhibit a bewildering variety of symptoms and behavior, captured by the following words: distraught; excited; agitated; enraged; panicky; circuitous or onetrack thoughts; muscle-twitching and jerking of extremities; convulsive seizures; aggressive; talkative; clumsy (ataxic); anxious; fearful; apprehensive; alternating chills and flushing; ravenous hunger; excessive thirst; giggling or pathological laughter; tense; jittery; "hopped up;" argumentative; overly responsive; sweating and chilling; insomnia; alcoholism; obesity; running or stuffy nose; clearing throat; coughing; wheezing; asthma; itching (eczema and hives); gas; diarrhea; constipation (colitis); urgency and frequency of urination; various eye and ear syndromes; tired; dopey; somnolent; mildly depressed; edematous with painful syndromes (headache, neck ache, back ache, neuralgia, myalgia, myositis, arthralgia, arthritis, arteritis, chest pain); cardiovascular effects; confused; indecisive; moody; sad; sullen; withdrawn or apathetic; emotionally unstable; impaired attention, concentration, comprehension, and thought processes (aphasia, mental lapse, and blackouts); unresponsive; lethargic; stuporous; disoriented; melancholic; incontinent; paranoid orientation; delusions; hallucinations; amnesia and coma.

Of course any one individual suffers from only a few of these symptoms, but the baffling spectrum of problems associated with sensitivity to chemicals has made many doctors wary of treating patients who think they may suffer from the disease. Indeed, many doctors have traditionally refused to acknowledge the existence of a single disease called "chemical sensitivity" or "multiple chemical sensitivity." As a consequence, a person who exhibits a cluster of debilitating symptoms will visit, on average, 6 or 7 physicians before he or she finds one who will take the problem seriously and will try to unravel the causes--or at least look for things that trigger the symptoms. Most doctors simply say, "I can't help you," or, "It's all in your head--take this tranquilizer." One of the worst aspects of this mysterious condition is the sense of loneliness and abandonment that patients feel; rejected by doctor after doctor, patients begin to believe it is somehow their own fault that they have gotten sick.

The situation is complicated by ongoing professional turf battles between traditional physicians, allergy specialists, and a group of specialists called clinical ecologists. They argue about definitions, diagnoses, causes, and appropriate treatments. The patient becomes a double victim--first to the disease itself, then to the medical profession that doesn't do well in the face of complex problems that may come and go, symptoms that encompass multiple organ systems, and vastly different medical training that causes doctors in different specialties to "see" different things when they look at the same patient. Medicine is not an exact science and nowhere is this more clear than when a person responds strongly--even violently and dramatically--to mild odors of perfume or paint, or to faint smells from a new rug or a new sofa, or from exposure to some new detergent or solvent in the workplace. The chemically sensitive are victims of the modern industrial environment; their inalienable right to the pursuit of happiness has been taken from them by corporate production and marketing decisions made without their votes or even their opinions being sought or considered.

Unfortunately, until the New Jersey report was issued, there was no really good single book or report that tried to put these problems into perspective and tried to sort out what was really known from what was merely suspected or assumed. (We reviewed the only other really good study we had come upon in RHWN #165, but for all its virtues it did not clarify many of the issues that the New Jersey study manages to throw light upon.)

The New Jersey study, CHEMICAL SENSITIVITY, is available from National Center for Environmental Health Strategies (NCEHS), 1100 Rural Ave., Voorhees, NJ 08043; phone (609) 429-5358. $15.00 for members of NCEHS, $17 for non-members. The New Jersey study is essential reading for anyone interested in this problem. NCEHS also sells copies of the new book (which we will review at a later time) by Ashford and Miller, CHEMICAL EXPOSURES: LOW LEVELS AND HIGH STAKES (NY: Van Nostrand Reinhold, 1990); $14.50 for members; $16.00 for others. (The New Jersey study is stronger on public policy aspects of the problem--what your state government can do to help the chemically sensitive.) Join NCEHS for $15.00; $10.00 for limited-income, seniors, and students. Request their publications list. Hats off to Mary Lamielle, NCEHS founder--a truly effective advocate for the chemically sensitive.
--Peter Montague, Ph.D.

Descriptor terms: allergies; multiple chemical sensitivity; diagnosis; nj department of health; studies; symptoms; medical treatments; clinical ecologists; fumes; national center for encironmental health strategies