Dear Reader,

Unfortunately, there is no "straight answer" to whether Multiple Chemical Sensitivity (MCS) exists. Regardless, your mother obviously has something and deserves sympathetic medical evaluation and treatment.

Multiple Chemical Sensitivity is a controversial medical topic. It is manifested differently in individuals who claim to have it, but it is usually characterized by multiple symptoms that occur with low-level chemical exposure. A 1998 report from a U.S. government interagency workgroup notes that there is no key definition of the illness, no protocols for treatment, few published studies on the subject, no information on the projected or real costs, and no federal group convened to study MCS. All of these factors make it difficult to give anyone a "straight answer" on Multiple Chemical Sensitivity.

Because MCS is diagnosed based on the symptoms an individual presents to her or his health care provider, and because there are no supporting laboratory tests, there is not yet a universally agreed-upon way to define or recognize the disorder in patients. Several medical groups, including the American Medical Association (AMA), the Centers for Disease Control and Prevention (CDC), the American Academy of Allergy and Immunology, and the American College of Physicians, have rejected MCS as an organic disease or a clinical diagnosis.

What could MCS be if not an organic disease? As you inferred in your question, some practitioners believe MCS is actually a psychological condition. This seems more plausible to some providers because there is usually no objective evidence of organ damage in patients who say they have MCS.

The debate surrounding MCS is affected by several social and economic factors, and it is important to keep those in mind when listening to each side. As Michael Lax notes in his article "Multiple Chemical Sensitivities: The Social Construction of an Illness," the recognition of MCS as a clinical diagnosis or an organic disorder would place responsibility for the illness on the environment, making employers and insurance companies liable for any associated costs. On the other hand, critics of MCS as a clinical diagnosis raise the suspicion of entrepreneurial activities, especially companies that tout MCS products and services that don't have patient welfare foremost in mind.

Who reports having Multiple Chemical Sensitivity? Like your mother, most people (85 - 90 percent) who claim to have MCS are female. According to American Family Physician [Sept. 1, 1998, vol. 58(3), pp. 721 - 8], the majority of those women are between the ages of 30 and 50. The government interagency workgroup cited figures of prevalence to be 2 - 33 percent of the general population.

There may be some progress in the near future in understanding what MCS really is. After the National Institutes of Health (NIH) 1999 Atlanta Conference on the Health Impact of Chemical Exposures During the Gulf War, 34 doctors and researchers signed a consensus published in Archives of Environmental Health [May/June 1999, vol. 54(3), pp. 147 - 9] that asked the major sponsors of the conference, including the NIH, the CDC, and the Department of Health and Human Services, to recognize a clinical definition of MCS that had been developed in 1989. The adoption of such a definition could help further research and the clinical evaluation and treatment of MCS.

Alice