A List of Case-specific Forms of Chemical Sensitivity and a Proposed Mechanism for MCS

Provided is an outline of 
the 2002 proposed mecha-
nism for MCS.  A pivotal
feature was added to the
diagram, in 2004.  It, too,
is discussed herein.  The
outline follows a listing of 
the case-specific forms of 
chemical sensitivity.  Nine
web links are also included
in this post.

Identified & Defined Forms of Chemical Sensitivity

The forms of chemical sensitivity listed below are those
which have already been identified and defined by main-
stream medical science.  The list automatically illustrates
that nontoxic\ambient levels of chemicals are not univers-
ally harmless.  The list, therefore, illustrates the need for
a plurality of people to avoid pertinent chemical exposures. 

The Merit in Making the List Known


The list serves to counter that which anti-MCS literature
serves to provoke.  Needless to say, anti-MCS literature
serves to:

1] provoke the powers-that-be into depriving chemically
sensitive persons of reasonable accomodation; 

2] provoke the powers-that-be into depriving severely
impaired chemically sensitive persons of disability com-
pensation;

3] persuade marketers into declining to provide consumer
product lines free of those chemical-bearing agents which
are known to trigger adverse reactions such as asthma.

When you illustrate that there are forms of  chemical sensi-
tiity that have already been found to exist, you illustrate the
need of an entire class of  people to avoid ambient levels
of the chemical-bearing agents known to harm them.  You
don't have to wait for the universal recognition of  MCS,
in order make this illustration.  The recognition of  irritant-
induced asthma alone, along with its subset condition,
Reactive Airways Dysfunction Syndrome, was all that
was needed to accomplish this. 

Even if  MCS comes to be declared a non-reality, there
will still exist the ethical requirement to consider the needs
of  those who suffer from the case-specific forms of  chem-
ical sensitivity.  Matters involving formaldehyde-releasing
agents, the organophosphate\carbamate class of pesticide,
perfume ingredients, additives, & reasonable accomoda-
tion will still have to be addressed.  Here is the list, con-
structed in two parts:

       Generalized\Systemic and Localized Forms

                               Irritant-induced Asthma
                            Irritant Rhinitis\Rhinosinusitis
                           Halothane-induced  Hepatitis  
                         Photoallergic Contact Dermatitis
                        Benzene-induced Aplastic Anemia
                       Airborne Irritant Contact Dermatitis
                       Formaldehyde-induced Anaphylaxis
                   (chlorhexidine-induced & other forms)
                   Reactive Airways Dysfunction Syndrome
                  Irritant-associated Vocal Cord Dysfunction
                   (symptoms include shortness of breath)
                 Acute Generalized Exanthematous Pustulosi
                               Chemical Worker's Lung
                    (a type of Hypersensitivity Pneumonitis)    
           Occup. Asthma due to low-weight molecular agents  
          Occ. Urticaria (due to low-weight molec. agents),
                       as well as systemic forms of urticaria

                               Chemical-specific Forms

            Pine Resin/Rosin Allergy Albietic Acid Sensitivity
               Peruvian Lily Allergy (Tuliposide A Sensitivity)  
                Red Cedar Allergy (Plicatic Acid Sensitivity)
                 Methyltetrahydrophthalic Anhydride Allergy
                   IgE-mediated Triethanolamine Sensitivity
                      Phthalic Anhydride Hypersensitivity
                       (Acetylated) Salicylate Sensitivity
                          Cyanuric Chloride Sensitivity
                           Ethylene Diamine Sensitivity  
                            Acetaminophen Sensitivity
                            Glutaraldehyde Sensitivity
                             Chlorhexidine Sensitivity
                             Methacrylate Sensitivity
                              Sulfite Hypersensitivity
                               Isocyanate Sensitivity
                                Chromate Sensitivity
                                  Paraben Sensitivity
                                  ...  etc., etc., etc.

Note 1:  The list of chemical-specific forms is long.  None
              the less, the subset provided should suffice in
              proving a point.

Note 2:  Sick Building Syndrome was not listed because
              it is not exclusively caused by ambient chemical  
              exposure.  It can also be caused by viral and
              mold exposure.

Note 3:  Reactive Upper-Airways Dysfunction Syndrome
              doesn't appear in the list, being that Irritant Rhinitis
              was listed.  None the less, RUDS is the subset of
               irritant-induced rhinosinusitis or rhinitis that works
              on the upper-respiratory tract the same way that
              RADS works on the lower respiratory tract.

Note 4:  Small Airways Disease was not listed, either.  Yet,
              it was found to exist in some of  the WTC clean-
              -up crew members who became ill during
              or after the clean-up.  

              See: CT helps find cause of puzzling cough
              in WTC Rescue workers.  It is found at:

http://www.medicalnewstoday.com/medicalnews.php?newsid=17093

Note 5:  There are a multiplicity of contact sensitivity con-
              ditions that were not posted.  They were omitted,
              in order to avoid the appearance of redundancy.
            
Note 6:  The diagnostic title, Reactive Intestinal Dysfunction
              Syndrome (RIDS), has been proposed.   See:
              Reactive intestinal dysfunction syndrome caused 
              by chemical exposure - RIDS.  It is found at:

http://www.findarticles.com/p/articles/mi_m0907/is_n5_v53/ai_21230719

The Most Recently Proposed Mechanism for MCS

The 21st Century proposed mechanism for MCS identifies
two general categories of chemical sensitivity.  They are
Central Chemical Sensitivity and Peripheral Chemical
Sensitivity.  The outline goes as follows:

Central Chemical Sensitivity  

This type of chemical sensitivity involves the central nervous
system, and it's triggering point is proposed to be found in
chemoreceptor activation (action potential.) 

Specific chemoreceptors, upon their activation, elevate
nitric oxide levels in the body.  The nitric oxide then reacts
with superoxide, producing peroxynitrite. 

While the nitric oxide is engaged in producing peroxynitrite,
it is simultaneously engaged in an additional function.  That
function is "retrograde signaling." 

Nitric oxide's role in retrograde signaling is proposed to be
that of  sending an electrical signal to the presynapse cells,
thereby stimulating the release of  two types of neurotrans-
mitters.  The neurotransmitters involved are glutamate and
aspartate. 

Those types of neurotransmitters then stimulate receptors in
the post synaptic cells, known as N-methyl-d-aspartate
receptors.  Abbreviated "NMDA receptors", they react
by producing nitric oxide from their own sites, thereby
maintaining the inordinately high level of nitric oxide al-
ready present.  Nitric oxide's ample presence proceeds
to maintain the inordinately high levels of  peroxynitrite.

While the NMDA receptors are maintaining an elevated
nitric oxide level, peroxynitrite is engaged in causing the
cells that contain those receptors to be depleted of their
energy pools.  That which is being depleted is adenosine
triphosphate (ATP), the carrier of energy in all living or-
ganisms.  Peroxynitrite inhibits mitochondrial function, and
therefore, the production of ATP.

When cells containing NMDA receptors become deprived
of their energy pool's replenishment, the NMDA receptors
become hypersensitive to stimulation.  And while the cells
containing NMDA receptors are being deprived of energy
replenishment, peroxynitrite is engaged in yet another pro-
cess; that of  breaking down the blood brain barrier.  This
enables increased chemical access to the brain. 

Meanwhile, nitric oxide performs yet another function;
that of  inhibiting cytochrome P450 activity.  Therefore,
nitric oxide is proposed to inhibit the process by which
chemicals get metabolized and become harmless.  The
result is heightened sensitivity to chemical exposure.

The aforementioned scenario was proposed by Dr. Martin
L. Pall, of  the School of  Molecular Biosciences of  Wash-
ington State.  And the aforementioned scenario is called
"a vicious cycle mechanism."  A paper written by Dr. Pall
which describes this vicious cycle can be accessed by
clicking on the following web address:

http://ehp.niehs.nih.gov/members/2003/5935/5935.html

Vanilloid Receptor TRPV1

Recently added to this proposed mechanism is the first
member of  the Vanilloid Receptor family, TRPV1.  The
involvement of  TRPV1 in MCS is the subject of a paper
written by Dr. Pall and a Dr. Julius Anderson, M.D., Ph.D.,
of  West Hartford, Vermont.  It is titled, The Vanilloid
Receptor as the Putative Target of Diverse Chemicals in
Multple Chemical Sensitivity.  The bibliographical citation
for it is Arch Environ Health. 2004 Jul;59(7):363-75.  (I
could not find it posted anywhere on the Internet, except
for the abstract of it at the ncbi website.  And that was
only a paragraph or two in length.)

The vanilloid receptor is implicated as a major target for
a number of chemicals which can activate it.  Therefore,
vanilloid receptor activation is proposed to be the point
where the vicious cycle begins.  The vanilloid receptor
paper also addresses the phenomenon of  masking, a
phenomenon duly noted in Central Chemical Sensitivity.

Masking is the phenomenon where a chemical exposure
scenario gets muted at the outset by the overshadowing
effect of  a previous and different one.  That same chemi-
cal exposure would have resulted in a notable adverse
reaction if  it were the first one of  that day.  That same
chemical exposure will result in an adverse reaction when
it becomes the first one, on some future day.  The masking
effect muted the presence of  that one chemical exposure
encounter for that particular day.

The authors of  the vanilloid receptor paper propose that
masking occurs during a cyclic phase known as dephos-
phorylation.  It is a phase triggered by Ca2+ calmodulin
phosphatease calcineurin.  The hypothesis is that vanilloid
receptor activity is decreased during that phase; the "de-
sensitization" phase.  Conversely, it is during the alternate
phase, the one known as phosphorylation, when vanilloid
receptor activity increases, and hypersensitivity reactions
resume.  Therefore, the phosphorylation state determines
the activity or inactivity (desensitization) of  the vanilloid
receptors.

In addition to the paper that Martin Pall co-authored, there
is an article on the vanilloid receptor that he individually
authored.  Titled, Multiple Chemical Sensitivity: towards
the end of  controversy.  It was published in in the August-
September 2005 edition of  Townsend Letter for Doctors
and Patients.  It can be accessed by clicking on the fol-
lowing web address:

http://www.findarticles.com/p/articles/mi_m0ISW/is_265-266/ai_n15688810/pg_3

The article cannot be regarded as a substitute for the recent
paper on TRPV1.  But, it does provide enough information
to enable a reader to become familiarized with the recently
added feature of  Dr. Pall's proposed mechanism for MCS.

In fact, clicking on the following web addresses can help
familiarize a reader with the basic of elements of  the bio-
science involved in Martin Pall's proposed mechanism:

Concerning Chemoreceptors, one can refer to:
http://en.wikipedia.org/wiki/Chemoreceptors

Concerning Action potential, one can refer to:
http://en.wikipedia.org/wiki/Action_potential#Underlying_mechanism

And concerning Synapses, one can refer to:
http://en.wikipedia.org/wiki/Synapse#Signaling_across_chemical_synapses

Now, the proposed mechanism of Dr. Pall is a hypothesis. 
It is a hypothesis which involves intricate details and in-
tricate mapping.  This means that the objective medical
findings of chemically sensitive patients continue to carry
the sole weight in proving that chemical sensitivity is a
physiological condition and not a psychiatric one.  The
objective medical findings include instances of  anaphy-
laxis triggered by nontoxic/ambient/therapeutic levels
of  chemical-bearing agents.  The findings include cases
where two entirely different forms of  localized chemical
sensitivity were found co-existing in the same one patient. 
Such co-existence hints of the authentic existence of  MCS.

Peripheral Chemical Sensitivity

This general type of chemical sensitivity is proposed to in-
volve the peripheral tissues.  Reactive Airways Dysfunction
Syndrome is placed in this category, as is Reactive Upper-
airways Dysfunction Syndrome.  The contact sensitivity
conditions, such as Airborne Irritant Contact Dermatitis,
are also placed in this category. 

This type of chemical sensitivity is proposed to involve
neurogenic inflammation.  One can obtain more informa-
tion on this type of chemical sensitivity by clicking on
the following links:

Hypothesis for Induction and Propagation of Chemical
Sensitivity Based on Biopsy Studies.

http://ehp.niehs.nih.gov/members/1997/Suppl-2/meggs-full.html

Neurogenic Inflammation and Sensitivity to Environmental Chemicals.

http://ehp.niehs.nih.gov/members/1993/101-3/meggs-full.html

Objective Medical Findings in the Chemically Sensitive

Posted below is a list of objective medical findings in chemi-
cally sensitive patients.  It appears after an introduction and
the narration of a recent case study.  The introduction illu-
strates how objective medical findings can be entirely missed
during initial examining.  And the case study reminds us that,
simply because insurance company attorneys allege something
in a workman's comp case, it doesn't mean it's true.

Not Detected by the Standard Chest CT Scan.
Yet Detected via the End-expiratory CT Scan.

A January 2002 article that remains posted on the Fox News
website declared it "junk science."  It was/is the emergent ill-
ness which afflicted persons exposed to the debris of  the
World Trade Center collapse.  Unofficially called "World
Trade Center Syndrome," its distinctive feature is the "the
WTC Cough,"  and its symptoms include shortness of 
breath.

The article attributed the ills of  the afflicted WTC cleanup
crew members to the 2002 "flu season."  It furthermore at-
tributed the ills of affected Manhattan residents to "anxiety
salted with hypochondria."  Its conclusion was that only
"minor and transient health effects from the site" were
to be expected.

A newly emerged illness had just made the scene, and just
as quickly on the scene was a political operative ridiculing
people's notice of  it.  Then came November 30, 2004,
when a press release reported that some of  the afflicted
crew members of  the ground zero cleanup operation were
actually suffering from the trapping of  air.  They had Small
Airways Disease.  And it was the end-expiratory CT scan
that confirmed it.  The standard chest CT scan entirely
overlooked it. 

The Fiberoptic Rhinolaryngoscopy Detects that
which the Garden Variety Cursory Exam Overlooks

The upper airway endoscopy is recognized by mainstream
medical science as an effective means by which pathologies
of  the septum, turbinates, mucosa, nasopharynx, adenoids,
eustachian tube orifice, tonsils, posterior tongue, epiglottis,
glottis, and vocal cords can be easily seen.  And it was the
fiberoptic rhinolaryngoscopic exam which resulted in re-
searchers realizing (in the early 1990s) that the Multiple
Chemical Sensitivity Syndrome which was presumed to
involve no objective medical findings showed signs of  a
physical pathology.  In addition, the golden rule for diagnos-
ing Irritant-associated Vocal Cord Dysfunction came to be
that of  a flexible fiberoptic rhinolaryngoscopic exam per-
formed upon a patient while the patient is symptomatic. 

The human body is regarded as exceptionally complex.  There-
fore, the reasonably minded person should understand that the
cursory physical exam and garden variety testing do not detect
everything.  This understanding, in addition to the preceding
paragraphs, offers insight as to why a number of  chemically
sensitive persons have been declared to have no objective
medical findings.  The account posted directly below should
offer more detailed insight to this.  It involves a recent case
study.  And, as was previously stated, the lesson derived
from it is that simply because defense attorneys assert some-
thing in a workman's comp case, it doesn't automatically
mean that it's true.

She Was Claimed to Have No Objective Medical
Findings to Verfiy Her Symptoms.  Multiple Medical
Findings Were Documented in One Day.

A woman whose workplace was a former coal tar research
building became ill six months after having worked there.  A
laboratory would come to confirm that her workplace was
laden with very fine monofilament fibers.  And the smaller
the molecular agent, the greater is its potential to infiltrate
and afflict the inner recesses of the complex human anatomy.
Furthermore, there is also the matter of  pesticide exposure,
ambient solvent exposure, and mold exposure to take into
account, concerning the woman's workplace environment.

After the woman had initially become ill, she kept going to
work.  Her condition then worsened and she had to quit
work entirely.  A fellow employee also quit working, and he
moved to Arizona.  Other fellow employees mentioned that
they were being sickened, too.  In fact, the business no long-
er operates in the former coal tar research building.  And it
is a large corporation that is involved in this matter, even
though the antics of  a small fly-by-night business are de-
scribed.  In fact, the corporaton's total stockholder equity
was marked at over eleven billion dollars in 2005.

Her Symptoms

The woman's symptoms included:

[1]  a stinging tongue.
[2]  shortness of  breath.
[3]  burning nasal passages.
[4]  a metallic taste in the mouth.
[5]  an adrenal-like stream throughout her solar plexus.
[6]  headaches accompanied by the bruised feeling at the
        cheekbones and temples.
[7]  ice-like numbness pervading her upper-respiratory
        tract (on specific occasion.)

She would be able to detect the presence of certain airborne
agents, simply because she unavoidably tasted them on her
tongue.  She could no longer go to the places she used to
frequent without becoming severely symptomatic.  A number
of  airborne agents would trigger her ills.  And this included
engine fragrances, engine exhausts, and musty cardboard
boxes.  In addition, she lived in the american state which
presently has the fourth worse air quality in the entire United
States.  Plus, she had no prior history of  asthma, no prior
history of  chronic upper-respiratory ills, and no history
of  allergies.

She received the diagnosis of agoraphobia & panic attacks,
by a "mental health person."  And the corporate attorneys in-
volved in her workman's comp case asserted that she had
no objective medical findings to support her claims.  However,
an allergist & immunologist gave her the diagnoses of  Asthma,
Rhinitis, and Chemical Sensitivities, while a cytopathologist
gave her the additional diagnosis of  Reactive Hyperplasia. 
In fact, in ER settings she received the Asthma and Rhinitis
diagnosis.  Yet, assertions of  mental illness had been set forth
on record and asserted in court depositions as the cause of 
her ills.  The assertions were significantly weakened in less
than an hour. 

Grossly Enlarged Turbinates, for Starters

On October 13, 2005, a fiberoptic rhinolaryngoscopic exam
was performed on her.  It was conducted by an Ear Nose
Throat & Allergy Specialist who was also a fellow of  the
American College of  Surgeons.  The woman who was said
to have no objective medcal findings to support her symptoms
was found to have:

[1]  postauricular adenopathy.
[2]  grossly enlarged turbinates.
[3]  shoddy posterior cervical adenopathy
[4]  some erythematous changes of the uvula.
[5]  some mild edema of the true vocal cords.
[6]  thickened coating over the dorsum of  the tongue.

The physician's impressions, as are stated on record, were:

[1]  multiple chemical and irritant sensitivities.
[2]  rhinitis and turbinate hypertrophy.
[3]  glossitis (tongue inflammation).

The conclusion is that whatever be the medical condition this
woman has, it is one of  a physical origin and mechanism.  If
she were not made ill from workplace exposure, then she was
made ill by some other physical cause. 

Gruntled Breathing and Rales Were Already Observed

The story isn't over, of course.  Objective medical findings
had been entered into her records even before the October
exam.  She was documented as having "gruntled breathing"
during one ER visit.  She was recorded as having wheezed
and crackled during other ones.  And she had already been
found to have the previously mentioned adenopathy.  In
fact, tachycardia, erythema of  the oropharynx, and
hypopotassemia had also been entered into her medical
records before the October 13 rhinolaryngoscopy.  Yet,
she was branded with the "mental illness stigma," especially
by the corporate attorneys and independent medical exam-
iner involved in her workman's comp case.

Furthermore, after she had become ill, she tested severely
positive for dust mites and no other high weight molecular
agent (such as ragweed, tree pollen, etc.)  And she has no
prior history of  allergies.  Now, she was exposed to inordi-
nate amounts of  dust at her former place of  work, and a
person can become sensitized to dust mites.  In fact, there
are cases where barn workers became sensitized to storage
mites.

The account of  the chemically sensitive woman who has over
a dozen objective meidcal findings attached to her medical re-
cords can be accessed by clicking on the web link provided
directly below.

Narrative of  the chemically sensitive woman
with over a dozen objective medical findings

Chemical Exposure During Testing is Often a Necessity

There is one thing to note about chemical sensitivity condi-
tions.  In order to acquire objective medical findings, you
often have to be tested/examined while exposed to a chem-
ical agent that assails you.  You have to be tested while you
are symptomatic.  You will not acquire objective medical
findings in a vaccuum, in most testing/examing.  Thus, it is
not an unheard event for a chemically sensitive patient to be
found hunched over a waste basket after having been ad-
ministered a skin prick test.  Patch testing has resulted in
a few occasions of  anaphylaxis.  And being made sympto-
matic before a rhinolaryngoscopic exam is not a painless
event.  Moreover, the inhalation challenge test that mea-
sures FEV1 and the such is not recommended for those
who are extremely hyperresponsive.

If the Detractors of  MCS Admit to Even One Objective
Medical Finding in any Type of Chemically Sensitive
Patient, the Effect of their Propaganda Will Be Diluted

If the detractors of Multiple Chemical Sensitivity disclose even
one objective medical finding in chemically sensitive patients,
they will risk extinguishing the disrespect and indifference that
their literature serves to incite.  This will incline people to take
a respectful view of environmental illness.  In learning that a
number of chemical-specific & case-specific forms of chem-
ical sensitivity have already been found to exist, people will
surmise that it is only a matter of  time before the controvesy
involving Multiple Chemical Sensitivity will be resolved.  In
light of this, a list of objective medical findings in chemically
sensitive patients is posted directly below:

Objective Medical Findings in the Chemically Sensitive

 Bronchial hyperresponsiveness in inhalation challenge testing.
         This includes things such as the drop in FEV1:
      Forced Expiratory Volume after 1 second of time.

        Objective skin whealing resulting from skin testing;
   See the article in Part 1, titled, Visible & Measurable
          Wheals Have Been Repeatedly Documented.

   Simultaneous release of Leukotriene B4 and Interleukin-8;
    (LTB4 is a chemokine.  IL-8 is a toxin to neutrophils.)

     Permeability of upper-respiratory epithelial cell junctions;
      found in biopsy studies, via the electron micrograph

       Abnormal liver function in the absense of viral infection.

         Exorbitant presence of  n-acetyl-benzoquinoniemine;
            a toxic liver metabolite associated with P450
            cytochrome inducers such as acetaminophen.

             Paradoxical adduction of the true vocal cords.

                Testing positive in traditional patch testing.

                     Peripheral nerve fiber proliferation.

                       Nasal and/or laryngeal erythema.

                        Turbinate swelling/hypertrophy.

                         Edema of the true vocal cords.

                              Lymphocytic infiltrates.

                               Glandular hyperplasia.

                                     Angioedema.

                                      Anaphylaxis.

                                       Dermatitis.

Note 1:  There are fiber optic rhinolaryngoscopic exam find-
              ings that were not posted above.  In order to read
             of  the additional findings, see:  Rhinolaryngoscopic
             Examination of Patients with Multiple Chemical
             Sensitivity Syndrome:

Note 2:  There are also instances of hematotoxicity triggered
             by nontoxic benzene exposure.  See: Hematotoxicity
              in workers exposed to low levels of benzene:

Note 3:  There is more that can be included, but the afore-
              mentioned things should suffice in proving a point.

Systemic Chemical Sensitivity and Coexisting Forms of Chemical Sensitivity

Anaphylaxis:  It impairs multiple body systems in one
systemic fashion, and it has been triggered by a number
of  chemicals at nontoxic levels.  The chemicals which
have thus far been documented as having triggered ana-
phylaxis ( at nontoxic levels) include:

[01]  the hair bleaching agent, Ammonium Persulfate.
[02]  the antimicrobial agent, Chlorhexidine (0.05%).
[03]  the medical disinfectant, Ortho-phthalaldehyde.
[04]  the fungicide, Chlorothalonil (0.01% aqueous).
[05]  the analgesic ingredient, Polyvinylpyrrolidone.
[06]  the diagnostic agent, Isosulphan Blue Dye.
[07]  the dialysis ingredient, Ethylene Oxide.
[08]  the additive, Sodium Benzoate.
[09]  the analgesic, Acetaminophen.
[10]  the xanthine dye, Flourescein.
[11]  the food coloring, Tartrazine.
[12]  the anesthesia, Propofol.
[13]  common aspirin.
[14]  formaldehyde.
[15]  nitrites.
[16]  sulfites. ... etc.

The existence of  Systemic Chemical Sensitivity has already
been documented under the name, anaphylaxis.  It is not a
proposed hypothesis yet to be proven. 

An Assertion Negated by Evidence Gathered
   in the Field of Occupational Medicine

An objection to the recognition of  Multiple Chemical Sen-
sitivity consists in the assertion that a chemical, whenever
encountered at a nontoxic level, can not impair more than
one body system in the same one person.  However, chemi-
cals have individually done this during anaphylaxis.  And then
there are documented instances in the world of occupational
medicine, where the same one chemical, at an ambient level,
has impaired two body systems in the same one worker (or
subset of workers.)  This phenomenon (one which can be
regarded as Dual Chemical Sensitivity) has thus far involv-
ed the integumentary system (the skin) in combination
with the respiratory system in the following forms:

[1]  airborne irritant uritcaria (hives) accompanied by rhinitis;
[2]  asthma and rhinoconjunctivits accompanied by dermatitis;  
[3]  asthma accompanied by dermatitis;
[4]  asthma accompanied by urticaria.

Dual Chemical Sensitivity has already been documented,
and it appears in documentation under the name "comorbid
conditions," as well as under "coexisting conditions."  It
is not a hypothesis yet to be proven.  The chemicals which
have thus far been documented as having induced it, within
the world of Occupational Medicine, include:

[1]  dental acrylates;
[2]  dusts of  persulfate salts;
[3]  epoxy resin diglycidyl ether of  bisphenol A;
[4]  leather tanning ingredient potassium dichromate;
[5]  spray paint additive, polyfunctional aziridine cross-
     linker CX-100.

The coexistence of distinctly different forms of  localized
chemical sensitivity negates the assumption that a chemical
sensitivity reaction can only impair one body system in any
one person.  (Clicking on each of  the following titles
will connect you to the documentary evidence, concern-
ing dual chemical sensitivity):

Occupational allergic airborne contact dermatitis and delayed
bronchial asthma from eposy resin revealed by
bronchial provocation test.

Occupational Asthma and Contact Dermatitis in a Spray
Painter after Introduction of  an Aziridine Cross-Linker.

Allergic contact dermatitis and new-onset asthma.

Occupational asthma and dermatitis after exposure to dusts
of  persulfate salts in two industrial workers (author's transl)

Dentist's occupational asthma, rhinoconjunctivitis,
and allergic contact dermatitis from methacrylates.

Acrylates induced rhinitis and contact dermatitis.

Pronounced Short-term Chemical Exposure
  Causing Long-term Illness in Dual Body Systems

And then there are cases where pronounced chemical
exposure (such as in the case of  chemical spills) has
resulted in adverse affects to dual body systems.  It has
furthermore resulted in hypersensitivity to a number of 
chemicals other than that which was encountered during
the chemical over-exposures.  One case study involves a
tank truck hauler who developed symptoms during and
after an eight and a half  hour stay around a tank of  par-
affin, due to the fact that he experienced a tire blowout
while driving and had to wait for a road crew to get him
back on the road.

Within one hour of  the blowout, the driver underwent a
racking cough, a severe headache, and an irritated throat.
And within forty hours, his feet, hands, and abdomen started
to swell.  The swelling continued to the point where it even
triggered shortness of  breath and chest pains.  The physical
examination of  the driver resulted in the following objective
medical findings:

[1]  an elevated CD 26 cell count;
[2]  a protuberant/distended abdomen; 
[3]  a decreased T-suppressor cell count;
[4]  the presence of  the antinuclear antibody;
[5]  and the presence of  the anti-thyroid antibody.
[6]  the presence of  the anti-smooth-muscle anti-body;
[7]  liver function test results consistent with hepatotoxic injury.

When the driver was examined a year after the blowout, he
stated that chemical exposure scenarios precede gastrointest-
inal distress, fatigue, weakness, arthralgia, & irritability.  Now,
this is a description of  Multiple Chemical Sensitivity, and this
is pertinent to note, in light of  the fact that the detractors of 
MCS have repeatedly claimed that persons manifesting signs
of  MCS have no objective medical findings to support their re-
ported symptoms.  This one driver had seven objective medical
findings documented at the outset of  his illness.

In meeting rooms where position statements are drafted, the
name, Multiple Chemical Sensitivity, was changed to Idiopathic
Environmental Intolerance.  This substitute title is an entirely
erroneous title in the case of  the tank truck hauler, being that
"iodiopathic" means "of  unknown origin," and the hauler's ills
originated at a known time and a known place, with already-
identifed mechanisms, and objective medical findings.

That case study and seven other ones are described in a
medical article titled, Reactive Intestinal Dysfunction
Syndrome Caused by Chemical Exposures - RIDS.  It
is already cited in the article posted above.  However, for
the sake of  convenience, a link to the full text is reposted
directly below:

http://www.findarticles.com/p/articles/
mi_m0907/is_n5_v53/ai_21230719

An Assertion in anti-MCS Literature
 Negated by Evidence Gathered in
  the Field of Occupational Medicine

Needess to say, anti-MCS literature asserts that persons suf-
fering from MCS are merely mentally ill, despite the fact that
there is no consensus as to what particular type of  mental ill-
ness this might be.  Nonetheless, a few anti-MCS propagandists
assert that persons suffering from MCS are merely phobic of 
chemical exposure, and therefore, the fear of chemicals causes
them to imagine illness.  However, a number of  persons suf-
fering from MCS are those who worked in chemically laden
environments.  If such persons were phobic of  chemical expo-
sure, they would have never taken the chemically laden jobs
that they took, in the first place.  They would have never even
applied for those jobs.

The Bridge to Part 1

Part 1 can be accessed by clicking on the web address below.

http://www.chemicalsensitivitypart1.blogspot.com

Mt. Sinai, Yale, Harvard & the MCS Diagnosis

Keep in mind that Dr. Stephen Barrett "MD" has zero exper-
ience in every field of  internal and dermatological medicine,
(outside of  the internship that he completed in 1958.)  Also
keep in mind that there are a number of  forms of  chemical
sensitivity which have already been identified and defined by
mainstream medical science.  This means that entire popula-
tions of  the chemically sensitive are not dependent upon the
universal recognition of  MCS, in order to have their medical
conditions validated.

Brief Outline

Stephen Barrett has repeatedly asserted that the Multiple Chem-
ical Sensitivity diagnosis is an act of malpractice, given to those
who are merely mentally ill.  He furthermore called Sick Building
Syndrome (SBS) a "fad diagnosis," stating that it is intertwined
with MCS.  He additionally stated that Multiple Chemical Sensi-
tivity is supported by "a small cadre of physicians" who identify
themselves as "clinical ecologists."

The Induced Deceptions

Barrett's literature can easily deceive a novice into assuming
that the MCS diagnosis has never been given at any occupa-
tional & environmental health clinic, as well as at any world
renown medical institution.  And being that Barrett associated
SBS with MCS, it leaves a novice to assume the same things
about Sick Building Syndrome.  Therefore, Stephen Barrett's
assertions call for a response.

The Response

The Association of  Occupational & Environmental Clinics
has posted profiles of  its members, in State-by-State direc-
tory form.  In each AOEC profile, mention is made of  the
profiled member's Most Common Occupational Diagnoses
and Most Common Environmental Diagnoses.  Placed into
focus at this point are the AOEC members listed directly be-
low.  The profile of each one is dated 03/05.

{1}  the world renowned Yale University,
{2}  the world renowned Mount Sinai,
{3}  Harvard affiliated Cambridge Hospital,
{4}  Harvard affiliated Northeast Specialty Hospital.

{1} 

In the AOEC directory for the State of Connecticut, the
       second member profiled is the Yale University Occupa-
       tional and Environmental Health Clinic. Among its Most
       Common Environmental Diagnoses is Multiple Chemi-
       cal Sensitivity.

See: http://www.aoec.org/content/directory_CT.htm

      This can be additionally confirmed at the following Yale
      University web address, under the heading, Chemical
      Exposures/Disease:

See:http://info.med.yale.edu/intmed/occmed/clinical_services.html

{2}  We next go to the State of New York. The fourth clinic
        profiled in the New York directory is The Mount Sinai
        Irving J. Selikoff Center. Among its three Most Com-
        mon Environmental Diagnoses is Multiple Chemical
        Sensitivity.

See: http://www.aoec.org/content/directory_NY.htm

{3}  We now come to the AOEC directory for the State of
{4}  Massachusetts. The third and fourth listed clinics are 
       the Harvard affiliates, Cambridge Hospital and North-
       east Specialty Hospital.  Multiple Chemical Sensitivity
       is listed as one of Cambridge Hospital's Most Common
       Environmental Diagnoses, while the exact same Mul-
       tiple Chemical Sensitivity is listed as one of Northeast
       Specialty's Most Common Occupational Diagnoses.

See: http://www.aoec.org/content/directory_MA.htm

Furthermore, a notable number of AOEC members have
Sick Building Syndrome listed among their most common
diagnoses. This includes:

[] Presbyterian Occupational Medicine Clinic (Albuquerque),
[] The University of Washington Harborview Medical Ctr,
[] The University of Iowa Department of Internal Medicine,
[] Georgia Occup. & Environ. Toxicology Clinic (Atlanta),
[] The University of Stony Brook School of Medicine,
[] The University of Illinois - Chicago,
[] Wayne State University (Detroit),
[] The University of Pittsburgh,
[] Johns Hopkins, as was previously mentioned.

In addition, a number of AOEC members have Indoor Air
Quality listed among their most common diagnoses. For
example, the world renown Duke Medical Center has
Indoor Air Quality Assessment listed among its most com-
mon diagnoses, while Yale University has Indoor Air
Quality Problems listed.

The 21st Century proposed mechanism for MCS does not
come from the world of the "clinical ecologist."  It comes
from the school of molecular biosciences of  an american
university.  The expanded diagram of  that proposed mech-
anism mentions, in a favorable light, the conclusions about
chemical sensitivity which come from the school of  emer-
gency medicine of  yet another american university.  In fact,
findings in chemical sensitivity also come from the techno-
logically advanced nations of  Germany, Sweden, Austria,
France, Spain, Italy, South Korea, the Netherlands, and
Japan.

An outline of the 2002/2004 proposed mechanism for
MCS can be accessed by clicking on the link provided
directly below.

The 2002/2004 Proposed Mechanism for MCS.
(Clicking here will take you there.)