| | Multiple Chemical Sensitivity, MCS |
| | 0,39 | | MB |
| | 123 | | stron |
| | 2973 | | ID | Danish Environmental Protection Agency |
| | 2005 | | rok |
| | CONTENTS 3 |
| | LIST OF SCIENTIFIC TERMS AND ABBREVIATIONS 7 |
| | PREFACE 11 |
| | SUMMARY AND CONCLUSIONS 13 |
| | 1 INTRODUCTION 16 |
| | 1.1 ABOUT THE REPORT 17 |
| | 1.2 SOURCES OF INFORMATION 17 |
| | 2 HISTORY, DEFINITION, NAME, AND DELIMITATION IN RELATION TO OTHER SYNDROMES |
| | 19 |
| | 2.1 MCS, DEVELOPMENT HISTORY 19 |
| | 2.1.1 Sensitivity in a toxicological context 21 |
| | 2.1.2 Disease, illness, syndrome 21 |
| | 2.2 DESCRIPTION OF MCS 21 |
| | 2.2.1 MCS symptoms 22 |
| | 2.2.2 MCS definition 22 |
| | 2.2.3 MCS, course 23 |
| | 2.2.4 MCS synonyms 23 |
| | 2.3 DELIMITATION IN RELATION TO OTHER SYNDROMES AND ILLNESSES 25 |
| | 2.4 COMMENTS 27 |
| | 3 CONFERENCES, WORKSHOPS, AND REPORTS ON MCS 29 |
| | 3.1 ACTIVITIES IN THE US 29 |
| | 3.1.1 Conferences, workshops, and expert reports 29 |
| | 3.1.2 The US – The intersectorial government committee: Interagency working group 33 |
| | 3.1.3 The attitudes of professional medical organisations to MCS problems 34 |
| | 3.1.4 Comments 35 |
| | 3.2 ACTIVITIES IN CANADA 35 |
| | 3.3 ACTIVITIES IN EUROPE 36 |
| | 3.3.1 Report from the Environmental Directorate of the EU, 1996 36 |
| | 3.3.2 Report to the British Health and Safety Executive (HSE) 37 |
| | 3.3.3 Report from the British Society for Allergy, Environmental and Nutritional Medicine (BSAENM) |
| | 37 |
| | 3.4 ACTIVITIES UNDER THE UN / WHO 37 |
| | 3.5 CONCLUSIONS 38 |
| | 4 EXAMPLES OF MCS 39 |
| | 4.1 MCS AFTER EXPOSURE TO ORGANIC SOLVENTS 39 |
| | 4.1.1 MCS in workers after acute exposure to gasoline fumes during tunnel construction work 41 |
| | 4.1.2 MCS after exposure to plastics 42 |
| | 4.2 MCS AFTER EXPOSURE TO PESTICIDES 42 |
| | 4.2.1 The situation in Denmark 43 |
| | 4.3 WOOD PRESERVATIVES – PENTACHLOROPHENOL (PCP) IN GERMANY 43 |
| | 4.3.1 MCS after exposure to Rentolin in Denmark 44 |
| | 4.4 MCS IN RELATION TO INDOOR CLIMATE 44 |
| | 4.5 THE GULF WAR SYNDROME (GWS) 45 |
| | 4.6 COMMENTS 46 |
| | 4.7 CHEMICALS WHICH CAN CAUSE MCS 46 |
| | 4.7.1 Chemicals and initial exposure in connection with MCS 46 |
| | 4.7.2 Chemicals which cause multiple reactions (trigger substances) 47 |
| | 5 FREQUENCY 49 |
| | 5.1 PREVALENCE 49 |
| | 5.1.1 Prevalence of MCS in occupational medicine materials 51 |
| | 5.2 INCIDENCE 52 |
| | 5.3 PREVALENCE ACCORDING TO ENVIRONMENTAL PHYSICIANS AND PATIENT |
| | ASSOCIATIONS 53 |
| | 5.3.1 Frequency of MCS in Denmark according to patient associations 53 |
| | 5.4 COMMENTS 53 |
| | 6 POSSIBLE CAUSES AND MECHANISMS OF ILLNESS 55 |
| | 6.1 IMMUNOLOGICAL MECHANISMS 56 |
| | 6.2 MECHANISMS IN THE MUCOUS MEMBRANE OF THE NOSE 57 |
| | 6.3 NEUROLOGICAL MECHANISMS 59 |
| | 6.3.1 The olfactory-limbic system 59 |
| | 6.3.2 Other mechanisms related to the neurogenic mechanism 60 |
| | 6.3.3 Changes in the functioning of the brain 61 |
| | 6.4 PSYCHOLOGICAL MECHANISMS 62 |
| | 6.4.1 Conditioned reflexes (Pavlov's reflex) 62 |
| | 6.4.2 Psychogenic factors 63 |
| | 6.4.3 Environmental somatization syndrome 64 |
| | 6.5 TOXIC-INDUCED LOSS OF TOLERANCE (TILT) 65 |
| | 6.6 ILLNESS MODEL BASED ON CLINICAL ECOLOGY 65 |
| | 6.7 DISCUSSION 67 |
| | 6.8 CONCLUSION 70 |
| | 7 METHODS OF EXAMINATION AND DIAGNOSIS 71 |
| | 7.1 METHODS OF EXAMINATION 71 |
| | 7.2 DIAGNOSING MCS 72 |
| | 7.3 COMMENTS AND CONCLUSION 73 |
| | 8 HOW MCS IS DEALT WITH BY THE AUTHORITIES 75 |
| | 8.1 THE US AND CANADA 75 |
| | 8.1.1 Regulation and recognition 75 |
| | 8.1.2 Conclusion 78 |
| | 8.2 EUROPE 78 |
| | 8.2.1 Regulation and recognition 78 |
| | 8.2.2 Other activities 79 |
| | 8.2.3 Conclusion 80 |
| | 8.3 CONDITIONS IN DENMARK 80 |
| | 8.3.1 Authorities 80 |
| | 8.3.2 Examination of persons with MCS 82 |
| | 8.3.3 The Danish MCS Organisation 82 |
| | 8.3.4 Conclusion and recommendations 83 |
| | 9 SUMMARY, CONCLUSIONS AND RECOMMENDATIONS 85 |
| | 9.1 SUMMARY 85 |
| | 9.1.1 Aim 85 |
| | 9.1.2 Description and definition of MCS 86 |
| | 9.1.3 International activities and research 86 |
| | 9.1.4 Examples of MCS 87 |
| | 9.1.5 Prevalence 87 |
| | 9.1.6 Possible mechanisms 88 |
| | 9.1.7 Methods of examination and diagnosis 89 |
| | 9.1.8 The handling of MCS by the authorities in the US and Europe 89 |
| | 9.1.9 Conditions in Denmark 90 |
| | 9.2 CONCLUSIONS 90 |
| | 9.3 RECOMMENDATIONS 92 |
| | 10 REFERENCES 95 |
| | ANNEX A 105 |
| | ANNEX B 107 |
| | ANNEX C 109 |
| | ANNEX D 111 |
| | ANNEX E 113 |
| | ANNEX F 115 |
| | ANNEX G 119 |