Mysterious Syndromes Studied

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http://www.latimes.com/news/science/environ/20010204/tCB00V0675.html

Sunday, February 4, 2001

Mysterious Syndromes Studied

By LINDA A. JOHNSON, Associated Press Writer

PISCATAWAY, N.J.--People desperate for explanations of mysterious health

problems from chronic fatigue syndrome to multiple chemical sensitivity

shouldn't blame the nearest toxic dump or exposure to chemicals, experts

say.

Numerous illnesses for which doctors can find no cause -or even

conclude it's all in the patient's head -probably are caused by multiple

physical, psychological and social factors interacting in complex ways not

yet understood, scientists said at a recent conference at Rutgers

University.

" Everybody (at the meeting) seems to agree that psychosocial factors

are very important for how people feel, for how they experience an illness, "

said conference organizer Dr. Kipen, a professor of occupational

health at the University of Medicine and Dentistry of New Jersey's

Wood Medical School. " But most physicians in the wider community

don't agree. "

About 100 physicians, psychiatrists, chemical experts, epidemiologists

and other researchers participated in discussions on the role environmental

factors play in medically unexplained symptoms. That's an issue of great

interest in New Jersey, a state full of Superfund sites (113), chemical

plants, clogged highways, an unexplained autism cluster in Brick Township

and abnormally high cancer rates among children in Toms River.

When pain, nausea or other troublesome symptoms send patients to a

doctor, Kipen noted, anywhere from 30 percent to 70 percent of those cases

cannot be explained by any known disease.

That's according to numerous studies of patients with what conference

participants called " Multiple Unexplained Symptom Syndromes. " While they are

poorly understood, most at least get names: chronic fatigue, irritable bowel

syndrome, fibromyalgia, Gulf War Syndrome, Lyme disease, sick building

syndrome, multiple chemical sensitivity, sensitivity to the gasoline

additive MTBE, or connective tissue disorder, as in women with silicone

breast implants.

The most common symptoms, at least in patients ill enough to seek

medical help, include headaches, fatigue, trouble concentrating or

remembering things, nausea, unusual chest pain, shortness of breath, trouble

sleeping and musculoskeletal pain.

" We're seeing overlap of symptoms " from one syndrome to another, said

Dr. Kreutzer of the California Department of Health Services.

Another puzzle, he said, is that " We're all exposed to low levels of

chemicals, but we really don't see (multiple chemical sensitivity) in most

people. "

The symptoms often seem worst in patients paying the most attention to

them, those living unstimulating, somewhat isolated lives, noted Anne

Spurgeon of the University of Birmingham in England.

New syndromes crop up periodically, and some appear to have

predecessors. For instance, some people working on computers or in

slaughterhouses today develop repetitive strain injury, whose forerunners

include telegraphist's cramp, Spurgeon said.

She is researching a " new " illness causing fatigue and memory problems

among U.K. sheep farmers, who by law each year must dip sheep in a toxic

chemical to kill parasites.

Despite the complexities of such syndromes, researchers hope to

understand them better.

Dr. Natelson and colleague Gudrun Lange of UMDNJ's New Jersey

Medical School, for example, are testing two hypotheses on what causes

chronic fatigue syndrome.

One involves previous findings that patients with CFS who have no

psychiatric problems have abnormalities in the structure of their brains;

the other concerns preliminary data that CFS patients have something wrong

with their hearts or blood vessels.

Kipen said the conference helped participants decide where future

research should go so that " we should be able to design better treatments

and prevention. "

The conference was sponsored by government agencies, the petroleum

industry and the 15 -year-old Environmental and Occupational Health Sciences

Institute in Piscataway, which is jointly run by Wood Medical

School and Rutgers University.

The environmental institute brings together experts from different

fields in programs focused on understanding how environmental factors affect

human health, treating people harmed by environmental agents, trying to

prevent risks to human health and the environment, and providing scientific

information to policy makers.

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On the Net:

Environmental and Occupational Health Sciences Institute:

http://www.eohsi.rutgers.edu