A 37-Year-Old Mechanic with Multiple Chemical Sensitivities

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http://ehpnet1.niehs.nih.gov/docs/2000/108p377-381kipen/abstract.html

Environmental Health Perspectives Volume 108, Number 4, April 2000

Environmental and Occupational Health Sciences Institute and

UMDNJ Wood Medical School

A 37-Year-Old Mechanic with Multiple Chemical Sensitivities

M. Kipen and Fiedler

Environmental and Occupational Health Sciences Institute and UMDNJ-

Wood Medical School, Piscataway, New Jersey, USA

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Abstract

A 37-year-old heating, ventilation, and air-conditioning mechanic developed

respiratory, musculoskeletal, and central nervous system symptoms associated

with a variety of odorous environmental chemicals. Organic disease was not

evident, but the patient was distressed by these symptoms and was at risk

for becoming disabled by them. His symptoms fit broadly into the condition

recognized as multiple chemical sensitivity. Multiple chemical sensitivity

is a diagnostic term for a group of symptoms without demonstrated organic

basis. The symptoms are characteristic of dysfunction in multiple organ

systems, they increase and decrease according to exposure to low levels of

chemical agents in the patient's environment, and they sometimes occur after

a distinct environmental change or insult such as an industrial accident or

remodeling. Although traditional medical organizations have not agreed on a

definition for this syndrome, it is being increasingly recognized and makes

up an increasing percentage of the caseload at occupational and

environmental medicine clinics. Although there is often dispute about

whether the symptoms have a functional or organic basis, an informed

approach to evaluation, diagnosis, and management and a careful assessment

of impairment, disability, and work relatedness are necessary. Careful

exclusion of organic causes is critical, and this should be followed by a

judicious approach to coping with symptoms. Key words: chemical exposure,

multiple chemical sensitivity, psychology. Environ Health Perspect

108:377-381 (2000). [Online 9 March 2000]

http://ehpnet1.niehs.nih.gov/docs/2000/108p377-381kipen/abstract.html