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Multiple Chemical Sensitivities (MCS) - Fact or Fiction?
MCS can leave you helpless, alone, lonely, frightened, and embarrassed. You try to seek out help but carefully so no one finds out your problem. You make secret calls when you are alone trying to find answers, or are there any answers? Family and friends turn their backs if you dare speak of your ills. Your spouse or significant other might leave you, your own children can make you physically ill just by being in the same room with you, people outside will point at you or laugh or even be intimidated by you if you wear a face mask while you are out. If you don't wear a face mask when you are out you can't breathe the same air as the next person because to you the air burns your lips, and face and lungs.
You might have a seizure, or vomit or become too dizzy to walk, pain will impart as you take a breath of the perfume being worn by a person coming around the corner in the next aisle in a grocery store. You finally realize that you can no longer eat the same foods, or dress in the same clothes, or be close to the ones you love. Your life is being threatened by your environment and isolation in a very controlled setting is all that can save you for now. With a heavy heart you close the door to the world you once knew-the world of familiarity, along with the support and the love that was yours. Does this sound familiar?
A brief overview of MCS as it relates to the immune system and the inflammation and tissue damage that can arise from chronic immune activation caused by chemical exposure follows:
"Multiple Chemical Sensitivities and the Immune System" * by William J. Meggs, M.D., Ph.D. an invited presentation at the workshop on Multiple Chemical Sensitivities sponsored by the Association of Occupational and Environmental Clinics , Washington DC, Sept. 19-20, 1991. Dr. Meggs served four years as a fellow in clinical research at the National Institute of Health and recently served as an invited member of the National Academy of Sciences Subcommittee on Immunotoxicology which just completed their publication, Biologic Markers in Immunotoxicology. Dr. Meggs is currently conducting research into chemical sensitivities and indoor air exposures and practices at the Division of Clinical Toxicology, Dept. Of Emergency Medicine, East Carolina University School of Medicine, Greenville, North Carolina.
Dr. Meggs provides an excellent description of the observed stages of chemically induced illness described as the "Hypothetical Chemical Stress Syndrome".
STAGE ZERO -- TOLERANCE: is what it appears to be, the ability of a person to tolerate their chemical environment.
STAGE ONE -- SENSITIZATION: or the irritant phase, "occurs when an individual is chemically stressed either by an acute high-dose chemical exposure, or by a chronic insidious exposure. Individuals in Stage 1 have symptoms on exposure to chemicals, but no physical findings on physical examination." Symptoms may include joint pain, muscle pain, headache, fatigue, flushing, pruritis, nausea, et al.
STAGE TWO -- INFLAMMATION: is when the chemical exposure has led to tissue inflammation, such as arthritis, vasculitis, some types of dermatitis, colitis, myositis, non-allergic asthma, multiple sclerosis and rhinitis. "It is at this stage that both findings in physical examination appear and a medical diagnosis can be given... The progression from Stage 1 to Stage 2 again follows increasing chemical exposures, and if tissue damage has not occurred, the inflammation can be reversed by removal of the chemical stimuli." When a person is in stage 2, the symptoms can be controlled through various medications if a person is not sensitive to those medications.
However, one needs to exercise caution because the medications are not a cure for chemical exposure, but rather can mask the root cause of the symptoms, allowing further subtle cell damage to occur if the chemicals are not avoided: "That is, progression between Stages 1 and 2 is a two-way process, with regression from Stage 2 to Stage 1 being possible if chemicals are avoided. The inflammation of Stage 2 can be reduced by medications such as corticosteroids and the non-steroidal anti-inflammatory agents, but these agents are not a curative. If the chemical stimuli are not removed, there is immediate relapse of inflammation with discontinuation of anti-inflammatory medications. Further, these medications do not prevent the progression from Stage 2 to Stage 3."
STAGE THREE -- TISSUE AND ORGAN DETERIORATION: is when chronic inflammation caused by chemical exposure has finally led to tissue damage such as nerve damage, kidney damage, liver damage, lung damage, autoimmune damage, etc. This stage is irreversible: "Unfortunately, once tissue is damaged there is little hope in current medical practice for reversal, and organ function is lost." This doesn't mean it's time to throw in the towel. It is a point where patients need to carefully reevaluate their situation and further examine their environment for possible contributing factors. They then need to adjust by making the necessary lifestyle changes to try to prevent sill worse damage from occurring. It is important to note here that individuals can pass throughout these apparent stages without ever having developed MCS, or even without making a mental connection to chronic chemical exposure in their environment.
MCS becomes debilitating for most of the individuals who eventually progress to stages two and three. Although MCS is very controversial both the U.S. Dept. of Housing and Urban Development and the Social Security Administration have recognized MSC as a disability. Many state agencies will help individuals with MCS by providing assistance with homemakers, counselors and many other very important services. Individuals with MCS have won Workers' Compensation cases. A human rights lawsuit in Pennsylvania established the right of an individual with MCS to safe living space in subsidized housing. Both the Maryland State Legislature and New Jersey State Dept. of Health have officially commissioned studies of MCS. The NJ study provides an excellent overview of medical and legal issues related to MCS.
One of the most important law right now for individuals suffering with MCS is The Americans with Disabilities Act (ADA). The ADA prohibits discrimination on the basis of disability in employment, programs and services provided by state and local governments, goods and services provided by private companies, and in commercial facilities.
The ADA was signed into law on July 26, 1990. It contains requirements for new construction, for alterations or renovations to building and facilities, and for improving access to existing facilities of private companies providing goods or services to the public. It also requires that state and local governments provide access to programs offered to the public. The ADA also covers effective communication with people with disabilities, eligibility criteria that may restrict or prevent access, and requires reasonable modifications of policies and practices that my be discriminatory.
The ADA gives the U.S. Dept. of Justice authority to issue regulations for title II and III of the ADA and to provide technical assistance and enforcement. The Department also has the authority to certify that a state or local accessibility code is equivalent to the ADA's requirements for new construction and alterations.
Title III is very important to individuals with MCS. It states that (a) General. A public accommodation shall make reasonable modifications in policies, practices, or procedures, when the modifications are necessary to afford goods, services, facilities, privileges, advantages, or accommodations to individuals with disabilities, unless the public accommodation can demonstrate that making the modifications would fundamentally alter the nature of the goods, services, facilities, privileges, advantages, or accommodations. 36.201 General. (a) Prohibition of discrimination. No individual shall be discriminated against on the basis of disability in the full and equal enjoyment of goods, services, facilities, privileges, advantages, or accommodations of any place of public accommodation by any private entity who owns, leases (or leases to), or operates a place of public accommodation.
If you feel that you were not treated fairly or you were still discriminated against even after you asked for accommodation due to your disability you may decide to file a formal complaint with the Dept. of Justice. The ADA laws will make life easier for you once you understand your rights as a disabled citizen.'
The Pioneer Days of MCS are almost over. Massachusetts Continuing Legal Education, Inc. in Boston, Mass. held a seminar in April 1997 titled "Multiple Chemical Sensitivity Cases. A Practical Guide to Understanding the Issues." This is from its promotional material:
"Why Attend? Multiple Chemical Sensitivity (MCS) is a highly controversial diagnosis that is rapidly becoming a hot spot for indoor environmental health cases. Recently In Massachusetts, workers complaints led to investigations of the indoor environmental quality of the Suffolk County and Norfolk County Courthouses, the closing of the new Registry of Motor Vehicles building and extensive renovations in a major area hospital. Workers' complaints can quickly progress to claims of "MCS" and assertions that as a result of occupational exposures, they are unable to work in any environment that contains certain chemicals or odors. Affected individuals claim that their lives are totally disrupted-they can no longer go to grocery stores, malls, movie theaters or other public areas-because of an increased sensitivity to perfumes, cleaning agents, tobacco smoke, diesel exhaust and deodorizers.'
'Legal disputes almost inevitably arise, and the stakes are quite high from everyone's perspective-workers, employees, insurers, contractors, landlords and manufacturers alike. Physicians across the country have joined the debate over whether MCS should be recognized as a valid scientific diagnosis. How much of the problem is psychogenic? What treatments are reasonable and necessary? Who should pay, and for what?"
The agenda continues, "You will Learn:
What claims & defenses are commonly asserted in MCS cases.
How can expert witnesses help to support or defeat a claim.
How environmental factors will play a part in a claim for MCS.
What are the areas of controversy among medical experts.
How to apply the Daubert and Lanigan standards to cases of MCS.
How to support or defend a claim alleging MCS."
I'm sure there were many registrations for that seminar. There is interest peaking about MCS and with this interest will come knowledge and with that knowledge plausible vindication.
* Chemicals and the Immune System - Profile by Cindy Duehring of Environmental Access Research Network, P.O. Box 1089, Minot, ND 58702; A brief overview of "Multiple Chemical Sensitivities and The Immune System" by William J. Meggs, M.D., Ph.D. [note: CSL does not endorse or promote the information mentioned in this partial overview.]
* Chemically Sensitive Living (CSL) offers Peer Counseling, Consulting, Research, Resources, and References pertaining to the arena of Chemical Sensitivities, or Multiple Chemical Sensitivities (MCS), Environmental Illness (EI) and other immune disorders. To learn more about CSL e-mail them at: [email protected]
This document was excerpted, modified and otherwise prepared by the 'Lectric Law Library (LLL) from materials supplied by CSL. Copyright 2006 LLL & Gail Sullivan Restivo. Reproduction in whole or part is expressly prohibited without prior written authorization.