MCS Research published from 2000 to June 2016

Selected Bibliography of Studies and Articles on Chemical Sensitivity Published in Peer-Reviewed Journals

If the study you want to read does not have a link copy and paste the title of the study into google where you will most likely be taken to the study.

Research published from 2000 to June 2016

Allergy Asthma Immunol Res. 2014 Sep

Allergic diseases and multiple chemical sensitivity in korean adults.
Jeong I1, Kim I1, Park HJ2, Roh J3, Park JW2, Lee JH2.
Graduate School of Public Health, Yonsei University, Seoul, Korea.
Institute for Occupational Health, Yonsei University, Seoul, Korea.
Division of Allergy and Immunology, Yonsei University, Seoul, Korea.
Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.

PURPOSE: Multiple chemical sensitivity (MCS) is a clinical syndrome representing multi-organ and psychological symptoms caused by chronic exposure to various chemicals in low concentrations. We evaluated the prevalence and related factors of MCS targeting Korean adults using the Quick Environmental Exposure and Sensitivity Inventory (QEESI©).

METHODS: A total of 446 participants were recruited from Severance Hospital. Participants underwent a questionnaire interview including questions on sociodemographic factors, occupational and environmental factors, allergic diseases, and the QEESI©. Among them, 379 participants completed the questionnaire and the QEESI©. According to the QEESI© interpretation results, participants were divided into very suggestive (VS) group and less suggestive (LS) group.

RESULTS: The estimated prevalence of MCS was higher in allergic patients than non-allergic participants (19.7% and 11.3%, respectively, P=0.04). In the multivariate logistic regression analysis, ages of 30-39 (OR, 2.94; 95% CI, 1.25-6.95) and those of 40-49 (OR, 2.51; 95% CI, 1.02-6.21) were significantly related to MCS compared to those aged less than 30 years. Female sex (OR, 2.16; 95% CI, 1.11-4.18), experience of dwelling in a new house (OR, 2.05; 95% CI, 1.04-4.03), and atopic dermatitis (OR, 1.95; 95% CI, 1.04-3.69) were also significantly related to MCS. However, only age of 30-39 in the allergic group was significant in the stratified analysis.

CONCLUSIONS: The estimated prevalence of MCS was higher among allergic patients than non-allergic participants. People with experience of dwelling in a new house and atopic dermatitis were more at risk of being intolerant to chemicals. Further studies to provide the nationally representative prevalence data and clarify risk factors and mechanisms of MCS are required.

Environ Health Prev Med. 2014 May 19

Prevalence and interannual changes in multiple chemical sensitivity in Japanese workers.
Cui X1, Lu X, Hiura M, Oda M, Hisada A, Miyazaki W, Omori H, Katoh T.
Department of Public Health, Faculty of Life Sciences, Kumamoto University, Japan.

OBJECTIVE: We aimed to evaluate the prevalence rates and interannual fluctuations in multiple chemical sensitivity (MCS) in Japanese workers.

METHODS: We assessed MCS using the Quick Environmental Exposure and Sensitivity Inventory, employing both Miller and Japanese criteria. Workers of two manufacturing companies located in Kyushu, Japan, were assessed, with company A surveyed in 2003, 2006 and 2011, and company B in 2003 and 2011.

RESULTS: In company A, the Miller criteria-based MCS prevalence rate was higher in 2011 than in 2003, and according to the Japanese criteria, it was higher in 2011 than 2006. In company B, the Miller criteria-based MCS prevalence rate was lower in 2011 than in 2003.

CONCLUSION: The results indicated that MCS exists among industrial workers in Japan. We found no statistically significant interannual changes in MCS rates.

Oxford University Press on behalf of the British Journal of Anaesthesia.
2011 Aug 10
Xenon anaesthesia for laparoscopic cholecystectomy in a patient with multiple chemical sensitivity
Christian Stoppe, Jan Cremer, Steffen Rex, Gereon Schaelte, Astrid Fahlenkamp, Rolf Rossaint, Raphael Rosch, Dirk O. Bauerschlag, and Mark Coburn
Department of Anaesthesiology, University Hospital, RWTH Aachen, Germany.

The management of general anaesthesia in patients suffering from multiple chemical sensitivity (MCS) poses a challenge. MCS has been described first in the 1940s (1, 2). It occurs in response to diverse stimuli and emerges after exposure to usually harmless doses of environmental chemicals or medications. The pathophysiology of MCS is still only poorly understood. Possible hypotheses include triggers from unspecific allergic or toxic exposure and neurobiological sensitization (3, 4). Therefore patients are exposed to a significant risk of adverse drug interactions while undergoing general anaesthesia (5). The noble gas xenon offers many characteristics of an ideal anaesthetic including hemodynamic stability and rapid induction and emergence from anaesthesia, regardless of its duration (6-8). Furthermore, as an inert gas, xenon is known to be independent of the patients` metabolism and biotransformation, hence interacting less putatively with mechanisms possibly involved in the triggering of MCS. Therefore we applied xenon anaesthesia in a patient with MCS undergoing laparoscopic cholecystectomy.

Here, we report the case of a 53-year-old woman (1.68m and 68.5 kg), who presented with increasing pain due to chronic cholecystolithiasis and a persistent ovarian cyst. The patient was scheduled for elective cholecystectomy and cyst enucleation. Since the early 1980s, the patient has suffered from MCS symptoms with high sensitivity to environmental chemicals, intermittent restlessness and unspecific breathing problems. Since that time, the patient manifested multiple sensitivities to various drugs, which led to her abstinence of all medication for more than 15 years. Preoperative evaluation classified the patient in the ASA II risk category and in a postoperative nausea and vomiting risk score of III (Apfel score).
The patient did not receive premedication. In the operation theatre, routine monitoring – consisting of 3-lead-ECG, pulse oxymetry and intermittent blood pressure measurements – was instituted according to our clinical standards. The patient received 100% oxygen for 3 minutes and subsequently a bolus of fentanyl 0.15mg. Induction of anaesthesia was started with a dose of 150mg disoprivan followed by a repeated bolus of 100 mg, while the use of muscle relaxant was avoided. After tracheal intubation, the patient was ventilated with a closed-circuit anaesthetic machine (TAEMA Felix Dual; ALMS, France) using volume control. After denitrogenation had been completed, xenon application was started aiming at a target concentration of 54%.
Two additional doses of fentanyl were applied i.v., 0.1mg prior to incision and 0.05mg 45 minutes after start of surgery. During surgery, neither heart rate nor blood pressures indicated anaphylaxis. At end of surgery (185 min) the xenon application was stopped. The patient opened her eyes 150 s after termination of xenon, and adequate reaction on verbal command as well as spontaneous breathing were observed 20 seconds later, resulting in extubation 3 minutes after stop of xenon application.
The patient was transferred to the post-anaesthesia care unit (PACU) and discharged 2 hours later to the surgical standard care unit. The patient did not show any signs of PONV and Aldrete Score was > 9 throughout the first 6 hours after end of surgery. Likewise, postoperative visits on the 1st and 2nd postoperative day did not show any adverse events or signs of intolerance and the patient`s recovery was appropriate. A fortnight after discharge, the patient was again interviewed.
The patient complained about difficulties regarding full mobilization, which she attributed to the surgery procedure but did not exhibit any signs of chemical sensitivity or intolerance during the whole postoperative course. At present there is no gold standard for general anaesthesia in patients with MCS. The special characteristics of the noble gas xenon may offer a new approach for safe anaesthesia in patients with MCS.

Toxicol Appl Pharmacol. 2010 Nov 1;248(3):285-92. Epub 2010 Apr 27.

Biological definition of multiple chemical sensitivity from redox state and cytokine profiling and not from polymorphisms of xenobiotic-metabolizing enzymes.
De Luca C, Scordo MG, Cesareo E, Pastore S, Mariani S, Maiani G, Stancato A, Loreti B, Valacchi G, Lubrano C, Raskovic D, De Padova L, Genovesi G.
Laboratory of Tissue Engineering & Skin Pathophysiology, Dermatology Institute (IDI IRCCS), Rome, Italy.

BACKGROUND: Multiple chemical sensitivity (MCS) is a poorly clinically and biologically defined environment-associated syndrome. Although dysfunctions of phase I/phase II metabolizing enzymes and redox imbalance have been hypothesized, corresponding genetic and metabolic parameters in MCS have not been systematically examined.

OBJECTIVES: We sought for genetic, immunological, and metabolic markers in MCS.

METHODS: We genotyped patients with diagnosis of MCS, suspected MCS and Italian healthy controls for allelic variants of cytochrome P450 isoforms (CYP2C9, CYP2C19, CYP2D6, and CYP3A5), UDP-glucuronosyl transferase (UGT1A1), and glutathione S-transferases (GSTP1, GSTM1, and GSTT1). Erythrocyte membrane fatty acids, antioxidant (catalase, superoxide dismutase (SOD)) and glutathione metabolizing (GST, glutathione peroxidase (Gpx)) enzymes, whole blood chemiluminescence, total antioxidant capacity, levels of nitrites/nitrates, glutathione, HNE-protein adducts, and a wide spectrum of cytokines in the plasma were determined.

RESULTS: Allele and genotype frequencies of CYPs, UGT, GSTM, GSTT, and GSTP were similar in the Italian MCS patients and in the control populations. The activities of erythrocyte catalase and GST were lower, whereas Gpx was higher than normal. Both reduced and oxidised glutathione were decreased, whereas nitrites/nitrates were increased in the MCS groups. The MCS fatty acid profile was shifted to saturated compartment and IFNgamma, IL-8, IL-10, MCP-1, PDGFbb, and VEGF were increased.

CONCLUSIONS: Altered redox and cytokine patterns suggest inhibition of expression/activity of metabolizing and antioxidant enzymes inMCS. Metabolic parameters indicating accelerated lipid oxidation, increased nitric oxide production and glutathione depletion in combination with increased plasma inflammatory cytokines should be considered in biological definition and diagnosis of MCS.

J Neurol Sci. 2009 Dec 15;287(1-2):72-8. Epub 2009 Oct 3.

Brain dysfunction in multiple chemical sensitivity
Orriols R, Costa R, Cuberas G, Jacas C, Castell J, Sunyer J.
Servei de Pneumologia, Hospital Universitari Vall d’ Hebron, Barcelona, Catalonia, Spain.

Multiple Chemical Sensitivity (MCS) is a chronic acquired disorder of unknown pathogenesis. The aim of this study was to ascertain whether MCS patients present brain single photon emission computed tomography (SPECT) and psychometric scale changes after a chemical challenge. This procedure was performed with chemical products at non-toxic concentrations in 8 patients diagnosed with MCS and in their healthy controls. In comparison to controls, cases presented basal brain SPECT hypoperfusion in small cortical areas of the right parietal and both temporal and fronto-orbital lobes.
After chemical challenge, cases showed hypoperfusion in the olfactory, right and left hippocampus, right parahippocampus, right amygdala, right thalamus, right and left Rolandic and right temporal cortex regions (p<or=0.01). By contrast, controls showed hyperperfusion in the cingulus, right parahippocampus, left thalamus and some cortex regions (p<or=0.01). The clustered deactivation pattern in cases was stronger than in controls (p=0.012) and the clustered activation pattern in controls was higher than in cases (p=0.012).
In comparison to controls, cases presented poorer quality of life and neurocognitive function at baseline, and neurocognitive worsening after chemical exposure. Chemical exposure caused neurocognitive impairment, and SPECT brain dysfunction particularly in odor-processing areas, thereby suggesting a neurogenic origin of MCS.

Int J Hyg Environ Health. 2008 oct

Clinical characteristics of physician-diagnosed patients with multiple chemical sensitivity in Japan.
Hojo S1, Ishikawa S, Kumano H, Miyata M, Sakabe K.
Department of Environmental Science, Shokei Gakuin University, 4-10-1 Yurigaoka, Natori-shi, Miyagi 981-1295, Japan.

Multiple chemical sensitivity (MCS), a syndrome in which multiple symptoms occur with low-level chemical exposure, has not been clarified in detail. The aim of our study was to clarify the clinical characteristics of physician-diagnosed MCS patients in Japan. We analyzed patient characteristics based on the medical records of 106 patients diagnosed with MCS according to the 1999 Consensus and the Japanese diagnostic criteria for MCS. We evaluated subjective symptoms using the Quick Environment Exposure Sensitivity Inventory (QEESI) and compared the QEESI scores with those of four MCS patient groups in the US reported by Miller and Prihoda [Miller, C.S., Prihoda, T.J., 1999b. A controlled comparison of symptoms and chemical intolerances reported by Gulf War veterans, implant recipients, and persons with multiple chemical sensitivity.
Toxicol Ind Health 15, 386-397]. Female patients accounted for 74.0%. Most male patients were in their 30s, whereas female ages ranged widely from 10 to 65 years. Among estimated onset factors, those seen in males tended to be workplace related, while female patients showed a variety of factors. Co-morbid allergic disease was present in 84.0% of patients.
A significant difference in the QEESI score between male and female patients was found in only one item out of 10 in symptom severity and life impact. However, all 10 items in chemical intolerance were significantly higher in females than in males. The mean QEESI score in the patient group in our study was lower than those in any of the four self-reported patient groups in the US.

Nihon Eiseigaku Zasshi. 2008 Jul

Questionnaire survey of workers in specific buildings regarding multiple chemical sensitivity.
Manabe R1, Kunugita N, Katoh T, Kuroda Y, Akiyama Y, Yamano Y, Uchiyama I, Arashidani K.
Division of Public Health, Department of Social Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.

OBJECTIVES: The purpose of this study was to investigate the incidence of multiple chemical sensitivity (MCS) and effectiveness of the Quick Environment Exposure and Sensitivity Inventory (QEESI) in Japanese workers in specific buildings.

METHODS: The survey was performed in 2004-2006 in Japan. QEESI (Japanese version) and a checklist on accumulation of fatigue developed by the Ministry of Health, Labour and Welfare were used in the examination of 410 workers in specific buildings. Three criteria of QEESI’s “symptom severity”, “chemical intolerance”, and “other intolerance” were evaluated in this study. Clinical histories were also surveyed.

RESULT: Responses were obtained from 368 (89.8%) workers. The results showed that 132 (35.9%) individuals have been diagnosed as having allergy. Only two (0.5%) individuals were found to be MCS patients. There was no sick building syndrome patient. Applying the “high” criteria with QEESI to the standard of Miller and Ashford, we determined that only four (1.1%) individuals met all the three criteria, and 17 (4.6%) individuals met two of the three criteria. The QEESI score of allergy persons was higher than that of nonallergy persons. Among nonallergy persons, those who have a high score on accumulation of fatigue in the checklist showed a high score in QESSI.

CONCLUSIONS: These findings indicated that the QEESI score tended to increase with workload and be high in individuals with allergy. Therefore, careful consideration is required, when QEESI is applied for screening MCS patients in Japan.

Ugeskr Laeger. 2006 Mar 13;168(11):1116-9

Multiple chemical sensitivity: a well-defined illness?
Kolstad HA, Silberschmidt M, Nielsen JB, Osterberg K, Andersen JH, Bonde JP, Fink P.
Arhus Universitetshospital, Arbejdsmedicinsk Klinik, Arhus C, Danmark.

Some people react to smells or chemicals at levels far below toxicological thresholds with nonspecific symptoms, fear and social isolation. They may be diagnosed with multiple chemical sensitivity. There is no empirical evidence indicating that this condition is explained by toxicological mechanisms, even though a number of theories have been proposed. The authors of this review conclude that this is a functional condition. These patients need information and treatment in accordance with this fact. Instead of being advised how to avoid exposure to chemicals, they should be properly trained in appropriate confrontation with the chemicals encountered in everyday life.

Med Clin (Barc). 2005 Apr 2;124(12):451-3
Chronic fatigue syndrome and multiple chemical hypersensitivity after insecticide exposition.
Fernandez-Sola J, Lluis Padierna M, Nogue Xarau S, Munne Mas P.
Servicio de Medicina Interna. Unidad Multidisciplinar de Fatiga Cronica. Hospital Clinic de Barcelona. IDIBAPS. Universitat de Barcelona. Barcelona. Spain.

Background and objective: Chronic Fatigue Syndrome (CFS) and Multiple Chemical Sensitivity (MCS) are well-defined illnesses that may appear after some toxic exposures. Patients and method: We report a consecutive series of 26 patients who developed CFS after exposure to insecticide products. It was associated with MCS in a third of cases. RESULTS: Toxic exposure was of labour origin after returning to usual work place after a process of fumigation. In 42% of cases there was no fulfilment of fumigation safety rules. The majority of patients were mean-aged women who developed an acute upper airway inflammatory syndrome, without muscarinic or nicotinic manifestations, followed by digestive syndrome, neurocognitive, fibromyalgic and chronic fatigue manifestations. The course of disease was shorter than 1 year in 5 cases (19%), longer than 1 year in 15(58%), and disabling in 6 cases (23%).

CONCLUSIONS: Due to the possible prevention of this toxic exposure, it is very important to carefully follow measures of environment isolation and ventilation after insecticide use in order to avoid the development of these diseases.

Nuklearmedizin. 2002 Dec;41(6):233-9
PET in patients with clear-cut multiple chemical sensitivity (MCS).
Bornschein S, Hausteiner C, Drzezga A, Bartenstein P, Schwaiger M, Forstl H, Zilker T.
Toxikologische Abteilung der II. Medizinischen Klinik und Poliklinik, Technische Universitat Munchen, Klinikum rechts der Isar, München, Germany.

AIM: Multiple chemical sensitivity (MCS) is a controversially discussed symptom complex. Patients afflicted by MCS react to very low and generally non-toxic concentrations of environmental chemicals. It has been suggested that MCS leads to neurotoxic damage or neuroimmunological alteration in the brain detectable by position emission tomography (PET) and single photon emission computer tomography (SPECT). These methods are often applied to MCS patients for diagnosis, although they never proved appropriate.

METHOD: We scanned 12 MCS patients with PET, hypothesizing that it would reveal abnormal findings.

RESULTS: Mild glucose hypometabolism was present in one patient. In comparison with normal controls, the patient group showed no significant functional brain changes.

CONCLUSION: This first systematic PET study in MCS patients revealed no hint of neurotoxic or neuroimmunological brain changes of functional significance.

Expo Anal Environ Epidemiol. 2004 Jan;14(1):84-91.
Identification of responsible volatile chemicals that induce hypersensitive reactions to multiple chemical sensitivity patients.
Shinohara N, Mizukoshi A, Yanagisawa Y.
Graduate School of Frontier Sciences, Institute of Environmental Studies, The University of Tokyo, Japan.

Multiple chemical sensitivity (MCS) has become a serious problem as a result of airtight techniques in modern construction. The mechanism of the MCS, however, has not been clarified. Responsible chemicals and their exposure levels for patient’s hypersensitive reactions need to be identified. We measured the exposure of 15 MCS patients to both carbonyl compounds and volatile organic compounds (VOCs) that may induce hypersensitive reactions. The exposures of those not suffering from MCS (non-MCS individuals) were also measured at the same time. To characterize the chemicals responsible for MCS symptoms, we applied a new sampling strategy for the measurement of carbonyls and VOCs using active and passive sampling methods. The results of our study clearly demonstrated that the chemicals responsible for such hypersensitive reactions varied from patient to patient.
Moreover, the concentrations during hypersensitive symptoms, which were apparent in some of the MCS patients, were far below both the WHO and the Japanese indoor guidelines. The average exposure levels of MCS patients within a 7-day period were lower than those of paired non-MCS individuals except for a few patients who were exposed to chemicals in their work places. This result indicates that the MCS patients try to keep away from exposures to the chemical compounds that cause some symptoms.Journal of Exposure Analysis and Environmental Epidemiology (2004) 14, 84-91.

Clin Diagn Lab Immunol. 2003 Nov;10(6):1029-36.
Reproducibility of immunological tests used to assess multiple chemical sensitivity syndrome.
Hoover DR, Donnay A, Mitchell CS, Ziem G, Rose NR, Sabath DE, Yurkow EJ, Nakamura R, Vogt RF, Waxdal M, Margolick JB.
Department of Statistics and Institute for Health, Health Care Policy and Aging Research, Rutgers University, Piscataway, New Jersey, USA.

Whether persons with multiple chemical sensitivity syndrome (MCS) have immunological abnormalities is unknown. To assess the reliability of selected immunological tests that have been hypothesized to be associated with MCS, replicate blood samples from 19 healthy volunteers, 15 persons diagnosed with MCS, and 11 persons diagnosed with autoimmune disease were analyzed in five laboratories for expression of four T-cell surface activation markers (CD25, CD26, CD38, and HLA-DR) and in four laboratories for autoantibodies (to smooth muscle, thyroid antigens, and myelin). For T-cell activation markers, the intralaboratory reproducibility was very good, with 90% of the replicates analyzed in the same laboratory differing by < or = 3%. Interlaboratory differences were statistically significant for all T-cell subsets except CD4+ cells, ranging from minor to eightfold for CD25+ subsets. Within laboratories, the date of analysis was significantly associated with the values for all cellular activation markers. Although reproducibility of autoantibodies could not be precisely assessed due to the rarity of abnormal results, there were inconsistencies across laboratories. The effect of shipping on all measurements, while sometimes statistically significant, was very small. These results support the reliability of fresh and shipped samples for detecting large (but perhaps not small) differences between groups of donors in the T-cell subsets tested. When comparing markers that are not well standardized, it may be important to distribute samples from different study groups evenly over time.

Int J Hyg Environ Health. 2003 Oct;206(6):531-8.
Multiple chemical sensitivity in male painters; a controlled provocation study.
Georgellis A, Lindelof B, Lundin A, Arnetz B, Hillert L.
Department of Occupational and Environmental Health, Stockholm County Council, Stockholm, Sweden.

The purpose of the present study was to examine whether male painters reporting multiple chemical sensitivity (MCS) differ from their matched controls (male painters without such sensitivity) during controlled chamber challenges to singular and mixtures of odorous chemicals with respect to: (1) Subjective rating of symptoms (i.e., symptoms related to central nervous system (CNS) and symptoms related to irritation) and sensations of smell elicited by low-level chemical exposures. (2) Changes in serum prolactin and cortisol levels, changes in nasal cavity and eye redness as a result of the various exposures. Moreover, background assessments were made regarding mental well-being, sense of coherence (SOC) as well as state of anxiety and depression in both groups.
The MCS and control group consisted of 14 and 15 male painters respectively. Regarding background assessments of mental well-being, anxiety, depression and SOC, statistically significant differences were obtained between painters with MCS and their controls. During the controlled chamber challenges, neither difference regarding sensations of smell nor development of CNS related symptoms were seen between MCS and control group. In contrast, subjective rating of symptoms related to irritation (i.e., eyes, nose, throat, skin, and breathing difficulties) was significant higher in subjects with MCS.
No differences between the groups as a result of the different exposures were seen concerning nasal cavity, eye redness and serum cortisol levels. However, a trend (P = 0.056) between the groups was measured regarding a decline of serum prolactin levels in the MCS group. This is a relatively small study with a limited number of volunteers; and no definitive conclusions can be drawn concerning the above findings. But it is the first controlled challenge study that incorporates similarly exposed groups (painters) recruited from a community rather than from a clinical population.

Occup Med (Lond). 2003 Oct;53(7):479-82.
Central neurological abnormalities and multiple chemical sensitivity caused by chronic toluene exposure.
Lee YL, Pai MC, Chen JH, Guo YL.
Department of Environmental and Occupational Health, National Cheng Kung University Medicine College, Tainan, Taiwan.

Multiple chemical sensitivity (MCS) is a syndrome in which multiple symptoms occur with low-level chemical exposure; whether it is an organic disease initiated by environmental exposure or a psychological disorder is still controversial. We report a 38-year-old male worker with chronic toluene exposure who developed symptoms such as palpitation, insomnia, dizziness with headache, memory impairment, euphoria while working, and depression during the weekend.
Upon cessation of exposure, follow-up neurobehavioural tests, including the cognitive ability screening instrument and the mini-mental state examination, gradually improved and eventually became normal. Although no further toluene exposure was noted, non-specific symptoms reappeared whenever the subject smelled automotive exhaust fumes or paint, or visited a petrol station, followed by anxiety with sleep disturbance. During hospitalization for a toluene provocation test, there was no difference between pre-challenge and post-challenge PaCO(2), PaO(2), SaO(2) or pulmonary function tests, except some elevation of pulse rate. The clinical manifestations suggested that MCS was more relevant to psychophysiological than pathophysiological factors.

FASEB J. 2002 Sep;16(11):1407-17.
NMDA sensitization and stimulation by peroxynitrite, nitric oxide, and organic solvents as the mechanism of chemical sensitivity in multiple chemical sensitivity.
Pall ML.
School of Molecular Biosciences, Washington State University, Pullman, Washington 99164-4660, USA.

Multiple chemical sensitivity (MCS) is a condition where previous exposure to hydrophobic organic solvents or pesticides appears to render people hypersensitive to a wide range of chemicals, including organic solvents. The hypersensitivity is often exquisite, with MCS individuals showing sensitivity that appears to be at least two orders of magnitude greater than that of normal individuals.
This paper presents a plausible set of interacting mechanisms to explain such heightened sensitivity. It is based on two earlier theories of MCS: the elevated nitric oxide/peroxynitrite theory and the neural sensitization theory. It is also based on evidence implicating excessive NMDA activity in MCS.
Four sensitization mechanisms are proposed to act synergistically, each based on known physiological mechanisms: Nitric oxide-mediated stimulation of neurotransmitter (glutamate) release; peroxynitrite-mediated ATP depletion and consequent hypersensitivity of NMDA receptors; peroxynitrite-mediated increased permeability of the blood-brain barrier, producing increased accessibility of organic chemicals to the central nervous system; and nitric oxide inhibition of cytochrome P450 metabolism. Evidence for each of these mechanisms, which may also be involved in Parkinson’s disease, is reviewed. These interacting mechanisms provide explanations for diverse aspects of MCS and a framework for hypothesis-driven MCS research.

Med Hypotheses. 2000 May;54(5):734-8
Chemical sensitivity and fatigue syndromes from hypoxia/hypercapnia
Ross PM.
The American Health Foundation, New York, USA.

The multiple chemical sensitivities syndrome (MCS) and other chronic syndromes causing fatigue, headache and other protean CNS symptoms without observable signs, are proposed to result from hypoxia/hypercapnia (H/H) due to disturbed breathing. The concept is explained in terms of sleep apnea (SA), although H/H could result from causes other than SA. Reasons for considering this etiologic linkage are as follows: 1. MCS symptoms resemble those of SA. 2.
The only physical signs associated with MCS (upper airway inflammation and obstruction) can aggravate SA. 3. The only neuropsychiatric finding common among MCS symptomatics, reduced verbal recall, is associated with SA. 4. Many MCS symptomatics attribute onset of their condition to a pesticide or solvent exposure. Solvent neurotoxicity may cause cacosmia, a symptom of MCS and SA. 5. Improved upper airway patency, a first-line therapy in SA, may improve symptoms in some MCS-like conditions. Implications for diagnosis and treatment of MCS are discussed. Copyright 2000 Harcourt Publishers Ltd.

Toxicol Ind Health. 1999 Apr-Jun;15(3-4):403-9
Odor sensitivity and respiratory complaint profiles in a community-based sample with asthma, hay fever, and chemical odor intolerance
Baldwin CM, Bell IR, O’Rourke MK.
Respiratory Sciences Center, University of Arizona, Tucson, USA.

This is a community-based study of odor sensitivity and respiratory complaints for persons reporting asthma (n = 14/141), hay fever (n = 72/140), and chemical odor intolerance (CI) (n = 41/181). CI, a symptom of multiple chemical sensitivity (MCS), was determined from self-ratings of feeling ‘moderately’ to ‘severely’ ill using the Chemical Odor Intolerance Index (CII). Index odors included perfume, pesticide, drying paint, new carpet odor, and car exhaust.
Six additional odors [natural gas, disinfectants, chlorinated water, room deodorizers, and environmental tobacco smoke (ETS)] were also assessed in the health and environment survey. Asthmatics reported feeling ‘frequently’ to ‘almost always’ ill from the CII index odors of drying paint, new carpet odor, perfume, and cleaning agents compared to nonasthmatics. People with hay fever documented feeling ‘frequently’ to ‘almost always’ ill from pesticides, drying paint, and car exhaust compared to individuals without hay fever.
The CI cited illness from air freshener, natural gas and chlorinated water, in addition to the index odors of perfume, paint, pesticides, new carpeting and auto exhaust. All three groups were significantly more likely to report feeling ill from ETS. People with asthma were significantly more likely to report lower lung complaints, such as wheeze and dyspnea. People with hay fever cited more chest tightness. The CI were significantly more likely to report upper and lower respiratory symptoms. Given this overlap in respiratory complaints, it could be that CI may serve to amplify these traditional immune-related disorders and/or suggest that having asthma or hay fever could make one more vulnerable to CI.Toxicol Ind Health. 1999 Apr-Jun;15(3-4):295-304

Toxicol Ind Health. 1999 Apr-Jun;15(3-4):295-304
Neural sensitization model for multiple chemical sensitivity: overview of theory and empirical evidence.
Bell IR, Baldwin CM, Fernandez M, Schwartz GE.
Department of Psychiatry, University of Arizona, Tucson 85723, USA.

This paper summarizes theory and evidence for a neural sensitization model of hyperresponsivity to low-level chemical exposures in multiple chemical sensitivity (MCS). MCS is a chronic polysymptomatic condition in which patients report illness from low levels of many different, structurally unrelated environmental chemicals (chemical intolerance, CI). Neural sensitization is the progressive host amplification of a response over time from repeated, intermittent exposures to a stimulus. Drugs, chemicals, endogenous mediators, and exogenous stressors can all initiate sensitization and can exhibit cross-sensitization between different classes of stimuli. The properties of sensitization overlap much of the clinical phenomenology of MCS. Animal studies have demonstrated sensitization to toluene, formaldehyde, and certain pesticides, as well as cross-sensitization, e.g., formaldehyde and cocaine.
Controlled human studies in persons with self-reported CI have shown heightened sensitizability in the laboratory to nonspecific experimental factors and to specific chemical exposures. Useful outcome measures include spectral electroencephalography, blood pressure, heart rate, and plasma beta-endorphin. Findings implicate, in part, dopaminergic mesolimbic pathways and limbic structures. A convergence of evidence suggests that persons with MCS or with low-level CI may share some characteristics with individuals genetically vulnerable to substance abuse: (a) elevated family histories of alcohol or drug problems; (b) heightened capacity for sensitization of autonomic variables in the laboratory; (c) increased amounts of electroencephalographic alpha activity at rest and under challenge conditions over time.
Sensitization is compatible with other models for MCS as well. The neural sensitization model provides a direction for further systematic human and animal research on the physiological bases of MCS and CI.

Toxicol Ind Health. 1999 Apr-Jun 15
A controlled comparison of symptoms and chemical intolerances reported by Gulf War veterans, implant recipients and persons with multiple chemical sensitivity.
Miller CS1, Prihoda TJ.
Department of Family Practice, University of Texas Health Science Center at San Antonio 78284-7794, USA.

Using the Environmental Exposure and Sensitivity Inventory (EESI), a standardized instrument for measuring chemical sensitivity, we obtained and compared ratings of symptoms, chemical (inhalant) intolerances, other intolerances (e.g., drugs, caffeine, alcohol, skin contactants), lifeimpact, and masking (ongoing exposures) in five populations: multiple chemical sensitivity (MCS) patients who did (n = 96) or did not (n = 90) attribute onset of their illness to a specific exposure event, patients with implanted devices (n = 87), Gulf War veterans (n = 72), and controls (n = 76).
For each patient group, mean scores on the first four scales were significantly greater than for controls. MCS patients reported avoiding more chemical exposures (were less masked) than the other groups. Across groups, for a given level of symptoms, as masking increased, mean scores on the Chemical Intolerance Scale decreased.
In contrast, mean scores on the Other Intolerance Scale appeared to be less affected by masking. These findings suggest that some patients with antecedent chemical exposures, whether exogenous (chemical spill, pesticide application, indoor air contaminants) or endogenous (implant), develop new chemical, food, and drug intolerances. Reports of new caffeine, alcohol, medication, food, or other intolerances by patients may signal exposure-related illness. Masking may reduce individuals’ awareness of chemical intolerances, and, to a lesser degree, other intolerances.

Med Pr. 1998;49(5):473-81
Multiple chemical sensitivity: a new type of toxicity?
Gralewicz S.
Zakladu Toksykologii i Kancerogenezy, Instytutu Medycyny Pracy, Lodzi, Poland.

Multiplechemical sensitivity (MCS) is a chronic condition manifested by the appearance of variable symptoms, involving many systems and organs, after exposure to extremely low levels of chemicals, mainly pesticides and solvents. The paper discusses briefly the main hypotheses concerning causes and mechanisms of MCS development. It was emphasized that during neurotoxicity assessment is necessary to pay more attention to these aspects of toxic effects of chemicals likely to generate MSc.

Environ Health Perspect. 1997 Mar;105 Suppl 2:515-9
Empirical approaches for the investigation of toxicant-induced loss of tolerance
Miller C, Ashford N, Doty R, Lamielle M, Otto D, Rahill A, Wallace L.
Department of Family Practice, University of Texas Health Science Center at San Antonio, 78284-7794, USA.

It has been hypothesized that sensitivity to low-level chemical exposures develops in two steps: initiation by an acute or chronic chemical exposure, followed by triggering of symptoms by low levels of previously tolerated chemical inhalants, foods, or drugs. The Working Group on Toxicant-induced Loss of Tolerance has formulated a series of research questions to test this hypothesis:
Do some individuals experience sensitivity to chemicals at levels of exposure unexplained by classical toxicological thresholds and dose-response relationships, and outside normally expected variation in the population? Do chemically sensitive subjects exhibit masking that may interfere with the reproducibility of their responses to chemical challenges?
Does chemical sensitivity develop because of acute, intermittent, or continuous exposure to certain substances? If so, what substances are most likely to initiate this process? An experimental approach for testing directly the relationship between patients’ reported symptoms and specific exposures was outlined in response to the first question, which was felt to be a key question.
Double-blind, placebo-controlled challenges performed in an environmentally controlled hospital facility (environmental medical unit) coupled with rigorous documentation of both objective and subjective responses are necessary to answer this question and to help elucidate the nature and origins of chemical sensitivity.

Environ Health Perspect. 1997 Mar;105 Suppl 2:437-41
Clinical characteristics of chemical sensitivity: an illustrative case history of asthma and MCS
Ross GH.
Environmental Health Center-Dallas, Texas 75231, USA.

A case history of the induction of asthma and chemical sensitivity in a 42-year-old registered nurse illustrates several of the characteristic features of multiple chemical sensitivity (MCS). This patient’s problems started shortly after moving into a new home under construction, with associated chemical exposures. Other MCS patients report the onset of the condition with other chemical exposures such as those encountered at their places of work or use of pesticides at their residences.
Patients often describe a spreading phenomenon of increasing intolerance to commonly encountered chemicals at concentrations well tolerated by other people. Symptoms usually wax and wane with exposures, and are more likely to occur in patients or families with preexisting histories of migraine or with classical allergies.
Idiosyncratic medication reactions (especially to preservative chemicals) are common in MCS patients, as are dysautonomia symptoms (such as vascular instability) and poor temperature regulation. Myalgia and joint pains and food intolerance are common features as well. Contamination with xenobiotic chemicals is frequently found in these patients when they are tested. Reactive airways dysfunction syndrome is a recently identified condition that exhibits features of both asthma and chemical sensitivity. MCS patients frequently have patterns of neurotoxic brain metabolism that can be confirmed on single photo emission computed tomography imaging.

More Research published from 2000 to June 2016

If the study you want to read does not have a link copy and paste the title of the study into google where you will most likely be taken to the study.

Arnold Liamosas, P.A., Arrizabalaga Clement, P., Bonet Agusti, M., de la Fuente Brull, X. “Multiple Chemical Sensitivity in Sick-Building Syndrome.”Medicina Clinica (Barcelona) 126, no. 20 (May 27, 2006):774-78.

Baines, C.J., McKeown-Eyssen, G.E., Riley, N., Cole, D.E., Marshall, L., Loescher, B., Jazmaji, V. “Case-Control Study of Multiple Chemical Sensitivity, Comparing Haematology, Biochemistry, Vitamins and Serum Volatile Organic Compound Measures.” Occupational Medicine 54, no. 6 (September 2004):408-18.

Bell, I.R., Baldwin, C.M., Schwartz, G.E. “Sensitization Studies in Chemically Intolerant Individuals: Implications for Individual Difference Research.” Annals of the New York Academy of Science 453 (2001):38-47.

Belpomme, D., Campagnac, C., Irigaray, P. “Reliable Disease Biomarkers Characterizing and Identifying Electrohypersensitivity and Multiple Chemical Sensitivity as Two Etiopathogenic Aspects of a Unique Pathological Disorder” Review of Environmental Health 30, no. 4 (2015):251-71.

Berg, N.D., Linneberg, A., Dirksen, A., Elberling, J. “Phenotypes of Individuals Affected by Airborne Chemicals in the General Population.”International Archives of Occupational and Environmental Health (August 28, 2008).

Calley, C.S., Kraut, M.A., Spence, J.S., Briggs, R.W., Haley, R.W., Hart, J. Jr. “The Neuroanatomic Correlates of Semantic Memory Deficits in Patients with Gulf War Illnesses: A Pilot Study.”Brain Imaging Behavior 4, nos. 3-4 (December 2010):248-55.

Caress, S.M., Steinemann, A.C.  “Asthma and Chemical Hypersensitivity: Prevalence, Etiology, and Age of Onset.” Toxicology and Industrial Health 25, no. 1 (February 2009):71-78.

Caress, S.M., Steinemann, A.C. “A National Population Study of the Prevalence of Multiple Chemical Sensitivity.” Archives of Environmental Health 59, no. 6 (June 2004): 300-305.

Caress, S.M., Steinemann, A.C. “National Prevalence of Asthma and Chemical Hypersensitivity: An Examination of Potential Overlap.”Journal of Occupational and Environmental Medicine 47, no. 5 (May 2005): 518-22.

Caress, S.M., Steinemann, A.C. “Prevalence of Fragrance Sensitivity in the American Population.” Journal of Environmental Health 71, no. 7 (March 2009):46-50.

Caress, S.M., Steinemann, A.C. “A Review of a Two-Phase Population Study of Multiple Chemical Sensitivities.” Environmental Health Perspectives 111, no. 12 (2003):1490-1497.

Caress, S.M., Steinemann, A.C., Waddick, C. “Symptomatology and Etiology of Multiple Chemical Sensitivities in the Southeastern United States.” Archives of Environmental Health 57, no. 5 (2002):429-36.

Cowan, J., Sinton, C.M., Varley, A.W., Wians, F.H., Haley, R.W., Munford, R.S. “Gene Therapy to Prevent Organophosphate Intoxication.” Toxicology and Applied Pharmacology 173, no. 1 (May 15, 2001):1-6.

Cui, X., Lu, X., Hiura, M., Oda, M., Miyazaki, W., et al. “Evaluation of Genetic Polymorphisms in Patients with Multiple Chemical Sensitivity.” PLoS ONE 8, no. 8 (August 13, 2013):e73708.

Dantoft, T.M., Elberling, J., Brix, S., Szecsi, P.B., Vesterhauge, S., Skovbjerg, S. “An Elevated Pro-Inflammatory Cytokine Profile in Multiple Chemical Sensitivity.” Psychoneuro-endocrinology 40 (February 2014):140-50.

De Luca, C., Gugliandolo, A., Calabrò, C., Currò, M., Ientile, R., Raskovic, D., Korkina, L., Caccamo, D. “Role of Polymorphisms of Inducible Nitric Oxide Synthase and Endothelial Nitric Oxide Synthase in Idiopathic Environmental Intolerances.” Mediators of Inflammation (2015):245-308.

De Luca, C., Raskovic, D., Pacifico, V., Thai, J.C., Korkina, L. “The Search for Reliable Biomarkers of Disease in Multiple Chemical Sensitivity and Other Environmental Intolerances.” Intermational Journal of Environmental Research and Public Health 8, no. 7 (July 2011):2770-97.

Elberling, J., Dirksen, A., Johansen, J.D., Mosbech, H. “The Capsaicin Cough Reflex in Eczema Patients with Respiratory Symptoms Elicited by Perfume.” Contact Dermatitis 54, no. 3 (March 2006):158-64.

Fukuyama, T., Ueda, H., Hayashi, K. Tajima, Y., Shuto, Y., Saito, T.R., Harada, T., Kosaka, T. “Detection of Low-Level Environmental Chemical Allergy by a Long-term Sensitization Method.”Toxicological Letters 180, no. 1 (July 30, 2008):1-8.

Gibson, P.R. “Chemical and Electromagnetic Exposures As Disability Barriers: Environmental Sensitivity.” Disability & Society 24, no. 2 (2009):187-99.

Gibson, P.R., Lockaby, S.D., Bryant, J.M. “Experience of Persons with Multiple Chemical Sensitivity with Mental Health Providers.” Journal of Multidisciplinary Healthcare 9 (2016):163-72.

Gibson, P.R. “Life Indicators, Illness Characteristics, and Psychosocial Concomitants of Self-Reported Multiple Chemical Sensitivity: A Two-Year Longitudinal Study.” Journal of Nursing Education and Practice 4, no. 3 (2014):204.

Gibson, P.R., Elms, A.N., Ruding, L.A. “Perceived Treatment Efficacy for Conventional and Alternative Therapies Reported by Persons with Multiple Chemical Sensitivity.” Environmental Health Perspectives 111 (2003):1498-1504.

Gibson, P.R., Vogel, V.M. “Sickness Related Dysfunction in Persons with Self-Reported Multiple Chemical Sensitivity at Four Levels of Severity.” Journal of Clinical Nursing 18 (2009):72-81.

Gibson, P.R., Kovach, S., Lupfer, A. “Unmet Health Care Needs for Persons with Environmental Sensitivity.” Journal of Multidisciplinary Healthcare 8(January 23, 2015):59-66.

Gibson, P.R., Leaf, B., Komisarcik, V. “Unmet Medical Care Needs in Persons with Multiple Chemical Sensitivity: A Grounded Theory of Contested Illness.” Journal of Nursing Education and Practice 6, no. 5 (2016):75-83.

Gibson, P.R. “Work Accommodation for People with Multiple Chemical Sensitivity.” Disability & Society 22, no. 7 (2007):717-32.

Gibson, P.R. “Of the World But Not in It: Barriers to Community Access and Education for Persons with Environmental Sensitivities.” Health Care for Women International 31, no. 1: (2010):3-16.

Gopinath, K., Gandhi, P., Goyal, A., Jiang, L., Fang, Y., Ouyang, L., Ganji, S., Buhner, D., Ringe, W., Spence, J., Biggs, M., Briggs, R., Haley, R. “FMRI Reveals Abnormal Central Processing of Sensory and Pain Stimuli in Ill Gulf War Veterans.”Neurotoxicology 33. no. 3 (June 2012):261-71.

Haley, R.W., Charuvastra, E., Shell, W.E., Buhner, D.M., Marshall, W.W., Biggs, M.M., Hopkins, S.C., Wolfe, G.I., Vernino, S. “Cholinergic Autonomic Dysfunction in Veterans with Gulf War Illness: Confirmation in a Population-Based sample.JAMA Neurology 70, no. 2  (February 2013):191-200

Haley, R.W, Spence, J.S., Carmack, P.S., Gunst, R.F., Schucany, W.R., Petty, F., Devous, M.D.,  Sr, Bonte, F.J., Trivedi, M.H. “Abnormal Brain Response to Cholinergic Challenge in Chronic Encephalopathy from the 1991 Gulf War.” Psychiatry Research Neuroimaging 171, no. 3 (March 31, 2009):207–20.

Haley, R.W, Tuite, J.J.  “Epidemiologic Evidence of Health Effects from Long-Distance Transit of Chemical Weapons Fallout from Bombing Early in the 1991 Persian Gulf War.

Neuroepidemiology 40, no. 3 (December 2012):178-89.

Hasegawa, M., Ohtomo, M., Mita, H., Akiyama, K. “Clinical Aspects of Patients with MCS from the Standpoint of Allergy.”Japanese Journal of Allergology 54, no. 5 (May 2005):478-84.

Heuser, G., Wu, J.C. “Deep Subcortical (Including Limbic) Hypermetabolism in Patients with Chemical Intolerance: Human PET Studies.” Annals of the New York Academy of Sciences 933 (March 2001):319-22.

Hojo, S., Ishikawa, S., Kumano, H., Miyata, M., Sakabe, K. “Clinical Characteristics of Physician-Diagnosed Patients with Multiple Chemical Sensitivity in Japan.” International Journal of Hygiene and Environmental Health 211, nos. 5-6 (October 2008):682-89.

Inomata, N., Osuna, H., Fujita, H., Ogawa, T. Ikezawa, Z. “Multiple Chemical Sensitivities Following Intolerance to Azo Dye in Sweets in a 5-Year-Old Girl.” Allergology International 55, no. 2 (June 2006): 203-5.

Ishibashi, M., Tonori, H., Miki, T., Miyajima, E., Kudo, Y., Tsumoda, M. Sakabe, K., Aizawa, Y. “Classification of Patients Complaining of Sick House Syndrome and/or Multiple Chemical Sensitivity.” Tohoku Journal of Experimental Medicine 211, no. 3 (March 2007):223-33.

Jinno, H., Tanaka-Kagawa, T., Obama, T., Miyagawa, M., Yoshikawa, J., Komatsu, K., Tokunaga, H. “Impact of Air Fresheners and Deodorizers on the Indoor Total Volatile Organic Compounds.”Kokuritsu Iyakuhin Shokuhin Eisei Kenkyusho Hokoku 125 (2007):72-78.

Katoh, T., Fujiwara, Y., Nakashita, C., Lu, X., Hisada, A., Miyazaki, W., Azuma, K., Tanigawa, M., Uchiyama, I., Kunugita, N. “Application of Metabolomics to Multiple Chemical Sensitivity Research.” Nihon Eiseigaku Zasshi 71, no.1 (2016):94-99.

Kilburn K. “Effects of Diesel Exhaust on Neurobehavioral and Pulmonary Functions.” Archives of Environmental Health 55, no.1 (January/February 2000):11-17.

Kimata, H. “Effect of Exposure to Volatile Organic Compounds on Plasma Levels of Neuropeptides, Nerve Growth Factor and Histamine in Patients with Self-Reported Multiple Chemical Sensitivity.” International Journal of Hygiene and Environmental Health 207, no. 2 (February 2004):159-63.

Kimata, H. “Exposure to Road Traffic Enhances Allergic Skin Wheal Responses and Increases Plasma Neuropeptides and Neurotrophins in Patients with Atopic Eczema/Dermatitis Syndrome.” International Journal of Hygiene and Environmental Health 207, no 1. (January 2004):45-49.

Lee, T.G. “Health Symptoms Caused by Molds in a Courthouse.” Archives of Environmental Health 58, no. 7 (July 2003):442-46.

Levallois, P., Neutra, R., Lee, G., Hristoa, L. “Study of Self-Reported Hypersensitivity to Electromagnetic Fields in California.” Environmental Health Perspectives 110, Suppl. 4 (August 2002):619-23.

McKeown-Eyssen, G., Baines, C., Cole, D.E., Riley, N., Tyndale, R.F., Marshall, L, Jazmaji, V. “Case-Control Study of Genotypes in Multiple Chemical Sensitivity: CYP2D6, NAT1, NAT2, PON1, PON2 and MTHFR.” International Journal of Epidemiology (July 15, 2004):971-78.

Millqvist, E., Ternesten-Hasséus, E., Stǻhl, A., Bende, M. “Changes in Levels of Nerve Growth Factor in Nasal Secretions After Capsaicin Inhalation in Patients with Airway Symptoms from Scents and Chemicals.” Environmental Health Perspectives 113, no. 7 (July 2005):849-52.

Nogué, S., Fernández-Solá, J., Rovira, E., Montori, E., Fernández-Huerta, J.M., Munné, P. “Multiple Chemical Sensitivity: Study of 52 Cases.” Medicina Clinica (Barcelona) 129, no. 3 (June 16, 2007):96-98.

Nutter, T.J., Jiang, N., Cooper, B.Y. “Persistent Na+ and K+ Channel Dysfunctions After Chronic Exposure to Insecticides and Pyridostigmine Bromide.” Neurotoxicology 39 (December 2013):72-83.

Odegard, T.N., Cooper, C.M., Farris, E.A., Arduengo, J., Bartlett, J., Haley, R. “Memory Impairment Exhibited by Veterans with Gulf War Illness.” Neurocase 19, no. 4 (August 2013): 316-27.

Ojo, J.O., Abdullah, L., Evans, J., Reed, J.M., Montague, H., Mullan, M.J., Crawford, F.C. “Exposure to an Organophosphate Pesticide, Individually or in Combination with Other Gulf War Agents, Impairs Synaptic Integrity and Neuronal Differentiation, and Is Accompanied by Subtle Microvascular Injury in a Mouse Model of Gulf War Agent Exposure.” Neuropathology (September 30, 2013):109-27.

Overstreet, D.H., Djuric, V. “A Genetic Rat Model of Cholinergic Hypersensitivity: Implications for Chemical Intolerance, Chronic Fatigue, and Asthma.” Annals of the New York Academy of Science 933 (March 2001):92-102.

Pall, M.L. “Elevated Nitric Oxide-Peroxynitrite Theory of Multiple Chemical Sensitivity: Central Role of N-Methyl-D-Aspartate Receptors in the Sensitivity Mechanism.” Environmental Health Perspectives 111, no. 12 (September 2003):1461-64.

Pall M.L., Anderson J.H. “The Vanilloid Receptor as a Putative Target of Diverse Chemicals in Multiple Chemical Sensitivity.” Archives of Environmental Health 59, no. 7 (2004):363-75.

Pigatto, P.D., Minoia, C., Ronchi, A., Brambilla, L., Ferrucci, S.M., Spadari, F., Passoni, M., Somalvico, F., Bombeccari, G.P., Guzzi, G. “Allergological and Toxicological Aspects in a Multiple Chemical Sensitivity Cohort.” Oxidative Medicine and Cellular Longevity (2013): 356235.

Piroli, A., Ciccozzi, A., Petrucci, E., Paladini, A., Marsili, I., Panella, L., Santucci, C., Coaccioli, S., Marinangeli, F. “Anaesthesia Management in Patients with Multiple Chemical Sensitivity Syndrome.” International Journal of Immunopathology and Pharmacology 26, no. 4 (October-December 2013):961-64.

Rayhan, R.U., Raksit, M.P., Timbol, C.R., Adewuyi, O., Vanmeter, J.W., Baraniuk, J.N. “Prefrontal Lactate Predicts Exercise-Induced Cognitive Dysfunction in Gulf War Illness.” American Journal Translational Research 5, no. 2 (2013):212-23.

Rayhan, R.U., Ravindran, M.K., Baraniuk, J.N. “Migraine in Gulf War Illness and Chronic Fatigue Syndrome: Prevalence, Potential Mechanisms, and Evaluation.” Frontiers of Physiology 4 (July 24, 2013):181.

Rayhan, R.U., Stevens, B.W., Raksit, M.P., Ripple, J.A., Timbol, C.R., Adewuyi, O., VanMeter, J.W., Baraniuk, J.N. “Exercise Challenge in Gulf War Illness Reveals Two Subgroups with Altered Brain Structure and Function.” PLoS One 8, no. 6. (June 14, 2013):e63903.

Rayhan, R.U., Stevens, B.W., Timbol, C.R., Adewuyi, O., Walitt, B, VanMeter, J.W., Baraniuk, J.N. “Increased Brain White Matter Axial Diffusivity Associated with Fatigue, Pain and Hyperalgesia in Gulf War Illness” PLoS One 8, no. 3 (2013):e58493.

Schnakenberg, E., Fabig, K., Stanulla, M., Strobl, N., Lustig, M., Fabig, N., Schloot, W. “A Cross-Sectional Study of Self-Reported Chemical-Related Sensitivity Is Associated with Gene Variants of Drug-Metabolizing Enzymes.” Environmental Health 6, no. 1 (January 2007):6.

Simon, T.R., Rea, W.J. “Use of Functional Brain Imaging in the Evaluation of Exposure to Mycotoxins and Toxins Encountered in Desert Storm/Desert Shield.” Archives of Environmental Health 58, no. 7 (July 2003):406-9.

Spencer, T.R., Schur, P.M. “The Challenge of Multiple Chemical Sensitivity.” Journal of Environmental Health 70, no. 10 (June 2008):24-27.

Steinemann, A.C., Gallagher, L.G., Davis, A.L., MacGregor, I.C. “Chemical Emissions from Residential Dryer Vents During Use of Fragranced Laundry Products.” Air Quality, Atmosphere and Health 6, no. 1 (March 2013):151-56.

Steinemann, A.C. “Fragranced Consumer Products and Undisclosed Ingredients.” Environmental Impact Assessment Review 29, no. 1 (2009):32-38.

Steinemann, A.C., MacGregor, I.C., Gordon, S.M., Gallagher, L.G., Davis, A.L., Ribeiro, D.S., Wallace, L.A.. “Fragranced Consumer Products: Chemicals Emitted, Ingredients Unlisted.”  Environmental Impact Assessment Review 31, no. 3 (2011):328-33.

Steinemann, A.C. “Volatile Emissions from Common Consumer Products.”
Air Quality, Atmosphere & Health 8, no. 3 (June 2015):273-81.

Ternesten-Hasseus, E., Bende, M., Millqvist, E. “Increased Capsaicin Cough Sensitivity in Patients with Multiple Chemical Sensitivity.” Journal of Occupational and Environmental Medicine 44, no. 11 (2002):1012-17.

Ternesten-Hasseus, E., Larsson C., Larsson, S., Millqvist, E. “Capsaicin Sensitivity in Patients with Chronic Cough: Results from a Cross-Sectional Study.” Cough 9, no. 1 (February 28, 2013):5.

Tillman, G.D., Calley, C.S., Green, T.A., Buhl, V.I., Biggs, M.M., Spence, J.S., Briggs, R.W., Haley, R.W., Kraut, M.A., Hart, J. Jr. “Visual Event-Related Potentials as Markers of Hyperarousal in Gulf War Illness: Evidence Against a Stress-Related Etiology.” Psychiatry Research 211, no.3 (March 30, 2013):257-67.

Wiesmuller, G.A., et al. “Nasal Function in Self-Reported Chemically Intolerant Individuals.” Archives of Environmental Health 57, no. 3 (May-June 2002):247-54.

Yun, M.J., Kang, D.M., Lee, K.H., Kim, Y.K., Kim, J.E. “Multiple Chemical Sensitivity Caused by Exposure to Ignition Coal Fumes: A Case Report.” Annals of Occupational & Environmental Medicine 25, no. 1 (November 1, 2013):32.

Research published from 1990 through 1999

Antelman, S.M. “Time-Dependent Sensitization in Animals: A Possible Model of Multiple Chemical Sensitivity in Humans.” Toxicology and Industrial Health 10, nos. 4-5 (July-October 1994):335-42.

Association of Occupational and Environmental Clinics. “Advancing the Understanding of Multiple Chemical Sensitivity.” Toxicology and Industrial Health 8, no. 4 (1992):1.

Ashford, N., Heinzow, B., Lütjen, K., Marouli, C., Mølhave, L., Mönch, B., Papadopoulos, S., Rest, K., Rosdahl, D., Siskos, P., Velonakis, E., et al. “Chemical Sensitivity in Selected European Countries: An Exploratory Study.” A Report to the European Commission. Ergonomia, 1995.

ATSDR (Agency for Toxic Substances and Disease Registry). “Proceedings of the Conference on Low-Level Exposure to Chemicals and Neurobiologic Sensitivity.” Toxicology and Industrial Health 10, nos. 4-5 (1994):25.

Bartha, L., Baumzweiger, W., Buscher, D., Callender, M., Dahl, K., Davidoff, A., et al. “Multiple Chemical Sensitivity: A 1999 Consensus.” Archives of Environmental Health 54, no. 3 (1999):147-49.

Bascom, R. “Multiple Chemical Sensitivity: A Respiratory Disorder.” Toxicology and Industrial Health 8, no. 4 (1991):221-28.

Bascom, R., Meggs, W., Frampton, M., Hudnell, K., Killburn, K., Kobal, G., Medinsky, M., Rea, W. “Neurogenic Inflammation: With Additional Discussion of Central and Perceptual Integration of Nonneurogenic Inflammation.” Environmental Health Perspectives 105, Suppl. 2 (1997):531-37.

Bell, I.R. “Clinically Relevant EEG Studies and Psychophysiological Findings: Possible Neural Mechanisms for Multiple Chemical Sensitivity.” Toxicology 111 (1996):101-17.

Bell, I.R. “White Paper: Neuropsychiatric Aspects of Sensitivity to Low-Level Chemicals: A Neural Sensitization Model.” Toxicology and Industrial Health 10, nos. 4-5 (July-October 1994):277-312.

Bell, I., Baldwin, C., Fernandez, M., Schwartz, G. “Neural Sensitization Model for Multiple Chemical Sensitivity: Overview of Theory and Empirical Evidence.” Toxicology and Industrial Health 15, nos. 3-4 (1999):295-304.

Bell, I., Rossi, J., Gilbert, M., Kobal, G., Morrow, L., Newlin, D., Sorg, B., Wood, R. “Testing the Neural Sensitization and Kindling Hypothesis for Illness from Low Levels of Environmental Chemicals.” Environmental Health Perspectives 105, Suppl. 2 (1997):539-47.

Buchwald, D., Garrity, D. “Comparison of Patients with Chronic Fatigue Syndrome, Fibromyalgia, and Multiple Chemical Sensitivities.” Archives of Internal Medicine 154 (1994): 2049-53.

Callender, T.J., Morrow, L., Submaranium, K. “Evaluation of Chronic Neurological Sequelae After Acute Pesticide Poisoning Using Brain SPECT Scans.” Journal of Toxicology and Environmental Health 41 (1994):275-84.

Cone, J., Sult, T. “Acquired Intolerance to Solvents Following Pesticide/Solvent Exposure in a Building: A New Group of Workers at Risk for Multiple Chemical Sensitivity.” Toxicology and Industrial Health 8, no. 4 (1992):29-39.

Costa, L., Li, W., Richter, R., Shih, D., Lusis, A., Furlong, C. “The Role of Paraoxonase (PON1) in the Detoxication of Organophosphates and Its Human Polymorphism.” Chemico-Biological Interactions 119-120 (1999):429-38.

Davidoff, A., Keyl, P. “Symptoms and Health Status in Individuals with Multiple Chemical Sensitivities Syndrome from Four Reported Sensitizing Exposures and a General Population Comparison Group.” Archives of Environmental Health 51, no. 3 (1996):201-13.

Davidoff, A., Meggs, W. “Development of Multiple Chemical Sensitivities in Laborers After Acute Gasoline Fume Exposure in an Underground Tunneling Operation.” Archives of Environmental Health 53, no.3 (1998):183-89.

Doty, R., Deems, D., Frye, R., Pelberg, R., Shapiro, A. “Olfactory Sensitivity, Nasal Resistance, and Autonomic Function in Patients with Multiple Chemical Sensitivities.” Archives of Otolaryngology-Head and Neck Surgery 114 (1988):1422-27.

Fernandez, M., Bell, I., Schwartz, G. “EEG Sensitization During Chemical Exposure in Women With and Without Chemical Sensitivity of Unknown Etiology.” Toxicology and Industrial Health 15, nos. 3-4 (1999):305-12.

Fiedler, N., Kipen, H., Natelson, B., Ottenweller, J. “Chemical Sensitivities and the Gulf War: Department of Veterans Affairs Research Center in Basic and Clinical Science Studies of Environmental Hazards.” Regulatory Toxicology and Pharmacology 24 (1996):S129-S138.

Fincher, E.F., Chang, T.S., Harrell, E.H., Kettkecut, M.C., Rea, W.J., Johnson, A.R., Hickey, H.C., Simon, T.R. “Comparison of Single Photon Computed Tomography Findings in Cases of Healthy Adults and Solvent-Exposed Adults.” American Journal of Industrial Medicine 31 (1997):4-14.

Galland, L. “Biochemical Abnormalities in Patients with Multiple Chemical Sensitivities.” Occupational Medicine 2, no. 4 (October-December 1987):713-20.

Haley, R., Billecke, S., La Du, B. “Association of Low PON1 Type Q (Type A) Arylesterase Activity with Neurologic Symptom Complexes in Gulf War Veterans.” Toxicology and Applied Pharmacology 157, no. 3 (1999):227-33.

Haley, R.W., Kurt, T.L., Hom, J. “Is There a Gulf War Syndrome? Searching for Syndromes by Factor Analysis of Symptoms.” JAMA 277 (1997):215-222.

Heuser, G. “Diagnostic Markers in Clinical Immunotoxicology and Neurotoxicology.” Editorial. Journal of Occupational Medicine and Toxicology 1, no. 4 (1992):v-x.

Heuser, G., Mena, I., Alamous, F. “Neurospect Findings in Patients Exposed to Neurotoxic Chemicals.” Toxicology and Industrial Health 10, nos. 4-5 (1994):461-571.

Heuser, G., Mena, I. “Neurospect in Neurotoxic Chemical Exposure. Demonstration of Long-Term Functional Abnormalities.” Toxicology and Industrial Health 14, no. 6 (1998):813-27.

Ionescu, G., Merk, M., Bradford, R. “Simple Chemiluminesence Assays for Free Radicals in Venous Blood and Serum Samples: Results in Atopic, Psoriasis, MCS, and Cancer Patients.” Forsch Komplementarmed 6, no. 6 (December 1999):294-300.

Kipen, H.M., Hallman, W., Kang, H., Fiedler, N., Natelson, B.H. “Prevalence of Chronic Fatigue and Chemical Sensitivities in Gulf Registry Veterans.” Archives of Environmental Health 54, no. 5 (September-October 1999):309-11.

Kruetzer, R., Neutra, R., Lashuay, N. “Prevalence of People Reporting Sensitivities to Chemicals in a Population-Based Survey.” American Journal of Epidemiology 150, no. 1 (1999):1-12.

Lax, M., Henneberger, P. “Patients with Multiple Chemical Sensitivities in an Occupational Health Clinic: Presentation and Follow-up.” Archives of Environmental Health 50, no. 6 (1995):425-31.

Lieberman, A.D., Craven, M.R. “Reactive Intestinal Dysfunction Syndrome (RIDS) Caused by Chemical Exposures.” Archives of Environmental Health 54, no. 5 (September-October 1999):365-66.

McFadden, S. “Phenotype Variation in Xenobiotic Metabolism and Adverse Environmental Response: Focus on Sulfur-Dependant Detoxification Pathways.” Toxicology 111 (1996):43-65.

Meggs, W.J. “Hypothesis for Induction and Propagation of Chemical Sensitivity Based on Biopsy Studies.” Review. Environmental Health Perspectives 105 (March 1997).

Meggs, W.J. “Neurogenic Switching: A Hypothesis for a Mechanism for Shifting the Site of Inflammation in Allergy and Chemical Sensitivity.” Environmental Health Perspectives 103, no. 1 (January 1995):54-56.

Meggs, W.J. “RADS and RUDS-The Toxic Induction of Asthma and Rhinitis.” Clinical Toxicology 32, no. 5 (1994):487-501.

Meggs, W.J., Cleveland, C. “Rhinolaryngoscopic Examination of Patients with the Multiple Chemical Sensitivity Syndrome.” Archives of Environmental Health 41, no. 1 (1993):14-18.

Meggs, W.J., Dunn, K., Bloch, R., Goodman, P., Davidoff, L. “Prevalence and Nature of Allergy and Chemical Sensitivity in a General Population.” Archives of Environmental Health 51, no. 4 (1996):275-82.

Meggs, W.J., Elsheik, T., Metzger, W.J., Albernaz, M., Bloch, R.M. “Nasal Pathology and Ultrastructure in Patients with Chronic Airway Inflammation Following an Irritant Exposure.” Journal of Toxicology-Clinical Toxicology 34, no. 4 (1996):383-96.

Miller, C.S. “Possible Models for Multiple Chemical Sensitivity: Conceptual Issues and Role of the Limbic System. Advancing the Understanding of Multiple Chemical Sensitivity.” Toxicology and Industrial Health 8, no. 4 (1992):181-202.

Miller, C.S. “White Paper: Chemical Sensitivity: History and Phenomenology.” Toxicology and Industrial Health 10, no. 4-5 (1994):253-76.

Miller, C.S., Gammage, R.B., Jankovic, J.T. “Exacerbation of Chemical Sensitivity: A Case Study.” Toxicology and Industrial Health 15, nos. 3-4 (April-June 1999):398-402.

Miller, C.S., Mitzel, H. “Chemical Sensitivity Attributed to Pesticide Exposure Versus Remodeling.” Archives of Environmental Health 50, no. 2 (1995):119.

Miller, C.S. “Toxicant-Induced Loss of Tolerance: An Emerging Theory of Disease?” Environmental Health Perspectives 105, Suppl. 2 (1997):445-53.

Miller, C.S., Prihoda, T. “The Environmental Exposure and Sensitivity Inventory (EESI): A Standardized Approach for Measuring Chemical Intolerances for Research and Applications.” Toxicology and Industrial Health 15 (1999):370-85.

Miller, C.S., Prihoda, T. “A Controlled Comparison of Symptoms and Chemical Intolerances Reported by Gulf War Veterans, Implant Recipients, and Persons with Multiple Chemical Sensitivity.” Toxicology and Industrial Health 15 (1999):386-97.

Miller, C.S., Ashford, N., Doty, R., Lamielle, M., Otto, D., Rahill, A., Wallace, L. “Empirical Approaches for the Investigation of Toxicant-Induced Loss of Tolerance.” Environmental Health Perspectives 105, Suppl. 2 (1997):515-19.

Millqvist, E., Bengtsson, U., Lowhagen, O. “Provocations with Perfume in the Eyes Induce Airway Symptoms in Patients with Sensory Hyperreactivity.” Allergy 54, no. 5 (May 1999):495-99.

Nethercott, J., Davidoff, L., Curbow, B., Abbey, H. “Multiple Chemical Sensitivities Syndrome: Toward a Working Case Definition.” Archives of Environmental Health 48 (1993):19-26.

Overstreet, D., Miller, C., Janowsky, D., Russell, R. “Potential Animal Model of Multiple Chemical Sensitivity with Cholinergic Supersensitivity.” Toxicology 111 (1996):119-34.

Rogers, W.R., Miller, C.S., Bunegin, L. “A Rat Model of Neurobehavioral Sensitization to Toluene.” Toxicology and Industrial Health 15, nos. 3-4 (April-June 1999):356-69.

Ross, G.H. “Clinical Characteristics of Chemical Sensitivity: An Illustrative Case History of Asthma and MCS.” Environmental Health Perspectives 105, Suppl. 2 (March 1997):437-41.

Ross, G.H. “History and Clinical Presentation of the Chemically Sensitive Patient.” Toxicology and Industrial Health 8, no. 4 (July-August 1992):21-28.

Ross, G.H., Rea, W.J., Johnson, A.R., Hickey, D.C., Simon, T.R. “Neurotoxicity in Single Photon Computed Tomography Brain Scans of Patients Reporting Chemical Sensitivities.” Toxicology and Industrial Health 15 (1999):415-20.

Rossi, J. “Sensitization Induced by Kindling and Kindling-Related Phenomena as a Model for Multiple Chemical Sensitivity.” Toxicology 111, nos. 1-3 (July 17, 1996):87-100.

Shirakawa, S., Ishikawa, S., Miyata, M., Rea, W.J., Johnson, A.R. “A Pupillographical Study on the Presence of Organochlorine Pesticides in Autonomic Nerve Disturbance.” Nippon Ganka Gakkai Zasshi 94, no. 4 (April 1990):418-23.

Simon, T.R., Hicket, D.C., Fincher, C.E., Johnson, A.R., Ross, G.H., Rea, W.J. “Single Photon Computed Tomography of the Brain in Patients with Chemical Sensitivities.” Toxicology and Industrial Health 10, nos. 4-5 (1994):573-77.

Sorg, B.A., Hochstatter, T. “Behavioral Sensitization After Repeated Formaldehyde Exposure in Rats.” Toxicology and Industrial Health 15, nos. 3-4 (April-June 1999):346-55.

Sorg, B.A. “Multiple Chemical Sensitivity: Potential Role for Neuralsensitization.” Review. Critical Reviews in Neurobiology 13, no. 3 (1999):283-316.

Sorg, B. “Proposed Animal Model for Multiple Chemical Sensitivity in Studies with Formalin.” Toxicology 111 (1996):135-45.

Tuite, J.J., Haley, R.W. Meteorological and Intelligence Evidence of Long-Distance Transit of Chemical Weapons Fallout from Bombing Early in the 1991 Persian Gulf War. Neuroepi-demiology (December 2012) 40 3 160-177.


Research published before 1990

Randolph, T.G. “Clinical Manifestations of Individual Susceptibility to Insecticides and Related Materials.” Industrial Medicine and Surgery 34 (February 1965):134-42.

Randolph, T.G. “Dynamics, Diagnosis, and Treatment of Food Allergy.” Review. Otolaryngology Clinics of North America 7, no. 3 (October 1974):617-35.

Randolph, T.G. “Ecologic Orientation in Medicine: Comprehensive Environmental Control in Diagnosis and Therapy.” Annals of Allergy 23 (January 1965):7-22.

Randolph, T.G. “Human Ecology and Susceptibility to the Chemical Environment.” Annals of Allergy 19 (May 1961):518-40.

Randolph, T.G. “Human Ecology and Susceptibility to the Chemical Environment: Air Pollution.” Annals of Allergy 19 (June 1961):657-77.

Randolph, T.G. “Human Ecology and Susceptibility to the Chemical Environment.” Annals of Allergy 19 (July 1961):779-99.

Randolph, T.G. “Human Ecology and Susceptibility to the Chemical Environment.” Annals of Allergy 19 (August 1961):908-29.