• Multiple Chemical Sensitivity
• Court Cases Involving MCS
• Definitions of MCS
• Selected Bibliography
• Toxic Notes
• Toxic Tips

The vast array of symptoms attributed to MCS and the lack of solid scientific evidence in the medical literature to date, validating MCS as a disease, is the main reason many in the medical community are skeptical of classifying it as a legitimate health syndrome. Mainstream doctors contend it is far too easy to ascribe MCS as the causation of ailments that run the gamut from health nuisances to actual threats to human life. Most courts have also rejected the claims of MCS patients and their scientific supporters, known as clinical ecologists. In a recent edition of Lancet, the claims of MCS adherents were likened to the medieval belief in supernatural "little arrows" as the cause of physiological ailments: "although in our advanced society we do not believe in little arrows, there is a constant desire to blame external influences for all kinds of adversity, especially for ill health. . . [such as] exposure to chemicals in the environment." Many scientists see in many of the MCS claims a confusion between effects, causes, and symptoms.

While efforts to understand MCS generally have focused on the problem as a syndrome or specific illness with diverse symptoms, one recent study looked at MCS rather as a mechanism for disease. One researcher believes it is erroneous to define MCS as illness resulting from chemical exposure, positing instead the phrase "toxicant-induced loss of tolerance" as a definition that more accurately describes what is theorized as a two step process. First, is either an initial or continuing exposure to pesticides, solvents, or air contaminants in a sick building which interacts with a susceptible individual, causing loss of tolerance for everyday, low level chemical inhalants (car exhaust, fragrances, cleaning agents) as well as for foods, drugs, alcohol, and caffeine--substances that usually provide no health difficulties; subsequently, such common, formerly well-tolerated substances, now linked in the personal history of the patient with more troublesome chemicals, trigger symptoms, thus causing or prolonging illness.

Though MCS as a correctly diagnosed syndrome has never been accepted by most medical associations, including the AMA, it has nevertheless made its way into American courtrooms, finding some success in Workers' Compensation lawsuits, liability case law, and federal regulation interpretations, such as the Department of Housing and Urban Development, the Social Security Administration, the Department of Transportation, and the Department of Education.

In a 1995 study, researchers found that over sixty percent of court cases in which plaintiffs allege MCS, the exposures most often dealt with by the court concerned solvents, poor indoor air quality, and materials used in building remodeling.

Frequently cited by courts--most particularly, Bradley v Brown--as justification for excluding MCS testimony is the vagueness of what MCS actually is, even when offered by proponents of the syndrome. Beyond the plethora of symptoms listed in Table I and the purported causes shown in Table II, many various syndromes have been appellated to Multiple Chemical Sensitivity, complicating the effort of a sound definition for MCS: allergic toxemia, cerebral allergy, chemical hypersensitivity syndrome, chemical-induced immune dysfunction, environment illness, environmental hypersensitivity disorder, Gulf War Syndrome, immune system dysregulation, sick building syndrome, toxic carpet syndrome, and the coup de grace, 20th Century Disease. (See Table IV)

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Recent Court Rulings Involving MCS Hundley v Norfolk & Western Railway Co., 1996 U.S. Dist. (N.D. Ill., 1996)--cited four reasons in excluding testimony by MCS experts and consequently granting judgement in favor of the defendant: (1) MCS methodology did not conform to scientific method; (2) MCS theories have yet to be subjected to peer review; (3) no feasible method exists to assess the rate of error of clinical ecology; (4) the rejection of clinical ecology by the scientific community. Denise Kehoe v Lockheed Sanders, Inc. New Hampshire Supreme Court, 1995--ruled that MCS was justified as a means for Ms. Kehoe to collect Workers' Compensation benefits. In finding for the plaintiff, who had reported symptoms of painful headaches, allergies, and other assorted respiratory problems from chemical exposure on the job, the court found that "little doubt exists that multiple chemical sensitivity syndrome due to workplace exposure is an occupational disease compensable under our workers' compensation statute." Carlin v RFE Industries, Inc., 1995 U.S. Dist. )N.D. N.Y. 1995)--ruled that testimony on MCS was unscientific on two fronts and subsequently subject to exclusion: (1) diagnoses were based on unsubstantiated and uncorroborated studies; and (2) previous court rulings, Bradley v Brown and Summers v Missouri Pacific Railroad System 897 F. Suppl. 533 (E.D. Okla., 1995) had discredited MCS generally. Bradley v Brown, 42 F. 3rd 434 (7th Cir. 1994) aff g F. Suppl. 690 (N.D. Ind. 1994)--held that the trial court's exclusion of data by an MCS clinical ecologist was correct in finding that "opinions about MCS's cause are, at best, hypothetical." In ruling that the theories of MCS have not been adequately tested, the court found that the "etiology of MCS has not progressed from the plausible, that is, the hypothetical, to knowledge capable of assisting a fact-finder, jury, or judge." Bahura v S.E.W. Investors, (D.C. Super. Ct. Dec. 23, 1993)--found the EPA negligent and awarded judgements to employees who claimed MCS after being exposed to contaminants during building renovation in which numerous chemicals were used without using adequate ventilation systems. McCreary v Industrial Commission of Arizona, 835 P.2nd 469, 471 (Ariz. Ct. App., 1992)--reversed lower court in finding that MCS was grounds for award under the state's accidental injury statute and that an employee was injured by being relocated to a new building where exposure to chemicals resulted in illness.

Table III

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Recent MCS Definitions Patients must have symptoms or signs related to chemical exposures at levels tolerated by the population at large. The symptoms must wax and wane with exposures and may be expressed in one or more organ systems. A chemical exposure associated with the onset of the condition doesn't have to be identified, and pre-existent or concurrent conditions--such as asthma, arthritis, or depression--should not exclude patients.--National Academy of Sciences, 1991. MCS is an acquired disorder characterized by recurrent symptoms, referable to multiple organ systems, occurring in response to demonstrable exposure to many chemically unrelated compounds of doses far below those estabilished in the general population to cause harmful effects. No single widely accepted test of physiologic function can be shown to correlate with symptoms. Mark Cullen, Professor of Medicine and Epidemiology, Yale University, "The Worker with Multiple Chemical Sensitivities: An Overview." Occupational Medicine 2:4 (1987): 655-661. (MEDLINE) MCS is a syndrome where individuals experience adverse, often debilitating, acute, and chronic health effects when exposed to any amount of an offending substance. Hypersensitivity describes those people whose immune systems have become highly sensitized to herbicides (or other chemicals) and who experience adverse health effect to minute amounts, even order of magnitude less than would affect the average person. Plaintiffs, Salmon River Concerned Citizens v Robertson, 32 F.3rd 1346, 1359 n.2 (9th Circ. 1994) MCS is a multi-symptom disorder which can be caused by exposure to chemical or environmental incitants. MCS results in a hyper-sensitivity to what would normally be acceptable doses of chemicals. Seventh U.S. Circuit Court Ruling, Bradley v Brown, 42 F.3rd 434, 436 n.1 (7th Cir. 1994).

Table IV

The court cases in Table III and the nebulous quality of the definitions offered so far by the legal and medical communities indicate that a clear consensus on the issue of MCS is a difficult matter. Perhaps the greatest problem is one that confronts virtually all claims in the toxic courtroom. As readers of the July1996 MTI review will recall, the lack of consensus in the scientific community is one of the main stumbling blocks for any issue in the path to an arrival at toxic truth. In a recent article in Defense Counsel Journal, attorney Wendi J. Berkowitz suggests that MCS is now and may forever be an entirely speculative and therefore unscientific endeavor. In the wake of 1993's Daubert v Merrill Dow Pharmaceuticals, which stipulated the burden of proof for expert testimony in scientific cases, she argues that unless clearer links to science are made that can create a consensus, MCS and clinical ecology claims may never be routinely accepted into medical cases in the nation's courtrooms.

However, such "clearer links to science" may be on the horizon. To date, three federally funded workshops have collated scholarship on MCS, the EPA recently sponsored a conference on the subject, and in Nova Scotia, Dalhousie University has established a clinic, with the Canadian government's backing, to help understand the syndrome better. Research into the physiological nature of MCS continues apace and the future should provide the consensus on

whether there exists a common mechanism or a continuum of confusion. At the very least, one may realistically expect the debate over MCS to continue. Selected Bibliography following

• Table I
• Table II
• Table III
• Table IV

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1. Berkowitz, Wendi J. "Multiple Chemical Sensibility in the Courtroom: Is There Life After Daubert?" Defense Counsel Journal (Oct 1996): 483-490.
2. Lieberman, Michael S.; DiMuro, Bernard J.; Boyd, John B. "Multiple Chemical Sensitivity: An Emerging Area of Law." Trial (Jul 1995): 22- 33.
3. Miller, C.S. "Chemical Sensitivity: Symptom, Syndrome, or Mechanism for Disease?" Toxicology 17 (Jul 1996): 69-86.
4. Pirages, Suellen; Richard, Cindy L. "Multiple Chemical Sensitivities." AIHA Journal (Feb 1997): 94-97.
5. Waldron, H.A. "Little Arrows." Lancet 346 (Dec 2 1995): 1475.

Complete Bibliography Available on Request

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