PESTICIDE PERCEPTIONS

World Health Organization Workshop on Multiple Chemical
Sensitivities: Recommendations for a Name Change and Specific
Conclusions

21-23 February 1996, a select panel from seven countries met in
Berlin Germany to discuss the phenomenon which has been called
"Multiple Chemical Sensitivities (MCS)". The panel concluded that
the name MCS should be discontinued because it makes an
unsupported judgement about cause(s). The recommended new name is
Idiopathic Environmental Intolerances (IEI).

The workshop was convened under the auspices of the World Health
Organization and the German Ministries of Health, of Health
Protection and of the Environment.

Some of the conclusions reached by the panel include:

1. The name MCS (multiple chemical sensitivities) should be
   discontinued because it makes an unsupported judgement about
   causation. The recommended new name is Idiopathic
   Environmental Intolerances (IEI). This also recognizes the
   fact that many environmental intolerances other than
   chemicals are claimed in various countries. These are
   characterized by similar symptoms and include--dental
   amalgams, electric and magnetic fields, and others.

2. IEI (formerly MCS) cannot be recognized as a
   clinically-defined disease. There are neither accepted
   underlying mechanisms; nor validated clinical criteria for
   diagnosis. A relationship between exposures and symptoms is
   unproven.

3. IEI is defined as:
   * An acquired disorder with multiple recurrent symptoms. 
   * Associated with diverse environmental factors tolerated by
     the majority of people.
   * Not explained by any known medical or psychiatric disorder. 

4. Clinical assessment should be designed to rule out any 
   medical or psychiatric conditions requiring therapy.

5. There are no specific tests to establish the IEI condition. 
   Certain tests such as immunological testing, porphyria
   testing, neuroimaging, biological monitoring and alternate
   medicine tests are of no confirmatory value.

6. Effective treatment has not been validated in controlled
   clinical trials. There is no justification for chelation
   therapy or other detoxification procedures including "sauna
   detoxification."

7. Approaches to care based on understanding and supportive care
   are appropriate.

   Avoidance and psychological/psychiatric care are the common 
   approaches.  Avoidance to minimize exposures may, in some
   instances be appropriate, but isolation of patients from the
   general environment may have adverse consequences. 

   Psychological/psychiatric approaches currently include
   self-regulation (relaxation, biofeedback), behavioral
   therapy, psychopharmacological treatment, cognitive therapy,
   and insight-oriented therapy which are tailored to the
   individual's condition. 

8. Human research is urgently needed to determine the nature 
   (e.g., psychogenic, toxicogenic) of IEI. The key question is
   whether subjects with IEI are able to distinguish in a
   double-blind placebo-controlled challenge study between
   reported environmental (e.g., chemical) triggers and
   placebos.

(From: Ronald E. Gots, M.D., Ph.D., Executive Director,
Environmental Sensitivity Research Institute, Rockville,
Maryland, USA via ag-health, the Newsgroup of the UC Agricultural
Health and Safety Center at Davis, CA.)