Self-reported chemical sensitivity in Germany: a population-based survey.
ABSTRACT Environmental clinics are frequented by patients with fears and complaints related to environmental triggers. A dose-independent overreaction to small doses of widely used and generally non-toxic chemicals is referred to as multiple chemical sensitivity (MCS), but no clearly defined clinical syndrome with objective physical findings has been delineated so far. We aimed to obtain information about symptoms, supposed environmental triggers, the frequency of self-reported chemical sensitivity, and of the diagnosis MCS in Germany.
We conducted a representative survey among 2032 adult Germans.
We found self-reported chemical sensitivity in 9% and physician-diagnosed MCS in 0.5% of our representative sample. Physical complaints were common in the whole study population and in chemically sensitive individuals, but there was no clear-cut symptom constellation among the latter. The most common complaints were headache, fatigue, sleep disturbances, joint pain, mood changes and nervousness. A subjective connection between complaints and environmental triggers was denied by 67% of the whole group and by 35% of the self-reported chemically sensitive. Factor analysis of environmental triggers suggested that a specific exposure situation rather than chemical similarity is the basis for individual trigger combinations.
The prevalence of subjective sensitivity towards chemicals is similar to such rates reported from other countries. There is a relatively low awareness of the MCS-concept, and it appears to be diagnosed less frequently than, e.g., in the USA. Since symptoms and triggers in chemically sensitive individuals did not differ from the general population, our data do not suggest the existence of a widespread new syndrome related to chemical sensitivities in Germany. We outline the limitations of self-reported chemical sensitivity as the major criterion for such a contentious diagnosis as MCS.
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ABSTRACT: There has been increasing recognition in the medical community and the general public of the widespread prevalence of gluten sensitivity. Celiac disease (CD) was initially believed to be the sole source of this phenomenon. Signs and symptoms indicative of nonceliac gluten sensitivity (NCGS), in which classical serum and intestinal findings of CD may be absent, have been frequently reported of late. Clinical manifestations in patients with NCGS are characteristically triggered by gluten and are ameliorated or resolved within days to weeks of commencing a gluten-free diet. Emerging scientific literature contains several reports linking gluten sensitivity states with neuropsychiatric manifestations including autism, schizophrenia, and ataxia. A clinical review of gluten sensitivity is presented alongside a case illustrating the life-changing difference achieved by gluten elimination in a patient with a longstanding history of auditory and visual hallucinations. Physicians in clinical practice should routinely consider sensitivity issues as an etiological determinant of otherwise inexplicable symptoms. Pathophysiologic mechanisms to explain the multisystem symptomatology with gluten sensitivity are considered.Gastroenterology Research and Practice 01/2014; 2014:293206. · 1.62 Impact Factor
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ABSTRACT: Life indicators, illness characteristics, and psychosocial concomitants were measured in a large sample of persons self-reporting multiple chemical sensitivity. Cross-sectional data are presented for 305 persons who responded to written surveys. Examined are employment status, income, relationship status, illness characteristics such as length, severity, and age respondents became sensitive, money spent on physicians and on home alterations, situations reported to cause the initial sensitization, and the psychosocial measures of social support and psychosocial adjustment to illness. In addition, relevant life indicators are re-examined two years later and presented for 209 persons who continued to participate. This paper examines life indicators for persons of four levels of severity of condition and three courses of condition over time.Journal of Nursing Education and Practice. 01/2014; 4(3):204-216.
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ABSTRACT: Background Multiple chemical sensitivity (MCS) is a medically unexplained condition characterized by reports of recurrent unspecific symptoms attributed to exposure to low levels of common volatile chemicals. The etiology of MCS is poorly understood, but dysregulation of the immune system has been proposed as part of the pathophysiology. Objective To compare plasma levels of cytokines in Danish MCS individuals with a healthy, sex- and age-matched control group. Method Blood samples were obtained from 150 un-exposed MCS individuals and from 148 age- and sex-matched healthy controls. Plasma concentrations of 14 cytokines, chemokines and growth and allergen-specific IgE were measured. All participants completed a questionnaire including questions on MCS, psychological distress, morbidities and medication use at the time of the study. Results Plasma levels of interleukin-1β, -2, -4, and -6 were significantly (P < 0.001) increased in the MCS group compared with controls, tumor necrosis factor-α was borderline significantly (P = 0.05) increased and interleukin-13 was significantly decreased (P < 0.001). Conclusion MCS individuals displayed a distinct systemic immune mediator profile with increased levels of pro-inflammatory cytokines and interleukin-2 and inverse regulation of Th2 associated cytokines interleukin-4 and interleukin-13 suggestive of low-grade systemic inflammation, along with a deviating Th2-associated cytokine response not involving IgE-mediated mechanisms.Psychoneuroendocrinology 01/2014; 40:140–150. · 5.14 Impact Factor