In "Sick of it All" (June), Michael Fumento did not discuss the connection between multiple chemical sensitivity and airway inflammation that has been documented by a number of investigators. A controlled study of chemically sensitive patients performed by Richard Doty and his collaborators at the University of Pennsylvania's Center for Taste and Smell Research found that these patients had increased nasal resistance relative to a control group. This observation led me to carefully examine the upper airways of the patients I saw with chemical sensitivity using a fiber optic laryngoscope, and every patient had gross inflammation on examination. To further investigate this issue, a research protocol was developed to perform nasal biopsies on MCS patients to see if a reason could be found for their heightened sensitivity to chemicals. The results were astonishing, for these patients have an increase in the nerve fibers in the upper airway that are known to respond to chemical irritants by producing inflammation. We also saw chronic inflammation, as well as gaps in the protective layer of cells lining the upper airway, so that the nerves can have an increased exposure to chemicals. Rebecca Bascom and her collaborators at the University of Maryland found in a controlled study that individuals with a sensitivity to environmental tobacco smoke developed increases in nasal resistance on exposure, but there was no change for the individuals in the control group.
The question can be turned around. Do people with airway inflammation (i.e., asthma and rhinitis) have chemical sensitivity? Surveys have found that asthma and rhinitis patients report exacerbations of their symptoms by the same chemicals the MCS patients complain of, such as tobacco smoke, perfumes, and pesticides. That some of these substances do indeed trigger changes in the airway has been proven in research studies. Further, it has been documented that a single acute high-dose exposure to irritating chemicals can produce asthma and/or rhinitis that is chronic and persistent, long after the exposure is over. Fumento's conclusion that individuals with chemical sensitivity are "trapped in a hell of their own--or their doctor's--creation" may apply to some individuals with chemical sensitivity, but it certainly does not apply to those who get severe respiratory tract inflammation when exposed to substances such as cigarette smoke and perfume.
William J. Meggs, M.D.
New York, NY
I thought we'd outgrown the dark ages that dismissed health-conscious, body-aware individuals as "hypochondriacs," accused sympathetic doctors of pampering them, and gave allergies, in particular, a bum rap. People have died of things that doctors dismissed as "psychosomatic."
For about 30 years I suffered from extreme cold sensitivity and from ridicule for wearing a mask or scarf outdoors. Cold still puts some limits on my life. I can tell you from experience, a mask-wearer is not hiding from life, but showing a lot of guts, getting out there and braving the ridicule.
Maybe some MCS sufferers are exaggerating or even imagining their problems. But maybe some aren't. Maybe the woman who hangs her mail out is really that sensitive to ink. I discovered I'm sensitive to standard newsprint ink; now I find I'm not alone, and our Austin newspaper and phone book have switched to hypo-allergenic ink.
Michael Fumento's article leaves readers with the impression that only liberals get MCS. Wrong. Nor does having MCS turn people into leftist environmentalists. The only thing MCS patients have in common is a belief that not enough is known about the impact that toxic chemicals have on human health, and that what is known is scary.
In addition, Fumento's story contained several factual errors. For example, there are more articles on MCS as a physiological illness in peer-reviewed medical and scientific journals than articles concluding MCS is psychogenic.
I also think Fumento confused MCS with chronic fatigue syndrome, which is diagnosed, in part, by a lack of objective medical findings. With few exceptions, in order to get a diagnosis of MCS, patients must have at least four positive tests of objective damage in more than one of the following areas: central nervous system, immune system, porphyrin biosynthetic pathway, lungs, sinuses, and peripheral nervous systems.
The World Health Organization workshop mentioned in the article was actually sponsored by the International Programme on Chemical Safety. In its report on the workshop, IPCS stated, "These conclusions and recommendations...do not necessarily represent the decisions or the stated policy of the United National Environmental Programme, the International Labour Organization, or the World Health Organization."
While this is not a mistake, I think since Fumento flaunted the supposed liberal bias of MCS supporters, he should have mentioned, at least in passing, the industry bias of Dr. Ronald E. Gots. Dr. Gots, under oath, did not dispute the fact that 95 to 100 percent of his time is spent working on behalf of industry. It is important that people know where everyone stands on the MCS issues because the tone of the controversy was set in 1991 by the Chemical Manufacturer's Association when it stated, "There is no doubt these patients are ill....The primary impact on society would be the huge cost associated with the legitimization of environmental illness." There were many other factual distortions in Fumento's article, but I'm certain they were intentional and any attempt to set the record straight would simply fall on deaf ears.
Chemical Injury Information
White Sulphur Springs, MT
Michael Fumento makes many ill-founded remarks about the treatment of MCS by clinical ecologists and, while so doing, fails to draw attention to the parallels between the management of MCS, as he portrays it, and the diagnoses and treatment of several syndromes and diseases recognized by mainstream medicine.