Letters to the Editor

Multiple Chemical Sensitivity



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Am Fam Physician. 2000 Jan 1;61(1):45.

to the editor: In their recent letter to the editor,1 Drs. Fung and Kennon misrepresented the position of the World Health Organization (WHO) when they stated that WHO recommends changing the name of multiple chemical sensitivities (MCS) to “idiopathic environmental intolerances.” The reference2 that the authors cited in their letter was anonymously published and was not authorized by the workshop's sponsors (UNEP-ILO-WHO). It contained the following disclaimer:

“These conclusions and recommendations contain the collective views of an international group of experts and do not necessarily represent the decisions or the stated policy of the United Nations Environment Programme (UNEP), the International Labour Organization (ILO) or the World Health Organization (WHO).”2

Despite this disclaimer, some of the workshop participants began to misrepresent WHO's position on MCS after the meeting. In response, WHO issued a statement to participants,3 which reaffirmed the disclaimer and stated that “(w)ith respect to ‘MCS’, WHO has neither adopted nor endorsed a policy or scientific opinion.”

REFERENCES

1. Fung F, Kennon R. Understanding patients with multiple chemical sensitivity [Letter]. Am Fam Physician. 1999;59:2108–9.

2. UNEP-ILO-WHO. Conclusions and recommendations of a workshop on multiple chemical sensitivities (MCS). Regul Toxicol Pharmacol. 1996;24:188–9.

3. World Health Organization. Note to Invited Participants in “MCS” Workshop, 21–23 February 1996, Berlin, Germany, June 7, 1998.

in reply: Dr. McCampell's letter1 appears to mis-state the content of our previous letter2 and then claims that the mis-stated information is a misrepresentation. In the era of evidence-based medicine, we have not seen validated evidence to support any pathophysiologic basis for “multiple chemical sensitivity.” We also would like to point out that the position papers3,4 previously used the term “idiopathic environmental intolerances” based on a published article.5

We remain comfortable about the objectivity and the contribution to the discussion presented in our letter.2 Staudenmayer6 states it best, “If all concerned would adhere to the scientific method and respect the principles of physics and chemistry that are the foundation of toxicological and biological medicine, this phenomenon will more likely find a resolution.”

REFERENCES

1. McCampell A. Understanding patients with multiple chemical sensitivity [Letter]. Am Fam Physician. 1999;59:2111–2.

2. Fung F, Kennon R. Understanding patients with multiple chemical sensitivity [Letter]. Am Fam Physician. 1999;59:2108–9.

3. Terr AI, Bardana EJ, Altman LC. Idiopathic environmental intolerances (IEI) [Position Paper]. AAAAI Board of Directors. J Allergy Clin Immunol, Academy News. June/July, 1997.

4. Idiopathic environmental intolerances (IEI) [Position Paper]. AAAAI Board of Directors. J Allergy Clin Immunol. 1999;103:36–40.

5. UNEP-ILO-WHO. Conclusions and recommendations of a workshop on multiple chemical sensitivities (MCS). Regul Toxicol Pharmacol. 1996;24:188–9.

6. Staudenmayer H. Environmental illness and multiple chemical sensitivity [Letter]. J Occup Environ Med. 1996;38:17.

Send letters to Kenneth W. Lin, MD, MPH, Associate Deputy Editor for AFP Online, e-mail: afplet@aafp.org, or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680.

Please include your complete address, e-mail address, and telephone number. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors.

Letters submitted for publication in AFP must not be submitted to any other publication. Possible conflicts of interest must be disclosed at time of submission. Submission of a letter will be construed as granting the American Academy of Family Physicians permission to publish the letter in any of its publications in any form. The editors may edit letters to meet style and space requirements.


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