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(c) 2004 by ALBERT DONNAY = ;
Multiple Chemical Sensitivity
... or MUSES Syndrome ?
u
Presented to the
Occupational Medicine Residents’ Seminar Series Environmental & Occupational Health Sciences Institute
Rutgers University, Piscataway NJ
 17 February 2004
by Albert Donnay, MHS, adonnay@jhu.edu
MCS Referral & Resources, www.mcsrr.org

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(c) 2004 by ALBERT DONNAY = ;
<= span style=3D'font-size:106%'>u1999 Consensus Definition (Arch Env Health 1999;54:1= 47-9)
  [1] MCS is a chronic cond= ition
u[2] marked by multiple symptoms in multiple or= gans
u[3] that recur reproducibly
u[4] in response to low levels of exposure *= 3;
u[5] to multiple unrelated chemicals and <= /i>
u[6] improve or resolve when incitants are remo= ved.
= uBest of  7 MCS Definitions at identifying MCS cases
 (McKeown-Eyssen = et al, Arch Env Health 2001;56:406-12)
Language is tricky: english, canadian, american
So I will try to be careful with my terminology
First, what do I mean by MCS?
Only disease def’d without ref to symptoms
Best of 7z


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(c) 2004 by ALBERT DONNAY = ;
How Many MCS Symptoms H= ave Been Reported ? 
List compiled by JHU Multi-Cen= ter Study of MCS Immunology
<= span style=3D'font-family:Arial'>uCARDIOVASCULAR<= span style=3D'mso-spacerun:yes'>  9
uDIGESTIVE 18
uEARS // HEARING=   7
uEYES // VISION<= span style=3D'mso-tab-count:1;width:17.26%'> 12
uGENITO-URINARY = 10
uHEAD   6
uMOUTH // TASTE<= span style=3D'mso-tab-count:1;width:10.55%'> 14
uMUSCULOSKEL. 14
uNECK   3
u
<= span style=3D'visibility:hidden'>u
<= span style=3D'font-family:Arial'>uNERVOUS SYSTEM<= span style=3D'mso-spacerun:yes'>  43
<= span style=3D'font-family:Arial'>uNOSE // SMELL <= span style=3D'mso-tab-count:1;width:13.75%'>   10
uSYSTEMIC // OTH= ER 17
<= span style=3D'font-family:Arial'>uVASCULAR     5
<= span style=3D'font-family:Arial'>uREPRODUCTIVE   17
<= span style=3D'font-family:Arial'>uRESPIRATORY     6
<= span style=3D'font-family:Arial'>uSKIN // TOUCH        = ;    7
<= span style=3D'font-family:Arial'>uTHROAT         = ;     5
Þ TOTAL # SYMPTOMS =3D  203
<= span style=3D'visibility:hidden'>Þ
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(c) 2004 by ALBERT DONNAY = ;
What Objective Findings Are Repor= ted in MCS ?
= uAbnormal Blood & Plasma
= uImpaired Circulation
= uImpaired Heart Function =
= uImpaired Detox Pathways <= /div>
= uEar & Hearing Abnormalities =
= uEndocrine Deficiencies
= uEye & Vision Abnormalities <= /span>
= uGastrointestinal Impairment
= uImmune System Activation =
= uIncreased Mast Cells
= uMineral Deficiencies
u
u Musculoskeletal Abnormalities =
<= span style=3D'font-family:"Arial Narrow";font-size:117%'>u Neurocognitive Deficiencies
<= span style=3D'font-family:"Arial Narrow";font-size:117%'>u Nose & Smell Abnormalitites= 3;
u Porphyrin Enzyme Abnorm. <= /span>
<= span style=3D'font-family:"Arial Narrow";font-size:117%'>u Respiratory Impairment
u Sensory Nerve Impairment <= /span>
<= span style=3D'font-family:"Arial Narrow";font-size:117%'>u Skin Tone Abnormalities
<= span style=3D'font-family:"Arial Narrow";font-size:117%'>u Vestibular Impairment
<= span style=3D'font-family:"Arial Narrow";font-size:117%'>u Vitamin Deficiencies
= u Xenobiotics in Fat, Blood,
    Urine = and Hair
Refs online at www.mcsrr.org
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(c) 2004 by ALBERT DONNAY = ;
Who is Funding This MCS Research ?
uMost MCS-related papers do not acknowledge any funding !
uBut 10 US federal agencies fund over $25M per year: ATSDR,
CDC, DOD, DOE, DVA, EPA, NIDCD, NIEHS, NIH & NIOSH <= /span>
uUS Dept of Defense also funds MCS studies of UK veterans
uState governments in California, Maryland, Missouri, New Jersey, New Mexico & Washington have funded MCS studies
<= span class=3DBB style=3D'position:absolute;left:-3.04%;top:.3em'>uBoth p= atient support groups (eg. CIIN) and chemical industry front groups (e= g. ESRI) have funded MCS conferences and
pilot studies that reflect their respective biases. =
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(c) 2004 by ALBERT DONNAY = ;
Which View Predominates: Physical= or Psychiatric ?
u     Overlaps:
Only 11% of
First Authors
and 30% of Publishers have ever  supported more than
one view !!!
u
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(c) 2004 by ALBERT DONNAY = ;
On What Do All Agree? Prevalence = is Very High !
u5 US studies find 28% - 37% of adul= ts say they are
“especially sensitive” to common chemical exposures
<= span class=3DBB style=3D'position:absolute;left:-3.0%;top:.3em'>u4 US st= udies find 15% - 17% say they’re “unusually sensitive”
u6.3% i= n CA and 1.9% in NM say they have been diagnosed
by a medical professional with MCS or “environmental illness”
<= span class=3DBB style=3D'position:absolute;left:-3.15%;top:.3em'>uUS, Ca= nadian and UK studies of Gulf War veterans all find
an increased prevalence of (still undiagnosed) MCS with a <= /span>