When Marny Turvil of suburban Evanston gets a whiff of certain cleaning products, fabric softener or gasoline fumes, she feels depressed, irritable, tired and foggy-headed.

At least one doctor has ridiculed her self-diagnosed hypersensitivity to chemicals. Friends wondered about her mental health. And once, while on an airplane, a perfumed flight attendant gazed at the respiratory mask and snarkily asked, "Where are you going, Mt. Everest?"

Such is life with a disorder known as multiple chemical sensitivity, or MCS, a confounding illness that is not officially recognized by the U.S. medical establishment but has very real symptoms for an estimated 12 percent of the population.

Though a controversial new branch of medicine called clinical ecology (or environmental medicine) has sprung up to help treat people who are hypersensitive to chemicals, the disagreement over whether the condition actually exists has provoked a schism among physicians and made it difficult to find care and research funding.

The theory behind the disorder is that vague symptoms such as fatigue, depression, memory loss, headaches, confusion and difficulty concentrating are triggered by either one large chemical exposure such as a pesticide application or low-level exposure to everyday chemicals in the environment. But so far science hasn't been able to link the causes and symptoms that patients describe.

"People who don't have it think we're crazy, making it up or hypochondriacs because (the triggers) are products that people are around all the time but have no problem with," says Turvil, a pediatrician who recently retired from practice to open Health Green Goods in suburban Evanston, a store caters to those with environmental sensitivities.

MCS, which has been described since the 1940s, has been discounted as an organic disease by several groups, including the American Medical Association and the American Academy of Allergy, Asthma and Immunology. It's often confused with an allergy because many of the reactions - including headaches, fatigue, general malaise, swelling and breathing difficulties - can be the same as those in delayed-type allergic reactions to foods.

"We have no real evidence to believe those things, at least in mainstream medicine," says dermatologist Andrew Scheman, director of the North Shore Center for Medical Aesthetics, who specializes in contact allergies.

Still, MCS is recognized by the National Institute of Environmental Health Sciences as a "chronic, recurring disease caused by a person's inability to tolerate an environmental chemical or class of foreign chemicals." The Americans With Disabilities Act includes MCS as a disability.

One problem is that MCS is not clearly named or defined. Since 1996 it has been officially called "idiopathic environmental intolerance," but it has also been labeled environmental illness, toxic injury, chemical AIDS, 20th century disease, total allergy syndrome, chemophobia, sick-building syndrome and toxicant-induced loss of tolerance.

The symptoms, which can affect the central nervous system or cause respiratory or gastrointestinal problems, vary depending on the person and the trigger. One study of 20 patients in the journal Clinical Toxicology showed that mold, indoor volatile organic chemicals and ink printers were thought to cause symptoms. In that study, a 30-year-old woman said she had migraines and dizziness from household cleaners, a 47-year-old man complained of back pain from model rocket glue and a 59-year-old woman experienced weakness and tremors from toilet tissue. But after evaluations, the researchers could not find a toxic cause in any of the cases.

Chemical sensitivity also overlaps with other "real" diseases, including chronic fatigue syndrome and fibromyalgia, making it impossible for someone to know which one is causing the problem. Some people believe it's a "sick building" phenomenon; other theories on the mechanism include allergy, a conditioned response, impaired biochemical and neurochemical pathways, psychological or psychiatric illness, a psychosomatic condition or altered sensitivity of the nervous system.

The only "cure" is to avoid exposure, which means limited access to public places, including libraries, doctor's offices, grocery stores and churches. Some people also make drastic changes such as removing wheat gluten, yeast and dairy from their diets or avoiding all processed foods, which contain trace amounts of processing chemicals.

Turvil, a mother of two, figured out she had MCS about five years ago, primarily because her mother also suffers from it. "In typical mainstream fashion I thought she was nuts. Then I started having clear symptoms."

The realization forced her to overhaul her life. She cleaned out her house, began eating a plain diet of meat, vegetables and fruit, and stopped going out in public. Finally, she even left her job as a pediatrician because if she spent 30 minutes in an exam room breathing in chemicals from fabric softener from a patient's clothing, she'd be knocked out for the day.

"People will discredit things that threaten their well-being," says Turvil, who suspects the increase in chronic childhood illnesses is due to chemical exposure. "To be told products you use every day are full of dangerous chemicals is a very threatening thing." By Julie Deardorff

Chicago Tribune



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For most people, their home is a sanctuary, a place to retreat to at the end of a busy day. But for those with multiple chemical sensitivity, 'home sweet home', becomes a toxic hell.

Inside Out meets two women with multiple chemical sensitivity or MCS, to discover how allergies and intolerances have affected their daily lives.

Catherine Hislop has multiple chemical sensitivity.

So debilitating are her allergies, Catherine has been unable to work for the last 10 years.

"The eyes sting, then underneath the eyes is all swollen up," she explains.

"It's like your throat is closing up and when that happens you can't breathe properly."

It took seven years for Catherine to discover that household cleaning products were the route of her allergy.

If Catherine comes into contact with any chemicals she is intolerant to she suffers a violent allergic reaction including stomach cramps, diarrhoea and skin rashes.

The secret ingredient

Melanie Garnham also has MCS, and has been able to pinpoint the precise chemical she is allergic to - formaldehyde.

This chemical is present in many household products including deodorant, mouthwash, air-freshener and many other cleaning solutions.

To add to the confusion, formaldehyde can be listed on bottles under one of five different names.

"The trouble I have is it will say 'ingredients contain preservatives', but it doesn't list what they are," explains Melanie.

In spite of her allergy, Melanie is still able to work, although as a midwife, she admits her heart sinks when a product is changed at work.

"If I put something on my hands they would come up very red and they would eventually blister and weep," she says.

All in the mind?

Despite being a recognised illness, both women have experienced difficulties convincing doctors that everyday products are causing the reaction.

"I was just told it's a contact dermatitis - a professional hazard because I wear rubber gloves and wash my hands a lot at work," says Melanie.

Dr Andy Jones, a lecturer in Environmental Sciences, explains: "Multiple chemical sensitivity is a very contentious issue.

"There are a number of people in the medical profession who would argue that it doesn't actually exist."

Dr Damien Downing is one of only a handful of doctors in the UK who treats patients with MCS.

At his private clinic in Whelby, Essex, Dr Downing dismisses claims it is a psychological illness rather than a physical one.

"It's a clear physical based illness," he says.

"It's in the brain certainly, but it's also in every other cell in the body besides - it's very real.

"I've seen people who are effectively housebound and even bedbound by it."

Catherine and Melanie are one of a growing number of people with allergies to household products and toiletries.

The increase, suggests Dr Downing, stems from the infinite number of chemical combinations found in products.

"I think it comes from over-exposure to things we weren't designed for," he suggests.

"Chemical companies produce four million registered chemicals and we never know what we're exposed to at any one time."

Cleaning with the enemy

The British Allergy Foundation has set up Allergy UK to provide support and information to people with chemical allergies.

"People call us when they're at their wits end, they don't know what's affecting them," explains Lindsey McManus of Allergy UK.

"When we get talking they realise it's the everyday things we use."

Those with chemical allergies do not just endure the physical discomfort of an allergic reaction, but often, unable to get help from their GP or even identify the product they are reacting to, suffer great psychological strain as well.

Judith May of Allergy UK has worked with patients who have become so desperate they have been prescribed anti-depressants.

Some were threatened with the prospect of being struck-off surgeries for becoming a nuisance and one became so desperate, they contemplated suicide.

Good old days

When it comes to cleaning without suffering a reaction, Lindsey insists that 'grandmother knows best'.

"The old fashioned ways - hot water, borax, bicarb', white vinegar - you'll get things clean, but they won't give off nasty chemicals," she says.

Whilst Allergy UK provides advice on alternative cleaning products, Melanie has found a solution that even those who don't have MCS may find agreeable.

Daughters Hannah and Sally undertake all the household chores.

"The girls don't get cross, they're patient with me, they do understand," says Melanie.

However Catherine worries that her allergies are a great burden to her children.

"Over the years I've had stages where I've been very ill, not even been able to get out of bed. They've had to grow up very quick," she says.

The need to act

The manufacturers of chemical cleaning products were invited to contribute, but were unable to provide a qualified spokesperson to pass comment.

This doesn't come as a surprise to Dr Downing who says, "I find it hard to know what they'd say that would appear constructive, because as far as I'm aware, no steps are being taken to protect the consumer.

"They will have to take note sooner or later because the problem is getting bigger and bigger."




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