A multiple center study of multiple chemical sensitivity syndrome

The lack of widely accepted, standardized, clinical and epidemiologic criteria for Multiple Chemical Sensitivity syndrome has led to confusion about the identification of the condition and has slowed pertinent research. In this article, the authors evaluated the psychometric properties of 2 sets of clinical/epidemiologic criteria for Multiple Chemical Sensitivity syndrome. In this cross-sectional survey of 1,166 patients who visited outpatient occupational, otolaryngology, allergy, and clinical ecological clinics, the authors used the aforementioned sets of criteria to (a) estimate the prevalence of the syndrome in these varied samples and (b) compare the current diagnostic practices of traditional physician specialists with those of clinical ecologists. The authors used a patient-completed questionnaire to assess the medical, psychosocial, and psychological status of patients who reported multiple chemical sensitivities. This approach enabled the formulation of 6 domains, which represented commonly observed characteristics of the syndrome. The authors used a physician-completed questionnaire to collect diagnoses of Multiple Chemical Sensitivity syndrome and other medical conditions. Domains, which were operationalized by the questionnaire and comprised the 2 sets of criteria for identification of the Multiple Chemical Sensitivity syndrome, had test-retest reliabilities that exceeded .75 and estimates of internal consistency that ranged between .59 and .94. Evidence of construct and face validity was considered acceptable. The overall clinic-based prevalences of Multiple Chemical Sensitivity syndrome, based on 6 and 4 domains, were 7% and 23%, respectively. Regardless of the identifying set of criteria used, physicians' diagnoses had relatively low sensitivities (range = 6-50%) and relatively high specificities (range = 82-99%). The study data suggested that the domains operationalized by the questionnaire had reasonable psychometric characteristics. Study data also support the fact that Multiple Chemical Sensitivity syndrome is often overlooked--even by those physicians who treat it most frequently--and that use of both sets of objective criteria for identifying the syndrome would greatly improve the sensitivity of physician diagnoses.