Environmental sensitivity

The concept of environmental sensitivity is popular among a small group of physicians who believe that exposure to low levels of numerous environmental chemicals can cause a disease with numerous symptoms but no objective physical or laboratory abnormalities. The condition lacks a clear definition. Numerous theories that have been offered to explain the condition encompass immunotoxic, allergic, autoimmune, neurotoxic, cytotoxic, metabolic, behavioral, psychiatric, iatrogenic, and sociologic mechanisms. Environmental sensitivity has many features in common with other controversial syndromes, such as the chronic fatigue syndrome. Patients with environmental sensitivity frequently are subjected to unproven and unnecessary diagnostic tests and therapeutic modalities. In spite of the lack of physical illness and absence of pathology, patients often experience extreme disability, because their symptoms are triggered by common environmental exposures. The phenomenon of environmental sensitivity needs to be evaluated critically using scientifically sound methods. The practice of clinical ecology encompasses the practices of environmental sensitivity and its theories. Most methods of diagnosis and treatment have been disproved, and the concepts underlying these theories are not scientific. Alternative means of diagnosis and management are presented.