Management of patients with multiple chemical sensitivities at occupational health clinics

The difficult task of managing patients with MCS requires a multidisciplinary effort involving the occupational medicine physician, social worker, occupational therapist, physical therapist, psychologist, vocational rehabilitation specialist, industrial hygienist, and other involved professionals. Important objectives of management include complete review of the history and clinical findings, appropriate choice of diagnostic tests, search for additional exposure information, emphasis of "well" behavior, health education of the patient and prevention of further illness. Because of the chronic nature of MCS and the difficulty many patients have in coping with MCS, pharmacologic and psychologic interventions should be considered. Interaction of the clinic with the patients employer, insurance carrier, or attorney must be carefully planned and communicated only after receiving the patient's informed consent. Patient education should include general principles of toxicology, industrial hygiene measures to reduce hazardous exposures, factors which may aggravate the illness, and resources available to obtain further information and assistance.