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Multiple chemical sensitivity (MCS) validity, prevalence, tools and interventions: systematic review protocol.

Susanne Hempel1, Diana Zhang2, Karen A Robinson3

  • 1Southern California Evidence Review Center, University of Southern California, Los Angeles, California, USA susanne.hempel@med.usc.edu.

BMJ Open
|May 9, 2025
PubMed
Summary
This summary is machine-generated.

This systematic review examines multiple chemical sensitivity (MCS), a condition involving adverse reactions to common chemicals. It assesses definitions, diagnostics, prevalence, evidence for MCS as a distinct disorder, biological mechanisms, and treatment effectiveness.

Keywords:
disabled personsgeneral medicine (see internal medicine)systematic review

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Area of Science:

  • Environmental Health
  • Toxicology
  • Clinical Medicine

Background:

  • Multiple chemical sensitivity (MCS) involves adverse reactions to low-dose chemical exposures, affecting multiple organ systems.
  • Symptoms are triggered by diverse, chemically unrelated substances, posing diagnostic challenges.

Purpose of the Study:

  • To systematically review and synthesize evidence on multiple chemical sensitivity (MCS).
  • To answer key questions regarding MCS definitions, diagnostics, prevalence, distinctiveness, mechanisms, and treatments.

Main Methods:

  • Comprehensive literature search across 22 databases, including research registries and guideline repositories.
  • Duplicate screening, pilot-tested data abstraction, and question-specific critical appraisal.
  • Meta-analysis using random effects models where feasible to determine effect sizes.

Main Results:

  • The review will identify validated MCS definitions and assess the diagnostic performance of relevant tools.
  • It will evaluate empirical evidence for MCS as a distinct disorder and explore underlying biological mechanisms.
  • Effectiveness and safety of MCS treatments and management strategies will be synthesized.

Conclusions:

  • This systematic review will provide a comprehensive evidence base on multiple chemical sensitivity (MCS).
  • Findings will inform clinical practice, diagnostic criteria, and future research directions for MCS.