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Provocative challenges in patients with multiple chemical sensitivity

¹Division of Clinical Immunology, St. Michael's Hospital, Toronto, Ontario, Canada.

The Journal of Allergy and Clinical Immunology

|April 1, 1997

Summary

Multiple Chemical Sensitivity (MCS) may stem from anxiety, not organic disease. Challenges revealed hyperventilation linked to perceived environmental triggers in patients.

Area of Science:

Environmental Medicine
Psychophysiology

Background:

The etiology of Multiple Chemical Sensitivity (MCS) remains debated, with theories suggesting either an organic disease triggered by environmental exposures or a psychologic disorder.
Investigating pathophysiologic or psychophysiologic mechanisms in MCS patients during controlled challenges is crucial for understanding the condition.

Observation:

Fifteen patients diagnosed with MCS underwent clinical observation after controlled exposure to their identified trigger substances.
Pulmonary function tests, including measurements of PCO2, PO2, and oxygen saturation, were conducted before and after the challenges.

Findings:

In 11 out of 15 patients, symptom reproduction during challenges was associated with clinical signs of acute hyperventilation.
This hyperventilation correlated with a significant decrease in PCO2, while oxygen saturation remained unchanged or increased.

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Pulmonary function tests showed no significant changes, and recovery from symptoms was rapid.

Implications:

The findings suggest that in these patients, MCS may manifest as an anxiety syndrome triggered by the perception of environmental insults.
Hyperventilation appears to be a mechanism contributing to some of the symptoms experienced by MCS patients.
Further research into the psychophysiological underpinnings of MCS is warranted.