Sensitivity multiple chemical T78.4

Subjectively experienced "hypersensitivity" caused by exposure to chemicals (see also eco-syndrome). Those affected react with diverse, non-specific complaints in different organs. The diagnosis of MCS is a diagnosis of exclusion, meaning that other causes of sympotmatics should be ruled out by means of basic diagnostics, allergy diagnostics or environmental diagnostics (Harter K et al. 2020).

A figure of 300,000 people affected is assumed for Germany!

In a Germany-wide study conducted over 15 years, 9% of those surveyed stated that they had experienced complaints due to chemical exposure (Hausteiner C et al. 2005).

w>m.

Unknown. A somatoform disorder can be ruled out.

In Germany, the suspected substances include in particular

• Wood preservatives,
• solvents,
• insecticides,
• heavy metals,
• disinfectants,
• fragrances.

Women >45 years are affected more than average.

Non-specific symptoms such as itching, burning skin, dry mouth, fatigue, sleep disorders, irritability, memory disorders, diarrhea, shortness of breath, feelings of anxiety. The symptoms are triggered even at very low concentrations of the suspected substances, which do not cause any reactions in healthy people. The threshold values are very individual and not generally known.

In the case of"sick building syndrome", vapors from buildings and indoor spaces are blamed as the cause of the symptoms.

In the case of electrical hypersensitivity, electrosmog, for example from overhead power lines, is blamed as the cause.

In the case of Gulf War syndrome, radioactive warfare agents have been blamed for causing fatigue and other unspecific symptoms.

In addition to a symptom-oriented diagnosis, a biopsychosocial "multimodal simultaneous diagnosis" of somatic and psychosocial conditions is recommended with interdisciplinary clarification of somatic and psychosocial causes.

Environmental causes, e.g. exposure to cadmium and mercury, should be excluded by appropriate analyses.

According to an MCS consensus, the following parameters are required:

• Symptoms are reproducible through repeated exposure.
• The condition is chronic.
• Symptoms are triggered by low concentrations (lower than generally tolerated) of different agents.
• Avoidance of exposure leads to improvement until complete recovery.
• Reactions to multiple chemically unrelated substances. Symptoms relate to food additives, pesticides, pharmaceuticals, indoor air pollutants, solvents, alcohols, perfume, cosmetics, clothing, plastic, chlorine, amalgam, vehicle exhaust fumes, ozone, etc.).
• Exclusion of MCS: The reported complaints can be fully explained (entire spectrum) by a known illness of the patient.

Sensitive skin syndrome: characteristic, subjective sensory perceptions such as a feeling of tension, abnormal stinging, burning, tingling, pain and itching defined, which significantly reduces the quality of life of those affected. Causative skin diseases are not present or can be excluded. Inconstantly associated is redness. Acceptable and objective screening tests are missing so far.

An evidence-based therapy recommendation for MCS does not yet exist. The avoidance strategy is often the first therapeutic measure and is perceived as helpful by those affected. Changes in diet (rotation diet, nutritional supplements such as Lactobacillus acidophilus or magnesium), air filters, massages, acupressure and self-help groups are also seen as helpful by many MCS patients. Pharmacological therapies, on the other hand, are not very promising.

1. MCS-Consensus (1999) Multiple chemical sensitivity: a 1999 consensus. Arch Environ Health 54: 147-149
2. Eggermann T et al. (2003) Multiple chemical sensitivity (MCS) strategies for the elucidation of genetic predispositions. Allergology 26: 280-286
3. Harter K et al. (2020) Multiple chemical sensitivity (MCS) - a guide for dermatologists on how to manage affected individuals. J Dtsch Dermatol Ges 18:119-130.
4. Hausteiner C et al. (2005) Self-reported chemical sensitivity in Germany: a population-based survey. Int J Hyg Environ Health 208:271-278.