1Environmental sensitivities (ES) describes a chronic condition whereby a person has symptoms when exposed to certain chemicals or other environmental agents at low levels tolerated by most people. The symptoms may range in severity from mild to debilitating.
ES has also been called multiple chemical sensitivity, chemical intolerance, environmental hypersensitivity, environmental illness, toxicant-induced loss of tolerance, and idiopathic environmental intolerance.
Approximately three percent of Canadians have been diagnosed with ES. It affects men, women and children of all ages, but the prevalence increases with age, and 60 to 80 percent of those diagnosed are women.
Carolines Story
Last winter, Caroline and her husband renovated their home, installing new carpet, painting the walls, and varnishing the woodwork. They didn’t open the windows much as they didn’t want to waste energy. During the renovations, Caroline became ill with flu-like symptoms, headache and nausea. After the renovations were completed, she continued to feel tired all the time, and to experience headaches, nausea, and occasional joint and muscle pain.
A few weeks later, Caroline noticed she had a stronger sense of smell than others, and that her symptoms were worse whenever she smelled perfumes, odours from cleaning products and their new furniture. She also began to feel dull, groggy and “spacey” when she came into contact with these products.
She stopped using scented cleaning and personal care products at home. However, it became more difficult for her at work, as others in her office wore perfumes. She developed headaches, had difficulty concentrating and often had to leave her workspace to feel better. Her symptoms would improve once she stepped outside for at least 20 minutes. However, her boss started to complain about her frequent breaks and Caroline felt increasingly stressed, as she was now also worried about losing her job.
She sought help from her family doctor, who referred her to several specialists over the course of many months: a neurologist, a gastroenterologist and a rheumatologist. Each doctor noted a few abnormal results from her physical and laboratory tests, but none could diagnose the problem. One doctor wondered if it might be “her nerves.” Caroline was finding it more and more difficult to cope, was getting more and more frustrated with the lack of progress in addressing her health problem, and began to feel depressed.
Did you know?
Up to 60% of people who report chemical intolerance may be dealing with a condition known as mast cell activation syndrome (MCAS). And up to 80% also deal with food allergy or food intolerance. Asthma and rhinitis or overlapping conditions like vocal cord dysfunction; and vasomotor rhinitis is also common in people with ES as well as people with ME/CFS and fibromyalgia.
People with environmental sensitivities (ES) often visit several doctors before being diagnosed with the condition.
There is no one test used to diagnose ES. Your doctor will start by taking a detailed medical and environmental history. You will be asked about environmental exposures in your community, your home, at work or school. You will also be asked about your hobbies, personal habits, diet and the medications you take. Your doctor will try to identify environmental exposures that may be triggering your symptoms.
She or he will do a careful physical exam and may order some tests. One of the challenges in diagnosing ES is that there are no consistently abnormal findings from physical exams or consistently abnormal results from lab tests. Your doctor will also want to rule out other conditions that could explain the signs and symptoms you are experiencing.
Your doctor will make sure that your symptoms meet the following diagnostic criteria:
- The symptoms are reproducible with repeated chemical exposure.
- The condition is chronic.
- Low levels of exposure (lower than previously or commonly tolerated) result in manifestations of the syndrome.
- The symptoms improve or resolve when the environmental factors that provoke the symptoms are removed.
- Responses occur to multiple substances that are chemically unrelated.
- Symptoms involve multiple organ systems.
Patients with ES are more likely to:
- feel dull or groggy
- have difficulty concentrating
- feel ‘spacey’
- have a heightened sense of smell
If you suspect that you have ES and are unable to find a doctor who has specific knowledge of this condition, try looking for a doctor who has a holistic approach, one who understands how ES can affect many areas of your life. A doctor who is aware of the connections between your environment and your health can help you make changes at home and at work, to avoid symptom-triggering exposures, and thereby improve your quality of life.
Your doctor may also suggest that you limit your exposure to other known environmental contaminants, to enable your body’s defense mechanisms to work better.
ES-MCS Sensitivities Status Report
For a more in-depth analysis of knowledge advancement and the identification of service gaps in Environmental-Multiple Chemical Sensitivites, read this 2011 Status Report (.pdf) developed by the Environmental Health Clinic.
See topics
- Exercise
- Relaxation
- Sleep
- Diet
- Environment
- Coping Emotionally
- https://www.womenscollegehospital.ca/care-programs/environmental-health-clinic/environmental-sensitivities/ ↩︎
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