Environmentally Ill Cry for Medical Recognition
A whiff of perfume or a breeze from a neighbor’s lawn can leave chemically sensitive people speechless. And they are becoming increasingly vocal about it.
They complain that they get sick from everyday exposure to common chemicals in the home, office and elsewhere.
Chemical sensitivity can cause headaches, respiratory discomfort and a paralyzing disorientation that can render one incapable of speaking.
Skeptics in the insurance, medical and chemical industries are not convinced that such miseries are real. Acute sensitivity to common chemicals has yet to win medical recognition or the insurance coverage that would come with it.
Yet some scientists insist that society is now seeing the first casualties of the modern-day proliferation of chemicals. From the end of World War II until 1988, annual production of synthetic organic chemicals in the United States jumped from less than 1 billion pounds to 273 billion pounds.
“(Sensitive people) may indeed be the canaries,” said Claudia Miller, a University of Texas Health Science Center allergist and immunologist who participated in a study for the state of New Jersey, which is second only to Texas in the production of chemicals.
“We don’t understand the mechanisms,” Miller said. “It may be neurological or immunological. It may be biochemical.”
Whatever the mechanism, the effects can be dramatic, say experts and those who suffer from chemical sensitivity, also known as environmental illness.
Illness often begins from a single exposure--after installation of new carpeting in the office or a leak from a sewage plant--that seems to leave one permanently hypersensitive, sufferers say.
What follows is a bewildering array of symptoms and the quest for diagnosis and treatment. Patients must try to avoid contact with any pesticide, plastic or building material that they fear will trigger an episode.
Some get breathing relief with Adrenalin, but drugs are often useless because many sufferers also react to pharmaceutics.
The number of people severely affected is unknown.
According to the New Jersey report, the National Academy of Sciences suggested that about 15% of the population has heightened sensitivity to chemicals, though not all such people have intense symptoms. A spokeswoman for the academy said, however, that 15% was an off-the-cuff estimate and should not have been quoted in the report.
Meanwhile, the medical Establishment remains dubious.
Carroll Brodsky, a psychiatrist with UC San Francisco who has written extensively on the subject, said it is likely a psychological disability.
“If you believe you couldn’t walk outside or walk anywhere where there were exhaust fumes, you would be disabled. If that is the issue, have I seen people like this who are disabled? Certainly,” Brodsky said.
“Now, whether they have anything wrong with them physically is quite another matter. . . . If physical doctors can’t find anything physically wrong with them, it must be within the realm of the psyche.”
Reputable, neutral organizations have given at least some credence to a physical basis of the disorder.
The U.S. Environmental Protection Agency, in a report to Congress on indoor air pollution, urged further research of chemical sensitivity. The Congressional Research Service has called it one of the consequences of poor indoor air quality.
And the U.S. Department of Housing and Urban Development has ruled that people with environmental illness who live in subsidized housing cannot be forced to have chemical extermination of their homes.
Some doubters say that malingering employees are looking for workers’ compensation benefits. They also suspect a subconscious fear of workplace pressures and fearful reaction to news reports about chemical hazards.
Clinical ecologists, the doctors who specialize in chemical sensitivity, also have met with skepticism. Allergists in conventional practice, for example, have urged the Health Care Financing Administration to deny reimbursement for clinical ecologists’ work.
But Miller and Nicholas Ashford of the Massachusetts Institute of Technology, the other author of the New Jersey report, say that the psychological explanation ignores the stunning similarity of the symptoms and exposure problems being reported.
“They’re all so diverse, yet they’re all coming up with the same thing. Is it all psychological when everyone is coming up with the same symptoms?” Miller asked.
She and Ashford both said that further research is needed.
One of dozens of proposals made to federal and state governments is establishment of an “environmental unit,” a contaminant-free chamber for testing an individual’s sensitivity to various common chemicals one at a time.
New Jersey health officials have not said what recommendation, if any, they will follow.
So far, the scientists have identified four groups who are most prone to be hypersensitive. They are industrial workers, people who work in well insulated and poorly ventilated offices, residents of contaminated communities and people who are exposed to chemicals in the household.
“(Hypersensitivity) is widespread in nature and is not limited to what some observers would describe as malingering workers, hysterical housewives and workers experiencing mass psychogenic illness,” the report said.
Those who believe the malady is a physical illness say the skeptics are afraid to admit that people could be getting sick from living in a chemical-laden world, because it would bode ill for a huge industry.
It might mean buildings with better ventilation, a less-than-perfect lawn or scrubbing the toilet with plain baking soda.
And, one industry briefing warned, formal recognition of chemical sensitivity as an illness could result in a spate of lawsuits and insurance obligations.
“The primary impact on society would be the huge cost associated with the legitimization of environmental illness,” the Chemical Manufacturers Assn. report continued.
“It would mean we had a new and very different problem to deal with,” said Gordon Strickland, a vice president of the chemicals lobby, “(but) we have looked through the data and looked through the arguments . . . and found nothing supportive” of a physical explanation.
Mary Lamielle of Voorhees, N.J., who suffers from chemical sensitivity and is heading a nationwide effort to have the condition recognized, said that economics, rather than science, is behind all the skepticism.
It was at Lamielle’s urging that state Sen. Lee Laskin persuaded New Jersey public health officials to commission the study of chemical exposure problems.
