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Profile of patients with chemical injury & sensitivity

  [ 35 votes ]   [ Discuss This Article ]
By Ziem G, McTamney J • • March 6, 1997

Patients reporting sensitivity to multiple chemicals at levels
usually tolerated by the healthy population were administered
standardized questionnaires to evaluate their symptoms and the
exposures that aggravated these symptoms. Many patients were
referred for medical tests. It is thought that patients with
chemical sensitivity have organ abnormalities involving the
liver, nervous system (brain, including limbic, peripheral,
autonomic), immune system, and porphyrin metabolism, probably
reflecting chemical injury to these systems. Laboratory
results are not consistent with a psychologic origin of
chemical sensitivity. Substantial overlap between chemical
sensitivity, fibromyalgia, and chronic fatigue syndrome
exists: the latter two conditions often involve chemical
sensitivity and may even be the same disorder. Other disorders
commonly seen in chemical sensitivity patients include
headache (often migraine), chronic fatigue, musculoskeletal
aching, chronic respiratory inflammation (rhinitis, sinusitis,
laryngitis, asthma), attention deficit, and hyperactivity
(affected younger children). Less common disorders include
tremor, seizures, and mitral valve prolapse. Patients with
these overlapping disorders should be evaluated for chemical
sensitivity and excluded from control groups in future
research. Agents whose exposures are associated with symptoms
and suspected of causing onset of chemical sensitivity with
chronic illness include gasoline, kerosene, natural gas,
pesticides (especially chlordane and chlorpyrifos), solvents,
new carpet and other renovation materials, adhesives/glues,
fiberglass, carbonless copy paper, fabric softener,
formaldehyde and glutaraldehyde, carpet shampoos (lauryl
sulfate) and other cleaning agents, isocyanates, combustion
products (poorly vented gas heaters, overheated batteries),
and medications (dinitrochlorobenzene for warts, intranasally
packed neosynephrine, prolonged antibiotics, and general
anesthesia with petrochemicals). Multiple mechanisms of
chemical injury that magnify response to exposures in
chemically sensitive patients can include neurogenic
inflammation (respiratory, gastrointestinal, genitourinary),
kindling and time-dependent sensitization (neurologic),
impaired porphyrin metabolism (multiple organs), and immune

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