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Diagnosis of environmental sensitivities

The Quick Environmental Exposure and Sensitivity Inventory (QEESI) is a validated questionnaire for chemical intolerance and the most widely used screening instrument available for personal use. Researchers and clinicians around the world use the QEESI to document symptoms and intolerances. People who use the QEESI find it helpful for self-assessment. It’s also a useful tool for you to take to your doctor to explain your exposures and symptoms.

Click here to view QEESI


Taking An Exposure History: A mnemonic (CH2OPD2) helps to organize the history, and the forms below can be given to patients to be completed at home and reviewed at a subsequent educational counseling visit.

Click here to view: Taking an Exposure History (CH2OPD2)


Environmental sensitivities are a range of reactions to environmental factors including chemicals, foods, biological agents and electromagnetic radiation, at levels of exposure tolerated by many people. It encompasses a range of overlapping chronic conditions such as Multiple Chemical Sensitivity (MCS) and Electromagnetic Sensitivity. Environmental sensitivities frequently contribute to illnesses such as Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) and Fibromyalgia (FM).

Taking an Exposure History (CH2OPD2)

In 1999, group of physicians and researchers published the criteria for diagnosis of MCS.

Case Criteria – 1999 Consensus on Multiple Chemical Sensitivity (MCS)

  • Symptoms are reproducible.
  • The condition is chronic.
  • Low levels of exposure (lower than previously or commonly tolerated) result in symptoms.
  • Symptoms improve or resolve when incitants are removed
  • Responses occur to multiple chemically unrelated substances.
  • Symptoms involve multiple organ Systems.

Reference: 1999 Consensus on Multiple Chemical Sensitivity. Archives of Environmental Health, May/June 1999, Vol. 54, No. 3, based on: J. R. Nethercott, L. L. Davidoff, B. Curbow. “Multiple Chemical Sensitivities Syndrome: Toward a Working Case Definition.” Arch Environ Health, 1993; 48:19–26.

Read more about the 1999 consensus ->

chevalThese diagnostic criteria were then validated by University of Toronto researchers, who also determined additional symptoms common in people with MCS.

  • Having a stronger sense of smell than others.
  • Difficulty concentrating.
  • Feeling dull or groggy.
  • Feeling spacey.

Reference: McKeown-Eyssen, G. E., C. J. Baines, L. M. Marshall, et al. “Multiple Chemical Sensitivity:
Discriminant Validity of Case Definitions.” Arch Environ Health, 2001; 56(5):406–12

Diagnostic Checklists –Ontario College of Family Physicians (go to Environmental Health Committee and scroll down (

Also noted commonly in the international medical literature:

  • Onset of ES most commonly reported after acute exposure to pesticides, solvents
  • Pain and fatigue may be severely disabling
  • If exposures are constant, sensitivities may be “masked” and not recognized until…

The Tipping Point

Cumulative contamination leads to tipping points. For example:

  • we are surpassing the environmental tipping point with climate change
  • human body burden and cellular/organ injuries build up over time

Multiple exposures can cause multiple effects, but until overloaded, a person may not feel ill

Sensitivities to various substances are individual, but may “spread” to more types of exposures.