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.
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)
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.
These 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 websitewww.ocfp.ca (go to Environmental Health Committee and scroll down (http://www.ocfp.on.ca/committees/env-health))
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.