Environmental Sensitivities Multiple Chemical Sensitivities · • Unscented (fragrance free) may...
Transcript of Environmental Sensitivities Multiple Chemical Sensitivities · • Unscented (fragrance free) may...
Environmental SensitivitiesMultiple Chemical Sensitivities
October 2018
Components
• The Story• Historical Perspective• Environmental Sensitivities – what is it? Who is involved? What
should you do?• Multiple Chemical Sensitivities• What is changing?• Resources• OHCOW, Lung Association and Work related lung diseases
Scents• Fragrances, aroma, perfumes• Anything that adds a smell to something else• Found in personal care products such as perfumes, aftershaves, colognes,
shampoos/conditioners, soaps, body lotions and deodorants• Found in cleaning products, adhesives, caulking• Made from a mixture of natural and man-made chemicals• A typical fragrance can contain between 100-350 ingredients• Problem with scented products is not necessarily the smell itself as to the chemicals that
produce the smell• Can contain several toxic chemicals that turn into vapour in the air and attach to hair,
clothing and surroundings• Diethyl phalate used to make scents last longer can cause allergic skin reactions• Unscented (fragrance free) may actually contain fragrances used to mask the smell of
some ingredients• Fragrances intensify with heat
Environmental Sensitivities• Approximately 3% Canadians have been diagnosed• Affects all socio-economic classes, women> men• Can occur at any age even at an early age• Prevalence of ES increases with age• Can be associated with circumstances (sick building), populations (veterans),
chronic conditions (fatigue) or initiating triggering factors• Develop gradually after chronic exposure to relatively low levels of chemicals or
after a major exposure (chemical spill)• Once develop ES reaction can occur to broader range of factors at levels that
were previously tolerable• Some people have mild chemical sensitivities. MCS is however the most severe of
chemical sensitivities• Recognized as a disability under the Canadian Human Rights Commission• Recognition by multiple Canadian organizations (CIHI, Health Canada, CCOHS,
Canadian Mortgage and Housing, WSIB
ES Symptoms
• Runny eyes/nose/sinus• Headaches• Fatigue• Pain• Breathing and digestive problems• Neurological impairment
Body Systems and Associated Symptoms
MEDICAL INTERVENTION:
• Often visit several doctors and specialists who complete full workups including investigations
• Often nonspecific abnormal findings• No specific tests available for a ES diagnosis• Limited medical clinics available – Women’s Hospital Toronto
Environmental Clinic
Defined by
• Symptoms are reproducible with repeated exposure• Resolve with avoidance of the environmental factors• Condition is chronic• Low levels of exposure result in manifestations• Response occur to multiple chemically unrelated substances• Symptoms involve multiple organ systems
Canadian Human Rights Commission 2007
Potential Causes
• VOC
• Combustion Products
• Microbiological Products• Pesticides• Natural Inhalants
• Foods
• Formaldehyde, solvents, scents, off gassing, petrochemicals
• Tobacco smoke, wood products, vehicle exhaust
• Moulds, bacteria, mycotoxins,metabolites
• Insecticides, Herbicides, fungicides, Algaecides
• Pollens, animal danders• Allergenic proteins, pungent foods
Chemicals Associated with MCS
Routes of Entry for Chemicals
How a Person Develops It:
• Initiation: 1. starts after an acute exposure, illness or injury or after a chronic
environmental exposure or acute large exposure (chemical spill/fire)
2. Exposed repeatedly to lower contaminants sick building or renovated areas
• Triggering: 1. when exposed subsequently to the offending substance to amounts
that were previously tolerable2. come into contact regularly (vehicle exhaust, fumes, perfumes,
newsprint, cleaning laundry agents
What Happens: Remains Disputed
• Smell sensitivity – amplification of the nocireceptive stimuli within the central nervous system
• Disturbed central pain mechanisms overlap with fibromyalgia• Neural sensitization – acquired hyper-responsiveness manifested in
several body systems• Neurogenic inflammation• Altered reactions to the CNS (psychophysiologic)• Genetics
• Needs more research
Socio-Economic Implications of Illness • Many people diagnosed are unable to work full-time• Decreased quality of life• Isolation • May not enjoy activities that you
used to
Treatment
Most Common Chemicals to Avoid
• Avoid “ALL” of Your Triggers if you know them• Perfumes- There can be up to 500 chemicals in one perfume. In most
modern fragrances, up to 95 percent of these chemicals are petroleum-based.
• Cologne• Scented aftershave• Scented hairspray, hair gels and other styling products• Scented creams and lotions• Scented sunscreen and self-tanning products• Scented antiperspirant and deodorant• Cleaning Agents
Avoid Using Scents
• Use scent free personal care products – Guide to less toxic products produced by the Environmental Health Association of Nova Scotia
• Skin deep database – compares the safety of various brands• LessToxicGuide.ca offers recommendations on personal and baby care
products
Workplace Interventions• Improve Ventilation
-Open windows- Maintain HVAC System
• Adopt a Scent Free Policy- Perfumes and other strong scents have repeatedly been reported to trigger symptoms in people with asthma and people with MCS-Indoor air can be two to five times more polluted than outside air. Fragrances are the most obvious indoor air pollutant-Canadian Human Rights legislation requires people with diagnosed environmental sensitivities to be accommodated in the workplace
When others abhor the scent you adore
Community Resources
• Women’s College Hospital –
-Environmental Health Clinic (Toronto) - a unique multidisciplinary clinic and the only one of its kind in Ontario- Physician referral is required
• Occupational Health Clinics for Ontario Workers (OHCOW) in Windsor- No Physician referral required
References
• https://www.arizonaadvancedmedicine.com/Articles/2013/June/Multiple-Chemical-Sensitivity-MCS-.aspx
• https://www.hopkinsmedicine.org/healthlibrary/conditions/environmental_medicine/multiple_chemical_sensitivity_85,P00480
• https://ca.search.yahoo.com/yhs/search?hspart=Lkry&hsimp=yhs-newtab&publisherid=53147&type=YHS_SA_53147&%20p=chemical+pathways+and+multiple+chemical+sensitivities¶m1=ij7zzSxCeE_ZFQBKWqum68P8rZ_LbZS3WAspk3gmMVM_zEsTQCJnPefmDtrd2z_3TBB4Rg66ePY80ugsZ7TIy6BXM8qBMTQ9inQhegYrai4loepEHFB7vrwwNFCqlzKNMFbd9DizZxZjY28NglVbd_-v_6cZrlOVxWF8wfojP1hIUVLePypUkNJ3O2I_veSPFMVKLWfWe4NEj0-FC0Y-OWAEV-D_RuSwZTWnPRd4ihHX13V-Fh2Jr5kM-tr63PJlyN9Xxg%2c%2c
• http://www.womenshealthmatters.ca/assets/legacy/wch/pdfs/ESMCSStatusReportJune22011.pdf
• http://www.chemicalsensitivityfoundation.org/pdf/What-Is-MCS-by-Ann-McCampbell.pdf
• http://www.ei-resource.org/treatment-options/treatment-information/multiple-chemical-sensitivity-treatment/
• http://emerge.org.au/wp-content/uploads/2015/03/Pall-M.-L.-NMDA-sensitization-and-stimulation-by-ONOO-NO-and-organic-solvents-as-the-mechanism-of-CS-in-MCS.-FASEB-J.-2002-1611-1407-1417.pdf
• http://mcsawareness.org/
• Dantoft, T.M. Current Rheumatology Reviews 2015