The Diversionary Tactic

The fight to breath, the metallic
taste in the mouth, & the stinging
tongue.  Numbness in the upper-
respiratory tract, the dry heaving
episode, and the headache that
leaves cheekbones & temples
feeling bruised.  It involves a
world that has also included he-
patic injury, dermatitis, urticaria,
hematotoxicity, and anaphylaxis.


The Razor Blades of  Defamation

Mainstream medical science has already established that
chemicals, at nontoxic levels, are not universally harmless.
Numerous chemicals have been identified as sensitizers,
while other ones have been identified as irritants.  Chemi-
cal Sensitivity has already been defined in case-specific
form.  Irritant-induced Asthma and its subset condition,
Reactive Airways Dysfunction Syndrome, is one form,
while Airborne Irritant Contact Dermatitis is yet another
form.  Chemical sensitivity is already an established com-
ponent in mainstream medical science, and so too is the
irritant-induced reaction.

However ...

Throughout the past ten years, literature has been posted
online that can easily deceive a novice into assuming that
no chemical of  any kind, whenever encountered at a
nontoxic level, could ever trigger an adverse reaction in
anyone.  It accentuated the Multiple Chemical Sensitivity
debate, while simultaneously declining to acknowledge the
names of  the case-specific forms of  chemical sensitivity
which had already been identified and defined.

Each piece of  propaganda asserted that Multiple Chem-
ical sensitivity is merely a matter of mental illness.  And as
a result, unfamiliarized persons were left entirely unaware
that sufficient medical findings in numerous chemically sen-
sitive patients had already been identified, along with the
numerous chemicals that triggered the adverse reactions.

The Corporate Claim of  Universal Harmlessness
  Contradicted by the Findings of  Medical Science

It had even gotten to the point where insecticide providers
boldly claimed that their product lines were entirely harm-
less, provided that they were used according to regulatory
guidelines.  This proclamation was accompanied by the
assertion that persons suffering from Multiple Chemical
Sensitivity are merely mentaly ill.  However, mainstream
medical science has already established that nontoxic
exposure to the carbamate/organophosphate class of 
pesticide can cause a build-up of  acetylcholine in one's
lungs and cause asthma to develop.

Perfumes Have Been Identified
  as Triggers of Asthma

The propaganda against the chemically sensitive was re-
lentless.  In fact, the nonchemically sensitive got caught in
the crossfire in 1996, when the perfume intolerant were
called "fragrance phobic fruitcakes."  Now, perfumes
contain potent nonchemical ingredients as much as they
contain sensitizing chemicals.  And perfume intolerance in-
cludes hyperreactivity to nonchemical ingredients as much
as it involves hypersensitivity to chemical-bearing agents. 
Therefore, in 1996, even persons who were not chemically
sensitive were placed under attack.

Never mentioned in the 1996 character assassination was
the 1995 publication detailing a research undertaking which
confirmed that perfume strips found in magazines are asth-
ma triggers.  [Ann Allergy Asthma Immunol., 1995 Nov;75
(5):429-33].

And in the years to follow, perfumes would come to be ac-
knowledged as asthma triggers by the American Medical
Association, the American Academy of  Allergy Asthma
& Immunology, the American Lung Association, and the
National, Heart, Lung, and Blood Institute (of  America).

Then, in 2001, a published medical report placed perfume
among the triggers of  anaphylaxis.  Yet, no apologies were
ever made to the perfume intolerant by the propagandist
who defamed them.

Sensitization Is Not Limitied To Chemical Exposures

The phenomenon of  sensitization is not new.  And neither
is it unproven.  Nor is it limited to matters involving Chem-
ical Sensitivity.  The recognition of  Sensitization spans
throughout the realms of:

1] metal dust exposure; Berylliosis (beryllium), etc.
2] mold exposure; Mushroom Worker's Lung, etc.
3] enzyme exposure; Detergent Worker's Lung, etc.
4] organic dust exposure; Byssinosis (cotton dust), etc.
5] chemicals & irritant gases; Irritant-induced Asthma, etc.

The Medical Doctrine of  Concomitant Sensitivity

Concomitant Sensitivity is also known as Cross-sensitization,
and it means that, if you are hypersensitive to one chemical
compound, then you are hypersensitive to all other chemical
compounds with similar characteristics.  An example of  Con-
comitant Sensitivity exists within the family of  the acetylated
salicylates.  To be adversely reactive to one of  them is to
be adversely reactive to all of  them.

High Production Volume Chemicals
  and their Ubiquitous Presence in Modern Life

There have been medical professionals who declined to
support the recognition of  MCS, but who simultaneously
acknowledged that a person can be severely hypersensitive
to "one or a few" chemicals.  Such an acknowledgement
needs to be accompanied by a qualifying statement, how-
ever, and that qualifying statement goes as follows:

          Persons who are hypersensitive to a few High
          Production Volume Chemicals are actually
          hypersensitive to the dozens of  commonly
          encountered products that contain those
          HPV chemicals.  Concomitant Sensitivity,
          combined with hypersensitivity to merely
          a few HPV chemicals, easily explains how
          a person can seem to be hypersensitive to
          almost everything.

The Demarcating Factor in MCS

If you are adversely reactive to dozens of chemical-bearing
agents, but have only one reoccuring symptom, then you
are outside of  the MCS controversy.  This is because the
demarcating factor in MCS is not hypersensitivity to multi-
ple chemicals.  The demarcating factor is adverse reactivity
affecting multiple body systems.  In as much, if  bron-
chial hyperresponsiveness is your only chemical sensitivity
reaction, then only one body system is involved, and there
is no presence of  Multiple Chemical Sensitivity to assess
in you.  The anti-MCS people will have to find another
way in which to call you mentally ill. 

That is to say, your case involves localized chemical sen-
sitivity.  It involves either Reactive Airways Dysfunction
Syndrome or Irritant-induced Asthma; two similar medi-
cal conditions not in controversy.

Nor does MCS have anything to do with multiple symp-
toms, per se.  You can have a repertoire of  reoccurring
symptoms and be outside of  the MCS controversy, if 
those multiple symptoms are limited to the reactions of 
only one body system.  In such a case, the anti-MCS
people will have to find another way by which call you
mentally ill, while simultaneously claiming chemicals to
be virtuous and blameless at nontoxic levels.

The respiratory system is an individual body system that
can host multiple symptoms.  Firstly, asthma can coexist
with upper-respiratory ills, and the upper-respiratory
tract can be the host of  a number of  symptoms.  In fact,
within the world of  Occupational and Environmental Med-
icine, it is a regular phenomenon to find asthma coexisting
with Rhinosinusitis\Rhinitis in the same one worker (or
subset of  workers.)

In summary, it is neither the number of  symptoms nor
the number of  chemicals that define Multiple Chemical
Sensitivity.  It is the number of  body systems that engage
in the hypersensitivity reactions that defines it.  And in
the world of  Occupational and Environmental Medicine,
chemical sensitivity reactions have been documented as
having adversely affected two body systems in the same
one worker (or subset of  workers.)  Such coexistence
hints of the authentic existence of  MCS.

Formaldehyde:  A Specific Example

Formaldehyde is a suitable example to employ, in illustrating
that hypersensitivity to merely one HPV chemical constitutes
hypersensitivity to dozens of chemical-bearing agents.  Form-
aldehyde is a known trigger of  asthma, rhinitis, dermatitis, and
anaphylaxis.  And it outgases from numerous products.  This
includes those liquid soap and shampoo products that con-
tain quarternium-15, DMDM hydantoin, diazolidinyl urea,
and imidazolidinyl urea.  In fact, go to the shampoo and
liquid soap section of  any store and see if you can find one
product free of  the ingredients listed above.  A detailed list
of  formaldehyde-releasing agents includes:

[] urea-formaldehyde foam insulation, [] oriented strand
board, [] medium density fiberboard, [] melamine resin,
[] plywood, [] surface coatings, [] joint cement, [] paints
[] wall coverings, [] durable press drapery, [] permanent
press clothing, [] floor wax, [] kerosene heater emissions,
[] burning wood, [] cosmetics, [] nail hardeners, [] sun
screen lotion, [] moisturizing lotions, [] tanning lotions,
[] liquid soaps, [] carpet cleansers, [] liquid scouring
cleansers, [] shampoos, [] medical venues, etc.

Formaldehyde shares common characterists with benzalde-
hyde and the sterlization agent, glutaraldehyde.  Therefore,
the products which bear glutaraldehyde and benzaldehyde
are to be included in the list of  formaldehyde-releasing
agents.  And this includes cinnamon oil.  In as much, the
phenomenon of  Concomitant Sensitivity, in combination
with hypersensitivity to a few High Production Volume
Chemicals, can account for the reason why some individ-
uals seem to be hypersensitive to almost everything.

Persistent Vulnerabilities,
  aka Pre-existing Conditions

And then there is the matter of  chronically existent vul-
nerabilities, also known as atopy.  One example is the
upper-respiratory inflammation known as boney turbinate
hypertrophy.  It is a condition not known to be able to
resolve itself,as surgery has been the only treatment
offered for it, by mainstream medicine.

Cases of  chronically existent vulnerabilities can make a
person hypersensitive to both chemical and non-chemical
odors.  Thus, such a person can be adversely reactive to
the smell of  cleaning agents and new vinyl products, as
well as cooking odors, and even musty cardboard.  Such
a person might appear to be allergic to almost everything.

Immunological in Some Cases. 
  Nonimmunological in Other ones.

A person can have either an immunological allergic
reaction or a non-immunological irritant reaction to
chemical-bearing agents.  It depends on the person, the
person's exposure history, the person's pre-existing vul-
nerabilities, the chemicals themselves, and the way
in which the chemicals are encounterd (by inhaling,
ingestion, touch, or ocular absorption.)

The bottomline is that chemical sensitivity is very real, and
to state otherwise is to defame the Occupational & Envi-
ronmental Health programs who diagnose such conditions,
the private practitioners who treat such conditions, and the
patients who develop such conditions.  Be it Reactive Air-
ways Dysfunction Syndrome, Airborne Irritant Contact
Dermatitis, Limonene Sensitivity, Aspirin Sensitivity, Methyl-
tetrahydrophthalic Anhydride Allergy, or Oil of  Turpentine
Allergy, it is all a matter of  chemical sensitivity.  Multiple
Chemical Sensitivity is not the only type of  chemical sensi-
tivity proposed to exist.  It simply was one of  the two forms
used in a prolonged diversionary tactic.  Other types have
already been validated.  So, any discussion about MCS
that does not admit to the existence of  chemical sensitivity
(in its case-specific forms) invalidates itself.

Visible & Measurable Wheals Have Been Repeatedly Documented

Dr. Stephen Barrett "M.D." is an outspoken individual who
retired from psychiatry in 1993 and then proclaimed himself 
"the media" in 2001.  He was never board-certified in psy-
chiatry, and he was never board-certified in anything else. 
He has zero experience as a practitioner in every form of 
internal, dermatological, & dental medicine.  And he was
not a researcher in any capacity, either.  That is to say, he
was neither a biochemist, nor a vaccinologist, nor a med-
ical technologist, nor anything similar.

An Allegation of  Stephen Barrett that Calls for a Response:

Stephen Barrett alleged, throughout his anti-MCS literature,
that a primary test for chemical sensitivities consists in ...

(I)   a very subjective and non-quantitative form of testing ...

(II)  by which a diluted chemical solution is placed under ...
       the tongue of a patient (or injected through his skin), ...

(III) followed by nothing more than the patient reporting if
       whether or not he experiences any symptom from the
       administered chemical solution.

       This allegation, in combination with numerous omissions
       of  fact, can easily deceive a beginner into assuming that
       there has never been a test to prove the existence of
       chemical sensitivities.  This allegation, therefore, calls for
       a response.

The Response:

(1)  The testing for chemical sensitivities has included, but
        has not been limited to, ...

(I) ... the traditional skin prick test, otherwise known as the
         SPT.

(II)  In skin prick testing, a test-subject is regarded as having
        tested positive when a visible and measurable wheal,
        equal to or larger than a designated size, appears as a
        result of the skin test.

(III) The size of  the wheal is then recorded in numerical form,
        and numerical measurement constitutes objectivity.       

IgE-mediated Chemicals, via the Process of Haptenation

(2)  The purpose for the SPT is to test for immediate onset
       Type I hyperreactivity.  Such a reaction occurs within
       one hour of  exposure.

(I)   IgE stands for Immunoglobulin E, and an immunoglobu-
       lin is a protein produced by plasma cells & lymphocytes,
       serving the function of  an antibody.

(II)  A number of chemicals have been found to trigger im-
       mediate onset reactions, and a subset of  those have
       been discovered to be IgE-mediated, via a process
       known as "haptenation."

(III) Haptein is a greek word which means "to fasten," and
        a hapten is a low weighted molecular agent that reacts
        with an antibody, but cannot induce the formation of
        an antibody until it is fastened to either a carrier protein
        or to a large antigenic molecule.  Chemicals happen to
        be agents of  low molecular weight.     

Type IV Hypersensitivity Reactions

(3)  In addition, there are a significant number of chemicals
      which have been found to induce Type IV, cell-mediated
       hyperreactivity.  This is known as "delayed allergic reac-
       tivity," and this type hypersensitivity results in dermatitis.

(I)  Concerning Type I and Type IV hyperreactivity, the
       Practice Parameter for Allergy Diagnostic Testing, as
       is issued by the Joint Council of Allergy Asthma and
       Immunology, states:          

            "Many chemicals (e.g., sulfonechloramides,
              azo dyes, parabens, fragrances) used as
              additives in foods, drugs, and cosmetics
              may induce either IgE-mediated reactions
              or contact dermatitis, or both." [Ann Al-
              lergy 1995; 75:543-625]      

Non-immunological Chemical Sensitivity Reactions,      
Including Anaphylaxis

(4)   In addition, a number of  chemicals have been identified
       as irritants, being that they trigger very real "nonimmuno-
       logical" responses.  There is even a nonimmunolgical
       form of  anaphylaxis, called an "anaphylactoid reaction."
       Such a reaction produces the same final result as does
       an immunologic anaphylactic reaction, and the only
       difference between the two types of  reactions is in the
       triggering mechanism of  them.  That is to say:             

             "An anaphylactoid reaction is another type of
              immediate reaction that mimics anaphylaxis.
              While symptoms and treatments are the same
               the reason for the reaction is not.  An ana-
               phylactoid reaction does not involve the IgE
               antibodies' immune system and is not consid-
               ered a true allergic reaction.  Even so, the
               reaction can be just as serious."  [American
               College of Allergy, Asthma & Immunology]
               See:

http://www.acaai.org/public/advice/anaph.htm

(I)    Thus, there is Allergic Asthma, and then there is Irritant-
        induced Asthma. One type of asthma is immunologic,
        while the other type is not. You are not inclined to run
        a 26 mile marathon in either case, whenever you are
        exposed to your asthma triggers.      

Allergic Sensitization, Direct Irritation,
and Pharmacological Reactions

(5)  Hypersensitivity reactions can be triggered via:

(a)  Allergic Sensitization.   This is induced by repeated
       exposure to a sensitizing agent such as formaldehyde,
       glutaraldehyde, or phenyl isocyanate.  And then, upon
       becoming sensitized, further exposure to the agent re-
       sults in an antibody release and/or an inflammatory
       chemical release.

(b)   Direct Irritation.   This is induced in those who are
       "atopic;" (in those who possess chronic vulnerabilites
        or pre-existent conditions).   Such persons develop
        "symptoms immediately after exposure to substances
        such as chlorine, ammonia, sulfur dioxide, and envi-
        ronmental smoke."

(c)   Pharmacological Reaction.   This comes as a result
        of the fact that some chemicals and nonchemical agents
        elevate the production of chemicals that naturally exist in
        the body.  An example of  a naturally existent chemical
        in the body, able to have its level elevated by nontoxic
        chemical exposure, is acetylcholine.  A case in point is
        the organophosphate/carbamate class of pesticide.  Even
        at nontoxic levels, it can elevate the level of acetylcholine
        in the lungs, because that class of  pesticide inhibits the
        enzyme acetylcholinesterase.

        For further understanding on this, see the Mayo Clinic's
        teaching on Occupational Asthma.   It is found at:

http://www.mayoclinic.com/health/occupational-asthma /DS00591/DSECTION=3&

A Sample of IgE-mediated Chemicals

(6)   For confirmation purposes, examples of IgE-mediated
        chemicals which can be involved in skin testing, include
        the following:

(a)   The disinfectant Ortho-phthalaldehyde.        

        It has even resulted in anaphylaxis, concerning the
        product "Cidex OPA." See:

<>  Nine episodes of anaphylaxis following cystoscopy
       caused by Cidex OPA (ortho-phthalaldehyde) high-
       level disinfectant in 4 patients after cystoscopy.
       {J Allergy Clin Immunol. 2004 Aug;114(2):392-7}

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd= Retrieve&db=PubMed&list_uids=15316522&dopt=Citation

(b)  Formaldehyde.

        It is masked behind a number of aliases, and it outgases
        from the shampoo and liquid soap ingredients, DMDM
        hydantoin, imidazolidinyl urea, diazolidinyl urea, and
        quaternium-15.   See:

<>   IgE-mediated urticaria from formaldehyde in a
        dental root canal compound.  (The full text describes
        28 cases of Formaldehyde Sensitivity.  {J Investig
        Allergol Clin Immunol., 2002;12(2):130-3}

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve &db=PubMed&list_uids=12371530&dopt=Abstract

<>   Exposure to gaseous formaldehyde induces IgE-
        mediated sensitization to formaldehyde in school
        children. {Clin Exp Allergy, 1996 Mar;26(3): 276-80}

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve &db=PubMed&list_uids=8729664&dopt=Abstract

<>   IgE allergy due to formaldehyde paste during
        endodontic treatment. Apropos of 4 cases:
        2 with anaphylactic shock & 2 with generalized
        urticaria. {Rev Stomatol Chir Maxillofac. 2000
         Oct;101(4):169-74}

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve &db=PubMed&list_uids=11103423&dopt=Abstract

(c) Vinyl Sulphone Reactive Dyes.

       They are also known as fiber-reactive dyes, as well as
       azo dyes. They include Remazol Black B.   See:

<>   Roll of skin prick test and serological measure-
        ment of  specific IgE diagnosis of  occupational
        asthma resulting from exposure to vinyl sulphone
        reactive dyes.    {Occup Environ Med. 2001 Jun;58
        (6):411-6}

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve &db=PubMed&list_uids=11351058&dopt=Citation

<>   Asthma, rhinitis, and dermatitis in workers exposed
        to reactive dyes. {Br J Ind Med. 1993 Jan;50(1):65-
        70}

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve &db=PubMed&list_uids=8431393&dopt=Abstract

(d)  Cyanuric Chloride.

     It is used in the production of  plastics, herbicides, pharma-
     ceuticals, and fiber-reactive dyes.  It is also a structural
     component of monochlorotriazine and dichlorotriazine dyes.
     See:

<>   Immunologic cross-reactivity between respiratory
       chemical sensitizers: reactive dyes and cyanuric
       chloride.    {J Allergy Clin Immunol. 1998 Nov;102(5):
       835-40}
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve &db=pubmed&dopt=Abstract&list_uids=9819302&query_hl=9

(e)  The disinfectant Chlorhexidine.

It has even triggered anaphylaxis.  See:

<>   FDA Public Health Notice:  
       Potential Hypersensitivity Reactions to
       Chlorhexidine-Impregnated Medical Devices

http://www.fda.gov/cdrh/chlorhex.html

<>   Immediate hypersensitivity to chlorhexidine:
        literaure review. {Allerg Immunol (Paris) 2004.
        Apr;36(4):123-6}

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve &db=pubmed&dopt=Abstract&list_uids=15180352&query_hl=16

(f)   Phthalic Anhydride.

Nail polish ingredient, ingredient in specific spray paints, and
an agent used in the making of  unsaturated polyester resins,
alkyd resins, polyester polyols, and insect repellents.     

<>   Detection of specific IgE in isocyanate and phthalic
       anhydride exposed workers:  comparison of RAST
       RIA, Immuno CAP System FEIA, Magic Lite SQ.
      {Allergy. 1993 Nov;48(8);627-30}

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve &db=PubMed&list_uids=8116862&dopt=Abstract

<>   In vitro demonstration of  specific IgE in phthalic
      anhydride hypersensitivity.  {Am Rev Respir Dis.,
     1976 May;113(5):701-4}

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve &db=PubMed&list_uids=1267268&dopt=Abstract

(7)  The test that Barrett condemns in his anti-MCS literature
       is the provocation-neutralization test.  And the only type
       of  practitioner that he mentions in the same literature is
       so-called clinical ecologist.  Barrett inaccurately explain-
       ed the provocation-neutralization test, in his omitting of
       pivotal fact, and he additionally gave the illusion that the
       only person on earth who tests for chemical sensitivity is
       the so-called clinical ecologist.

(I)   Firstly, the diagnosing of  the various forms of chemical
       sensitivity has been occurring in the worlds of the Occu-
       pational and Environmental Health Specialist, the Ear
       Nose Throat & Allergy Specialist, the Dermatologist,
       and even the Chest Physician.   In fact, from the world
       of  the chest physician came the golden rule for diagnos-
       ing Irritant-associated Vocal Cord Dysfunction.  And,
       two pivotal papers on chemical sensitivity were pro-
       duced by the head of  the department of  emergency
       medicine of an american university.  Yes, emergency
       medicine.      

(II)  And secondly, Barrett failed to mention that the provo-
       cation-neutralization test has included the measuring of
       objective skin wheals.

Barrett Failed to Mention that it is an Offshoot
of  the Serial Endpoint Titration Skin Testing
Procedure, Covered by Aetna Insurance

(8)   The provocation-neutralization test is actually an
        offshoot of the serial endpoint titration skin testing
        procedure, covered by Aetna Insurance.  And this
        is pertinent to note in light of  the observation that
        Stephen Barrett has repeatedly stated what Aetna
        covers, as if  Aetna alone is the ultimate benchmark
        in diagnostic testing.

(I)    Now, the Skin Endpoint Titration seeks to first identify
        a patient's allergens or hymenoptera venom hypersen-
        sitivities (such as to that of hornets, bees, wasps, fire
        ants, and/or yellow jackets.)   That is to say, the Skin
        Endpoint Titration first seeks to find the triggering dose
        of  a hypersensitivity reaction.

(II)   The same testing then seeks to find the neutralizing
        dose of  the same allergen or venom.  Now, this is
        done for immunotherapy purposes, and the neutraliz-
         ing dose is found in a series of skin tests.  The dose
         at which the patient no longer experiences a hyper-
         sensitivity reaction is the "endpoint."   It constitutes
         the neutralizing dose.  It then becomes the "safe
         starting dose" for immunotherapy.   Thus originates
         the name "neutralization" in the provocation-neutrali-
         zation test.  The goal of the provocation-neutralization
         test is to identify the "neutral dose."

(III)   In summary, the provocation-neutralization test
         looks for objective skin wheals, while simultane-
         ously asking the patient how he/she feels when,
         of  course, such testing involves skin testing.  And the
         appearance of wheals have been documented in such
         testing.

(IV)  The diagnostic parameters become exceeded when
         the testing is considered positive on an either/or basis;
         on the basis of either the appearance of an objective
         skin wheal or the subjective reporting of a symptom.
         However, this is a test that concerns itself  with prog-
         nostic parameters, also.

(V)   Nonetheless, to consider a test positive exclusively on
         the merits of  an objective skin wheal is to keep the
         diagnostic part of  any type of  skin test within accept-
         able parameters.  It's the sublingual drops version of
         such testing which raises eyebrows.

Wheal Reactions Showed a Distinct Pattern

(9)   Objective skin whealing was consistently documented
        during a research undertaking that tested the reliability
        of the provocation-neutralization test.   The result of
         the research goes as follows:            

            "Reaction by symptoms to foods, chemicals,
               and normal saline solution showed a random
               pattern, although wheal reactions showed a
               distinct pattern."

(I)    Let it be repeated.  In the skin test version of  the
        provocation-neutralization test:

      "wheal reactions showed a distinct pattern."

(II)   The conclusion of that research undertaking goes
         as follows:          

               "Skin response alone may be a more
                 reliable indicator and require cross-
                 validation with other tests, such as
                 oral and inhalation challenges and
                 comparison with a control population."  
                 See:

<>     Intradermal skin testing for food and chemical
         sensitivities:  a double-blind controlled study.
         {J Allergy Clin Immunol. 1999 May;103(5 Pt 1):
          907-11}

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd= Retrieve&db=PubMed&list_uids=10329827&dopt=Abstract

(III)  Concerning the prognostic aspect of the provocation-
         neutralization test, Aetna states:

               "Since provocation-neutralization requires
                the provoking and neutralizing of symptoms
                to a single item at a time, the patient could
                be required to undergo hundreds of  indi-
                vidual tests requiring weeks or months of
                full-day testing." (Well, this is what Aetna
                states.)

(IV)   The bottomline is that skin testing has been used to
          identify individual chemical sensitivities to chemicals
          such as formaldehyde and phenyl isocyanate, and
          phthalic anhydride.  Tested patients produced the
          objective medical finding of visible and measurable
          wheals.  And this has included forms of testing other
          than that of  the neutralization-provocation test

(V)   Chemically sensitive patients have tested positive in
         inhalation challenge testing, as well as in patch testing
        (the testing that seeks to detect delayed hypersensitivity
         reponses.)  And chemically sensitive patients were also
         documented as having objective medical findings via
         the fiberoptic rhinolaryngoscopy and even the biopsy. 
         Some patients were found to have inflamed air sacs of
         the lungs, while other ones were found to have hepatic
         injury in the absence of viral infection.  And other ones
         were found to have upper-respiratory erythema and
         swelling.  Chemical Sensitivity exists in a number of
          forms.  It is very real, and it can be quite brutal.  In as
          much, it has been repeatedly documented that chemicals,
          at ambient (nontoxic) levels, are not universally harmless.

Herman Staudenmayer Didn't Take into Account that Anise Oil, Cinnamon Oil, Lemon Oil and Peppermint Spirit are Chemical-bearing Agents

The Research Undertaking that Barrett waved
Like a National Flag

In his attempt to convince mankind that Chemical Sensitivity
is merely a mental illness, the never-board-certified Stephen
Barrett repeatedly cited a "research undertaking" conducted
in Denver during the 1980s.  That test is formally titled:

"Double-blind provocation chamber challenges in 20 patients
presenting with "multiple chemical sensitivity."

The article detailing that research undertaking was published
on August 18, 1993.  

The research team who conducted that test consisted
of psychologist Herman Staudenmayer (Ph.d),  allergist
John Selner (MD), and chemist Martin P. Buhr (Ph.d).

The title of that test is misleading, being that it was not based
on standard challenge testing, such as the methacholine chal-
lenge test which measures FEV1 and the such.  In fact, it was
subjective testing; the type of testing that Barrett condemns as
invalid.  Thus, we see another instance of contradiction, and
even hypocrisy, in Stephen Barrett's anti-MCS literature.

Background in Brevity

1) The test consisted in 145 occasions where a test subject
received into his/her chamber an injection of air.  The test
subject was then instructed to discern if whether or not
the injected air was accompanied by a chemical agent.

Each of the twenty test subjects participated in at least one
"provocation challenge." 

2) The challenges were divided into two types:

a) active challenges, 
b) sham challenges. 

Eighty-eight of the provocation challenges were defined
as "sham" challenges, and they were recorded as injections
of chemical-free air.  The other fifty-seven were defined as
"active" challenges, and they were recorded as injections of chemical-bearing air.

3) The sham challenges came in two forms:

a) clean air injected alone,
b) clean air accompanied by an aromatic agent.

4) The active challenges also came in two forms:

a) the injection of an airborne chemical alone,
b) an airborne chemical accompanied by an aromatic agent.

5) The aromatic agents were called "maskers." 
Maskers used in the "Staudenmayer Test" included:

a) anise oil,
b) cinnamon oil,
c) lemon oil,
d) peppermint spirit (10% oil and 1% leaves.)

4) The overall result of the test, as recorded by the research
team, goes as follows:  "Individually, none of these patients
demonstrated a reliable response pattern across a series of
challenges."  The conclusion was that persons diagnosed with
Multiple Chemical Sensitivity are merely psychologically ill.

The Invalidating Feature of that Test

The maskers that Stephen Barrett cited as having been used
in the "Herman Staudenmayer Test" are known triggers of 
adverse reactions in susceptible persons.  And they are
chemical-bearing agents.

Now, concerning anything aromatic, keep in mind that the
AMA, the world-renown Mayo Clinic, the American Lung
Association, and the American Academy of Allergy, Asthma,
& Immunology each recognize, in publicly accessible print,
that "strong odors" can be triggers of adverse upper and/or
lower respiratory reactions in susceptible people, simply be-
cause they are strong odors.  And this includes anise oil,
cinnamon oil, lemon oil, and peppermint spirit.

The Chemical Ingredients in the Sample List of Maskers
Used in 'the Staudenmayer Test' that were Alleged to
be Chemical-free


Concerning the sample list of maskers used in the "Stauden-
mayer Test," observe the following:

Anise Oil:

- An active ingredient in it is anethole.
- Anethole's chemical composition is C10H12O.
- Its CAS No. is 104-46-1.
- It is a known trigger to those adversely reactive to it.
- In fact, Anethole is known as p-1-propenylanisode.
- It is also known as 1-methoxy-4-(1-propenyl)benzene.
- Thus, anise oil is a chemical-bearing agent.

In all occasions where anise was used as a masker in a
clean air injection, a chemical-bearing agent was being
injected into the test subject's chamber.  Therefore, to
have recorded such an injection as one of chemical-free
air was to have recorded a falsehood.

Cinnamon Oil:

Along with being a "strong odor," cinnamon oil is an aldehyde
bearer.  In fact, the naturally occurring trans-cinnamaldehyde
unassistedly becomes benzaldehyde in the presence of heat.

In as much, to have recorded a cinnamon oil air injection
as a chemical-free one was to have recorded yet another
falsehood.  Cinnamon oil is a chemical-bearing  agent.

Lemon Oil:

The most prevalent constituent in lemon oil is the monoterpene,
limonene, aka 4-isopropenyl-1-methyl-cyclohexene.  Limo-
nene develops a potent sensitizing capacity when it is oxidized,
and it is a reputed skin sensitizer.  In addition, a Swedish re-
search undertaking recorded the following about limonene:
"Bronchial hyperresponsiveness was related to indoor concen-
trations of limonene, the most prevalent terpene."  Lemon oil
also includes the same alpha-pinene that was implicated in
oil of turpentine allergy.

Peppermint:

This aromatic agent is the bearer of Methyl Salicylate, and
as is shown below, it is among the salicylate allergy triggers.
It is also the bearer of  the sensitizing agents (a) limonene,
(b) phellandrene, and (c) alpha-pinene.  It is additionally
the bearer of (d) methyl acetate, (e) menthofurane, and
(f) methone.

Now, as far as concerns methyl salicylate, Supplement 5
of  the Journal of the American Society of Consultant
Pharmacists, 1999 / Vol. 14, states:

"Of note, methyl salicylate carries the same warnings as oral
salicylates and has the potential to cause Reye's Syndrome in
children with flu-like symptoms, as well as adverse reactions
in those with aspirin allergy, asthma, or nasal polyps."

In as much, to record an airborne injection of peppermint spirit
as a chemical-free one, is to record yet another falsehood.

Dephosphorylation

The research team gave no consideration to the "the masking
of sensitivity responses;" a phenomenon attributed to the in-
volvement of Ca2+ calmodulin phosphatase calcineurin and
the ensuing dephosphorylation that it induces.

Barrett's Predictable Response to the Test

As is to be expected, in an article written by him, Stephen
Barrett recommended that clinical researchers conduct more
tests likened to the one conducted by Staudenmayer and
his colleagues; anise oil, cinnamon oil, and all. 

You should be able to conjecture why he recommended this.

A 1999 AAAAI Position Statement and the AAAAI's Reading Material on Occupational Asthma

Stephen Barrett is co-author of "Chemical Sensitivity:  the
Truth about Environmental Illness."  The book is an attempt
to convince mankind that Chemical Sensitivity is merely a
matter of  mental illness.  In his relentless campaign, which
has shown itself  to have been solely a money making venture,
Barrett repeatedly cited a 1999 position statement issued by
the American Academy of Allergy Asthma & Immunology. 
It is titled "Idiopathic Environmental Intolerances." 

Abbreviated IEI, Idiopathic Environmental Intolerance re-
placed the name, Multiple Chemical Sensitivity, in meeting
rooms where position statements are drafted.  However,
IEI did not replace MCS at Johns Hopkins, Mount Sinai,
Yale, and Harvard.

Perhaps Barrett Should Have Read the Entire Text
Before Citing It

The irony to Barrett's citing of the 1999 text, in order to
strengthen his assertion, consists in the fact that the 1999
position statement expressly recognizes the existence of:

       "true environmentally caused diseases." 

Within that same published text appears examples of such
true environmental illnesses.   The examples include:

1) "hypersensitivity pneumonitis,"
2) "sick building syndome,"
3) "reactive airways dysfunction syndrome."

[The aforementioned diseases appear by name at the
section nearest to the Summary.  That section is titled,
"Comparison with Other Illnesses."]

In as much:

1)  Stephen Barrett called Sick Building Syndrome "a fad
diagnosis."  The AAAAI did not do so.

2)  Reactive Airways Dysfunction Syndrome (RADS) is
regarded by the AMA as "a subset of Irritant-induced
Asthma."  And it is a Chemical Sensitivity disease.  It is an
environmental illness.  Yet, has Barrett ever acknowledged
the existence of  that particular chemical sensitivity disease
in any of his volumes of writings?

3)  Furthermore, a subset of  Hypersenstivitiy Pneumonitis
is "Chemical Worker's Lung."  Now, the Stephen Barrett
who has zero experience in internal medicine, zero experi-
ence in dermatology, zero experience in cytopathology,
zero experience in immunology, and zero experience in
biochemistry has mocked "Multiple Chemical Sensitivity" by
name.  But has he ever acknowledged that there exists some-
thing known as Chemical Worker's Lung?

The Chemical-bearing Agents that MCS patients Avoid
Are the Same Ones that the AMA, AAAAI, and ALA
Recognize as Triggers of Asthma and Rhinitis

4) The 1999 position statement acknowledged the following:

       "Certain environmental irritants, including some of
         those mentioned above, are recognized as triggers
         for patients with asthma and rhinitis."

[The above-cited quote appears at the section titled,
"Clinical Description of IEI."]

The environmental irritants mentioned in the same section
of  the AAAAI's 1999 position statement are:

   - "perfumes and scented products, pesticides,
     domestic and industrial solvents, new carpets,
     car exhaust, gasoline, diesel fumes, urban air
     pollution, cigarette smoke, plastics, and
     formaldehyde."

   - "certain foods, food additives, and drugs"

   - two things which are not claimed to be
     triggers of asthma and rhinitis. 

In order to confirm that the above-mentioned things are recog-
nized as asthma triggers by mainstream medical science, see:

http://www.ama-assn.org/ama/pub/category/13603.html

http://www.aaaai.org/patients/publicedmat/tips/asthmatriggersandmgmt.stm

http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=22916

The above-cited web addresses are those of the American
Lung Association, the AMA, and the same AAAAI which
Barrett elected to use in his campaign to convince mankind
that Chemical Sensitivity is nothing more than a psychological
illness.  In as much, count the number of chemical-bearing
agents that the three mainstream associations regard as
asthma triggers.

The AAAAI's public education material on the subject of
Occupational Asthma

Concerning the AAAAI that Barrett cited in his campaign to
convince mankind that Environmental Illness is merely a matter
of  mental illness, it published an instructional website about
Occupational Asthma.  The link to the AAAAI Occupational
Asthma page appears directly below the block of  information
derived from it.  And within that webpage is the AAAAI's
acknowledgement that Occupational Asthma can be caused
by a number of  chemicals at nontoxic/ambient levels, afflicting
a number of  workers employed in a number of  industries.

     Acrylates  . . . . . . . . . . . . . . . . . .  Adhesive handlers
     Amines  . . . . . . . . . . . . . . . . . . .   Shellac & lacquar handlers
     Anhydrides . . . . . . . . . . . . . . . . .  Plastic, epoxy resin users
     Chloramine-T . . . . . . . . . . . . . . .  Janitors, cleaning staff
     Dyes  . . . . . . . . . . . . . . . . . . . . .  Textile workers
     Fluxes  . . . . . . . . . . . . . . . . . . . .  Electronic workers
     Formaldehyde/glutaraldehyde . . .  Hospital staff
     Isocyanates . . . . . . . . . . . . . . . . . Spray painters, Insulation
                                                          installers; plastic, rubber,
                                                          foam manufactory workers.
     Persulfate . . . . . . . . . . . . . . . . . .  Hairdressers

     The same public education material of  the AAAAI states:

          "The cause may be allergic or nonallergic in nature,
            and the disease may last for a lengthy period in some  
            workers, even if they are no longer exposed to
            the agents that caused their symptoms."

           "Inhalation of  some substances in aerosol form can di-
            rectly lead to the accumulation of  naturally occurring
            chemicals in the body, such as histamine or acetyl-
            choline within the lung, which in turn lead to asthma."

            "For example, insecticides, used in agricultural work,
            can cause a buildup of  acetylcholine, which causes
            airway muscles to contract, thereby constricting air-
            ways."

           "Allergic occupational asthma can occur in workers
            in the plastic, rubber or resin industries following re-
            peated exposure to small chemical molecules in the
            air."

          "If occupational asthma is not correctly diagnosed early,
           and the worker protected or removed from the expo-
           sure, permanent lung changes may occur and asthma
           symptoms may persist even without exposure."

          "Up to 15% of  asthma cases in the United States may
           have job-related factors."

          "Isocyanates are chemicals that are widely used in many
           industries, including spray painting, insulation installation,
           and in manufacturing plastics, rubber and foam.  These
           chemicals can cause asthma in up to 10% of exposed
           workers."

See:   The AAAAI:  Tips to Remember:  Occupational Asthma

Thus, Chemical Sensitivity, as it applies to asthma and rhinitis,
is acknowledged as valid and authentic by the same AAAAI
that Barrett elected to use, in order to support his assertion
that chemical sensitivity is merely a psychological illness.

Conclusion

Stephen Barrett can mock the diagnostic title, Multiple Chem-
ical Sensitivity, all that he wants to.  It will not take away the
fact is that chemical sensitivity has already been recognized
in case specific form.  And it will not take away the fact that
the sufferers of those case-specific forms of  chemical sensi-
tivity need to avoid the chemicals which exacerbate their
medical conditions.

Avoidance and AMA (CSA) Report 4 (A-98)

Avoidance is not 'detrimental.'  Nor is it nonsense.  Avoidance
is a medical necessity.  And as it applies to asthma, the AMA
has stated:

       "Regardless of the efficiency of clinician assessment
         and patient self-monitoring, if the patient's exposure
         to irritants or allergens to which he or she is sensitive
         is not reduced or eliminated, symptom control and
         exacerbation rate may not improve.  Formerly titled
         "Environmental Control," the key points in this area
         logically include efforts by clinicians to pinpoint
         causative agents and to provide specific advice on
         how to avoid or reduce exposures to environmental
         or dietary triggers and drugs that may provoke or
         exacerbate symptoms."  [AMA Report 4 of  the
         Council on Scientific Affairs (A-98)]

The Bridge to Part 2

Part 2 can be accessed by clicking on the web address
posted directly below:

http://www.chemicalsensitivitypart2.blogspot.com