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From: Tim Campbell on 28 Jun 2006 20:44


By FRED A. BERNSTEIN -

THE NEW YORK TIMES

LAST year, Mary Lamielle, of Voorhees, N.J., traveled to Washington for
a
business meeting. Her room, at the Grand Hyatt, "was perfect," she
recalled. But
when she ventured into the conference area, she experienced vertigo and

breathing problems, which she believed were caused by chlorinated water
in the
hotel's decorative pools. Within a day, she was so sick, she said, that
she
couldn't attend the session she had organized on healthy housing for
people with
disabilities.

Ms. Lamielle, the executive director of the National Center for
Environmental
Health Strategies, an advocacy group, suffers from what doctors
variously
label multiple chemical sensitivities or environmental illness, an
elusive malady
that can make exposure to household and industrial chemicals
debilitating.
Sufferers tend to purge their environments of products that cause them
distress.
But it's almost impossible to do that in hotels. For those with the
symptoms,
Ms. Lamielle said, traveling for pleasure is an oxymoron.

But there are resources that can help.

Nancy Westrom of Ocala, Fla., publishes the Safer Travel Directory -
$17, on
the Web at www.safertraveldirectory.com - a booklet meant to help the
chemically sensitive find lodging in 40 states and a dozen foreign
countries
promising relative safety from pesticides and other chemicals. But the
needs of such
travelers vary widely, and Ms. Westrom warns in the front of the book
that all
lodgings pose "unforeseen risks."

Some of the hotels in the book are run by people with the disease, like
Joyce
Charney, who, with her husband, Alan, owns the Natural Place, in
Deerfield
Beach, Fla., www.thenaturalplace.com . The Natural Place offers
apartment-style
units with organic bedding and filtered water, a block and a half from
the
ocean. The owners depend on the cooperation of guests, who are "asked
to sign a
'quality assurance form' when they check in," said Ms. Charney. On the
form,
guests promise not to use "cologne, perfume or any scented make-up,
soaps,
lotions, sun tan products, shampoo, conditioner, hair spray, deodorant,
etc."

Kim Bowen, who with her husband, John, owns the Crow Wing Crest Lodge,
www.crowwing.com , in Akeley, Minn., said she makes her own organic
cleaning
products and insect repellants from herbs and essential oils. One of
her recent,
chemically sensitive guests, Zane Madsen, of Dennison, Minn., said that
she was
attracted to the hotel's no-pet and no-smoking policies, and its
avoidance of
products with artificial scents.

A number of hotels in the Safer Travel Directory use air- and
water-filtering
devices offered by EverGreen Rooms, www.evergreenrooms.com , based in
Wilmington, N.C. Other hotels buy cleaning products from Green Suites
International,
www.greensuites.com , of Upland, Calif.

One focus of Green Suites is sustainability - energy efficiency and use
of
recycled materials. But some of those materials, Ms. Lamielle said, may
harm
chemically sensitive people. For example, flooring may be made of
recycled rubber
bound with chemical adhesives. "They're doing things that are
environmentally
more sound, but not necessarily more healthy," she said.

Ms. Westrom, who began publishing the Safer Travel guide in 1998, said,
"I'm
surprised by how many new listings come my way all the time." On her
Web site,
environmental illness sufferers leave comments that would never appear
in a
conventional travel guide. "As nontoxic as my own bedroom, " wrote a
traveler
of the Arbor House, a bed-and-breakfast in Madison, Wis.

But there are also complaints. A hotel guest who believed that her
mattress
was making her sick demanded to have it covered in heavy foil. And a
hotelier,
Ms. Westrom said, complained that a guest with multiple chemical
sensitivities
"was so comfortable in the hotel that she refused to leave."

Ms. Lamielle said that sufferers are best off finding a hotel that they
can
tolerate, and sticking with it. In Washington, she said, she generally
chooses
the Capital Hilton, where her linens and towels are washed in baking
soda
before her arrival. She asks for a room away from renovation work
(which often
involves chemical compounds) and on a corner, where there are more
windows: "Not
that the D.C. air is so great, but sometimes it's best to let the
inside air
dissipate," she said.

Ms. Lamielle said she reserves far in advance whenever possible, and
sends
multiple e-mails confirming that various measures have been taken. The
Capital
Hilton doesn't charge for the services she requests, but Ms. Lamielle
said she
leaves generous tips for the housekeepers.

She added that with a couple of exceptions, hotels have been willing to

answer her questions about their use of chemicals. But those instances
of a lack of
cooperation, she said, illustrate a need to educate the hospitality
industry
to the requirements of chemically sensitive travelers.

It helps, she added, that those needs overlap the preferences of
millions of
Americans who don't have the disease. "There are plenty of other people
who,
when they open the door to a hotel room, don't want to smell perfume,"
she
said.
http://mcstravel.resourcez.com/

From: Mark Thorson on 28 Jun 2006 20:54
Ann Allergy 1993 Dec;71(6):538-46
Adult sequelae of childhood abuse presenting as
environmental illness.
Staudenmayer H, Selner ME, Selner JC.
Allergy Respiratory Institute of Colorado, Denver 80222.

Sixty-three patients with polysomatic complaints
attributed to sensitivity to environmental
chemicals had detailed clinical assessments and
diagnostic psychologic evaluations. Objective
medical parameters failed to substantiate their
beliefs that multiple chemicals were the cause of
their problems. A group of 64 patients with chronic
medical conditions and defined psychologic
disorders not attributed to chemical exposure
served as controls. Approximately half the patients
in each group underwent long-term psychotherapy,
and in these patients, the prevalence of
physical and sexual childhood abuse was significantly
higher (P < .05) among the cohort of
women who attributed their symptoms to environmental
or chemically related illness. These data
suggest that somatization may reflect sequelae of
childhood abuse and may play an important role
in the illness experienced by women who believe
they are sensitive to environmental chemicals.
From: Mark Thorson on 28 Jun 2006 20:54
Med Hypotheses. 2003 Oct;61(4):419-30.
Are syndromes in environmental medicine variants
of somatoform disorders?
Wiesmuller GA, Ebel H, Hornberg C, Kwan O, Friel J.
Institute of Hygiene and Environmental Medicine,
University Hospital Aachen, Aachen, Germany.

To date, relatively little is known about the
etiology, pathophysiology, diagnosis, therapy,
prevention and prognosis of environment-related
syndromes like multiple chemical sensitivity
(MCS), idiopathic environmental intolerance (IEI),
sick building syndrome (SBS), chronic fatigue
syndrome (CFS), candida syndrome (CS) and
burnout syndrome (BS). Part of the reason is that
these syndromes have not been clearly defined
and classified in scientific categories distinct from
each other, and that they show clinical similarities
to classified somatoform disorders.
Furthermore, there are at least three possible
explanations for the existence of these syndromes:
(1) The syndromes may result from the interaction
of environmental factors, individual
susceptibility and psychological factors (i.e., how
they are perceived and seen by the patient); (2)
they may reflect socially and culturally accepted
methods of expressing distress; and/or (3) they
may be iatrogenic. Despite all the uncertainties
in evaluation of environmental syndromes,
physicians have the duty to take the affected
person's problems seriously. A comprehensive
systematic classification which better accounts
for these complex clinical manifestations is long
overdue. Until these syndromes are well defined,
the terms used for them should definitely not be
applied to connote a specific disease process.
From: Mark Thorson on 28 Jun 2006 20:54
Psychol Med 2002 Nov;32(8):1387-94
Psychiatric and somatic disorders and multiple
chemical sensitivity (MCS) in 264 'environmental
patients'.
Bornschein S, Hausteiner C, Zilker T, Forstl H.
Psychiatric Clinic and Department of Toxicology,
I, Medical Clinic, Technical University of
Munich, Germany.

BACKGROUND: An increasing number of
individuals with diverse health complaints are
currently seeking help in the field of environmental
medicine. Multiple chemical sensitivity (MCS)
or idiopathic environmental intolerances (IEI)
is defined as an acquired disorder with multiple
recurrent symptoms associated with environmental
chemicals in low concentrations that are well
tolerated by the majority of people. Their symptoms
are not explained by any known psychiatric
or somatic disorder.

METHOD: Within a 2-year period we
examined 264 of 267 consecutive
patients prospectively presenting to a university
based out-patient department for environmental
medicine. Patients underwent routine medical
examination, toxicological analysis and the
structured clinical interview for DSM-IV
psychiatric disorders (SCID).

RESULTS: Seventy-five per cent of the patients
met DSM-IV criteria for at least one psychiatric
disorder and 35% of all patients suffered from
somatoform disorders. Other frequent diagnoses
were affective and anxiety disorders, and
dependence or substance abuse. In 39%
a psychiatric disorder, in 23% a somatic
condition and in 19% a combination of the two
were considered to provide sufficient
explanation of the symptoms. Toxic chemicals
were regarded as the most probable cause in only
five cases. The suspected diagnosis of MCS/IEI
could not be sustained in the vast majority of cases.

CONCLUSION: This investigation confirms
previous findings that psychiatric morbidity is
high in patients presenting to specialized centres
for environmental medicine. Somatoform
disorders are the leading diagnostic category,
and there is reason to believe that certain
'environmental' or MCS patients form a special
subgroup of somatoform disorders. In most
cases, symptoms can be explained by well-defined
psychiatric and medical conditions other than
MCS, which need specific treatment. Further
studies should focus on provocation testing in order
to find positive criteria for MCS and on therapeutic
approaches that consider psychiatric aspects.
From: Mark Thorson on 28 Jun 2006 20:54
Psychol Med 1999 Mar;29(2):399-406
The association of sexual and physical abuse with somatization:
characteristics of patients presenting with irritable bowel syndrome
and non-epileptic attack disorder.
Reilly J, Baker GA, Rhodes J, Salmon P.
Department of Clinical Psychology, University of Liverpool.

BACKGROUND: Physical symptoms are
commonly presented for treatment in the absence of
physical pathology. This study tests predictions
arising from the theory that childhood sexual
abuse leads to emotional distress, illness orientation
and social dysfunction as adults and that one
or more of these effects, in turn, leads to presentation
of functional (i.e. unexplained) symptoms.

METHODS: Two groups of patients with physical
symptoms in the absence of organic disease
(non-epileptic attack disorder or irritable bowel
syndrome) were contrasted with organically
diseased groups with comparable symptoms
(epilepsy and Crohn's disease, respectively).

RESULTS: Despite their contrasting clinical presentation,
irritable bowel and non-epileptic attack
groups were similar in recalling more sexual and
physical abuse, as both children and adults, than
their comparison groups. They were also similar
in being more emotionally and socially disturbed
and illness-orientated, but these putative mediating
variables could not account for the relationship
of abuse with presentation of functional symptoms.

CONCLUSIONS: Adults presenting
functional neurological and abdominal symptoms
are characterized by history of abuse. The
current focus on childhood sexual abuse should
be broadened to include sexual, and particularly
physical, abuse in adulthood as well as childhood.
The intervening processes that link abuse to
somatization remain to be identified but are
unlikely to include adult emotional and social
disturbance or general illness-orientation.
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Prev: Revici was right...and Darwin was wrong
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