Review of Multiple Chemical Sensitivity: Identifying
Treatment/management strategies
Download 454.32 Kb.
|
4.4Treatment/management strategiesMCS individuals may see a variety of specialist medical practitioners depending on the stage of their illness and the background to their referral. For the majority, the general practitioner is likely to be the first consulted. If the condition is regarded as an allergic response, a specialist allergist may be seen, or if considered work-related, an occupational physician may be consulted. In a recent survey of Danish general practitioners, the majority (74%) referred individuals with chemical sensitivities to other medical specialties, the most common of which was allergology (Skovbjerg et al., 2009). Established pharmaceutical treatments for MCS currently do not exist. Psychotherapy, biofeedback and relaxation and other behavioural therapies are described for some cases as efficacious (Wolf, 1996; Stenn and Binkley, 1998; Staudenmayer, 2000; Sparks, 2000a, b; Bornschein et al., 2001). Gibson et al. (2003) surveyed 917 individuals with self-reported MCS to ascertain the perceived efficacies of 101 treatments including environmental techniques (chemical avoidance, sauna, rotation diet, and/or personal oxygen), nutritional supplements, Eastern-origin techniques (meditation, yoga), detoxification techniques, holistic (homeopathy, chelation) or body (chiropractic, kinesiology) therapies and prescription medicines. The study reported significant drain on personal resources in seeking treatment for MCS and described respondents' attitudes toward the possibility of a positive treatment outcome. On average, participants consulted 12 health care providers and spent over one-third of their annual income on health care costs. The most helpful treatment/management strategies rated by 95% of respondents in this survey were creating a chemical-free living space and chemical avoidance. These authors also reported that whilst a majority of individuals (65%) claimed no noticeable effect from psychotherapy to cure their MCS, a majority (65%) found psychotherapy very or somewhat helpful in assisting in coping with their MCS. Others also claim that the prognosis of MCS is strongly affected by access to multimodal therapy and an understanding between doctor and patient of a multifactorial model of disease (Bauer et al., 2008). A recent survey of Danish general practitioners with experience of multiple chemical sensitivities also uncovered disparate views on causes and treatments. The majority (65%) perceived the aetiology of their MCS cases as multifactorial, with 28% a somatic/biologic and 7% a psychological aetiology. Amongst the practitioners, treatment advice ranged from avoiding chemical exposures associated with symptoms (75%), avoiding all chemical exposures (12%), not avoiding chemical exposures (linked to perceived psychological aetiologies) (3%), to providing no clinical advice (10%) (Skovbjerg et al., 2009). Some advocacy and support group websites (national and/or overseas) note a wide range of treatments that are, or have been, used including intravenous vitamins, nutritional supplements, detoxification, chelation therapy, colonic irrigation, desensitisation, use of medication to boost the immune system, antidepressants, antibiotics, antifungals, homeopathy, acupuncture, mind-body therapy, psychotherapy and total or partial avoidance. However, in terms of a specific treatment, information from these societies and groups does not establish a consensus for the treatment of MCS other than management by avoidance of chemicals that cause symptoms. In Australia, there are a number of societies and groups that provide specific support and understanding to individuals suffering from MCS. Such groups include:
These groups provide support and guidance for MCS sufferers and some also present information on a range of treatments. In 1994, Winder reviewed cases of what he termed at that time “chemically related chronic fatigue syndrome” (Winder, 1994). He considered that early detection and intervention including minimising exposure to the triggers resulted in improved outcomes. Although dedicated to management rather than medical treatment, the Human Rights and Equal Opportunity Commission in Australia recently included reference to MCS in their revised Guideline, Access to Buildings and Services: Guidelines and Information (HREOC 2007). The section on use of chemicals and materials in the Guidelines states: “A growing number of people report being affected by sensitivity to chemicals used in the building, maintenance and operation of premises. This can mean that premises are effectively inaccessible to people with chemical sensitivity. People who own, lease, operate and manage premises should consider the following issues to eliminate chemical sensitivity reactions in users:
The South Australian Department of Transport, Energy and Infrastructure has recently published a Disability Access Checklist Guide for Government Owned and Leased premises (2010). Part 3 of the guide includes a checklist for MCS. The guide was developed using information in the HREOC’s guideline referred to above. Directory: data -> assets -> word doc word doc -> Northern territory of australia word doc -> Number: caveat in the [Will/Will and Codicil/Estate of] word doc -> List of accessible executive records word doc -> National Industrial Chemicals Notification and Assessment Scheme word doc -> This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced by any process without prior written permission from the Commonwealth word doc -> Commonwealth of Australia 2002 word doc -> Commonwealth of Australia 2000 word doc -> Priority Existing Chemical word doc -> Rail safety news issue 6 – October 2011 word doc -> Board Endorsed October 2009 amended 13-09-11 with extra units Download 454.32 Kb. Share with your friends:
|