Chemical Sensitivity

It may not be surprising that chemical exposure seems to make some people ill, as we are now exposed to many more man-made chemicals than ever before. Most have not been fully tested even for individual toxicity. Even fewer have been checked for the possibility that combinations could give problems not seen with exposure to a single substance.

Chemicals enter the body by being ingested (in food, as additives, in water, from the hands, or as drugs), inhaled, injected, or by being absorbed through the skin. Any chemical that enters the body has to be 'detoxified' (broken down) and eliminated. This process is carried out by a range of enzymes and pathways in the body, notably in the liver, kidneys and blood. One theory is that chemical sensitivity develops when these pathways don't work effectively enough to keep up with demand.

Chemical sensitivity often (but not always) develops in people who are prone to other types of allergy. They may have a history of asthma, eczema or hayfever in the past, or in close family members. Some will have been prone to headaches from perfumes, or nausea from paint smells, for many years and this gradually develops into more serious chemical sensitivity. In other patients illness follows an acute exposure to a high level of a particular chemical such as a pesticide, or fumes from an office photocopier. In this latter group a higher than normal chemical exposure triggers illness and after this the patient reacts to the much lower levels found in everyday life, which previously were not a problem. Initially they react to the same chemical that set off their sensitivity (although at much lower doses); then they begin to react to related chemicals; then (often) the sensitivity spreads to almost any chemical.

Patients with these problems can also be triggered into reactions to foods (food intolerance) and/or classic inhalant allergens like house dust mite, moulds, pets or pollens. They tend easily to acquire new allergies. This pattern has been termed Toxicant induced Loss of Tolerance (TILT) and is an important feature of the condition.

What sort of illness does it cause?

Even 'classic' allergy is usually a multi-organ disease; for example, hay fever can affect the eyes, nose, chest and skin. Thus in chemical sensitivity multi-organ complaints should be expected and their presence is not evidence of psychological origin, even though brain functions are often involved. Most chemically sensitive people are grossly fatigued and have trouble with coordinating (brain fog) and lengthy concentration (brain fag).

Headaches are common. Many tend to have skin rashes (urticaria and/or eczema), irritable bowel, musculoskeletal pains, asthma and rhinitis. Burning sensations are common.

Whilst many become depressed, in some this may be a consequence of having the cause of their problems rejected by unsympathetic doctors, although primary depression also occurs. Some patients manage to create a safe island within their own homes where they can keep fairly well and find leaving this environment makes them worse and they become frightened about doing so.

How does it make you ill?

The mechanism of chemical sensitivity is not known. As mentioned, it appears to be due to an alteration in the ability of the body to detoxify and get rid of chemicals, combined with some sort of increased sensitivity to the effects of these chemicals on the body. Detoxification pathways rely heavily on vitamins, minerals and some amino acids to work effectively, and in some people there may be a link with low levels or inadequate absorption and use of these substances.

The body has a limited number of detoxification pathways, down which all chemicals and other substances must pass to be detoxified. There seems, therefore, to be a 'total load' effect - if a pathway is busy detoxifying one chemical, there is less availability for other chemicals to be 'cleared'.

What can be done about it?

It is important that patients should be given a correct diagnosis. Currently so few people are trained to recognize and treat MCS that there is a real danger that patients are misdiagnosed, usually as suffering from a psychiatric condition. General practitioners should be enabled to identify the possibility that individual patients may be affected and to ensure that they receive appropriate management.

A Doctor or specialist skilled in the management of chemical sensitivity should be able to take a full medical and environmental exposure history (usually a lengthy procedure) and would be familiar with the various methods which might be used to aid diagnosis using specialist laboratory testing.  Biochemical tests of nutritional status may be required.

There are four main strands to the self-management of chemical sensitivity.

1) Reduction of exposure to chemicals.

As chemical sensitivity tends to spread from one substance to others over time, it is important to reduce exposure to all chemicals, not just those to which you are reacting at the moment. This also frees up the detoxification pathways to work more effectively.

See below for 'Chemical Avoidance' information. Note that some of the enzymes that detoxify chemicals are 'inducible' - that is to say, they are only produced in response to the chemical being present. Therefore over-zealous avoidance of chemicals may lead to a reduction in the ability to detoxify that chemical (and perhaps related chemicals). While it is important to create a 'safe-haven' at home, it is also important to maintain contact with the outside world for this reason, and for psychological benefit.

2) Reduction of exposure to other allergens

Chemically-sensitive people seem to have an increased tendency to become affected by other allergens such as housedust mites, moulds and animals. It is therefore important to follow general allergen reduction advice (see the Avoiding Indoor Allergens fact sheet).

3) Diet

Good nutrition is vitally important in managing chemical sensitivity. A wide range of vitamins, minerals, essential fatty acids and proteins are needed for detoxification pathways to work.
Chemically sensitive people seem to have an increased tendency to develop food intolerances. The risk of this is increased if the diet is limited, as repeated eating of the same few foods makes it much more likely that sensitivity to those foods will follow.
The key to dietary management is to eat a wide-ranging, varied diet.

4) Specialist help.

Increasing the level of certain vitamins, minerals and amino acids will benefit many chemically-sensitive people. However there are risks in using high-dose supplements of some substances if they are not 'balanced' correctly. This should therefore not be done without specialist advice.
For some people other special supplements, or high-dose intravenous vitamins and minerals may be beneficial, both in boosting detoxification pathways and in 'chelating' (getting rid of) harmful chemicals. Some other supplements such as digestive enzymes or prescription drugs may also be helpful in some people.

Chemical Sensitivity Avoidance Information

Sensitivity to chemicals has been called the '20th-century disease' as we are exposed to an ever increasing number of chemicals in our food, water, consumables and environment. Our ability to cope with this increasing load on the system cannot be infinite, and it is therefore sensible for us all to reduce the load of chemicals that we have in our homes and come into contact with on a daily basis. Most of our homes are considerably more polluted than the air outside.

For those who have already become chemically sensitive, avoidance is vital and a complete review of household substances in use and the way they live their life may need to be undertaken. Most chemically-sensitive people initially develop problems with one specific chemical, perhaps following a 'toxic' or heavy exposure. In time, the sensitivity spreads to other chemicals, and eventually to many of them.

Any chemical that enters the body has to be 'detoxified' (broken down) and eliminated. This process is carried out by a range of enzymes and pathways in the body, notably in the liver, kidneys and blood. Chemical sensitivity seems to develop when these pathways don't work effectively enough to keep up with demand. The number of pathways is limited, and all the detoxification requirements have to 'share' the available pathways. For these reasons, avoidance of single chemicals is rarely effective. It is a general reduction in exposure to chemicals in our lives that is required.

Chemical avoidance - first steps

• DON'T SMOKE or allow smoking in the house; if someone in your house just won't give up, ask them to only smoke outside or in only one room and get a good air filter in there.
• Don't use ANY perfume or hairspray.
• Switch to unperfumed deodorants; use sticks/roll-ons, not sprays.
• Use fragrance free shampoo and conditioner.
• Use a 'cleaner' toothpaste, ie homeopathic, herbal, baking soda.
• Don't use ANY air fresheners, carpet powder cleaners, scented vacuum bags.
• Use oxygen bleaches, not chlorine bleach. Borax can be put down toilet bowls, and for soaking clothes.
• Cut down on the use of strong smelling disinfectants. Most people use disinfectants when they only need to clean with soap and water. When a disinfectant is needed use a non-taint, safer type.
• Switch to an unperfumed soap powder of the 'sensitive skin' type or basic soap-flakes. Avoid all fabric conditioners.
• Cut down on (or ideally stop) the use of furniture polishes and spray cleaners; use pump sprays or tins (beeswax) rather than aerosols, or just damp dust.
• Half-used tins of paint, brush cleaner, cleaning materials etc. should not be kept under the sink. Eventually the paint dries out in the tin - where does the solvent go? Into the air in your house! Move all of these items into the garage or bin.
• When decorating use low-odour, solvent-free paints, varnishes and glues, and always ventilate well.
• If buying new carpets and furnishings, sniff them well in the shop. There can be a big difference in makes. European furniture and materials often have to meet more stringent standards and give off less gases such as formaldehyde. Try to avoid cheap 'chipboard' materials; MDF is better, solid wood is best. Allow anything new to air off for a while before bringing it into use; if possible, ventilate rooms well until the smell goes.
• Investigate an air filter for your car.
• Avoid additives in foods as far as possible.
• Consider fitting a water filter, or using a jug filter, but change the cartridge regularly, follow the instructions closely, and keep filtered water in the fridge.
• Buy a recommended air filter for your home (one that reduces chemicals as well as particulates such as pollens and dusts).

Further advice

Gather together (or preferably have this done for you) everything within your home that is scented. Empty the bedroom dressing table, cupboard under the stairs, under the kitchen sink, the bathroom cabinets of all the perfumed soaps, powders, toiletries including toothpaste, air fresheners (don't forget to remove the one in the toilet) biological washing powders, fabric conditioners, sprays and synthetic cleaning materials.

Pack them up and store them safely away in the loft, shed or garage. After a six-week period you can try to reintroduce them one at a time starting with the one you miss most. If you continue to feel well and do not react that is fine but do avoid using that item too often - remember moderate use is the key.

If you have children, do not use pesticides on the hair for lice even if it is prescribed - for details of an effective non-toxic method ring Allergy UK.

Consider the glues, coloured pens, paints etc that your children are using and if necessary replace them with non-chemical items, such as non-toxic crayons, paste, water colour and poster paints.
Use unperfumed toiletries and basic unscented vegetable soap. To replace toothpaste use bicarbonate of soda, either alone or mixed with sea salt. After the six-week period try using homeopathic or herbal toothpaste but you should avoid toothpaste gel, as this has to contain preservatives. For washing clothes use very plain washing powders - Allergy UK can provide names of companies able to supply suitable products.
Sodium bicarbonate, perhaps one of the best friends of the chemically sensitive, is a very useful general cleaning tool. Smear sodium bicarbonate on the inside of the oven and any fat splashes will turn into soap and be easily removed. To clean the loo and drains use washing soda.

Other cleaning tips are given in the 'Handy Hints' fact sheet from Allergy UK.

Food & well-being

There are numerous additives, chemicals, pesticides, and preservatives involved in the food chain. If possible try changing to organic food as some people have reported benefit from this.

• Do not leave food in open tins even if refrigerated.
• Switch to water sold in glass bottles not plastic.
• Stop using plastics to store/wrap food. Use cellophane, pottery or glass.
• Take a good vitamin and mineral supplement.
• Exercise and saunas have been found to be beneficial to many people (take medical advice first).
• Adding two tablespoonfuls of Epsom salts to your bath may be beneficial.

Indoor environment

Ventilation is extremely important - open windows, have the trickle vents open and sleep with an open window if safe to do so. Use the extract fans. If you can afford to do so consider having a house ventilation system installed, but if you do make sure it is regularly serviced. If using a gas cooker, ensure that you have good ventilation and use an extractor hood which vents to the outside. If you are thinking of changing your cooker consider changing to electricity.

Living gas fires and back boilers should be avoided if possible. Central heating from a sealed gas boiler is usually tolerated but do ensure that it is in good order and regularly serviced. Fit a carbon monoxide monitor.
Be very careful when buying carpets or underlay as many are now sprayed against mould, stains, house dust mite etc. Do a 'sniff-test' before ordering - ask for a small sample (a couple of inches square is enough) and place the sample in a sealed glass jar. Leave it on the window-sill for a few days, then take the top off the jar and sniff - this will give you a good idea of whether the carpet or material will affect you. If you are very sensitive and have an understanding non-chemically sensitive friend ask them to do it for you. If on delivery your carpet/underlay does retain a smell you might well need to air them for a considerable length of time. Steam cleaning (using high-temperature steam only) can speed up the process.

If ordering new armchairs or suites again do the "smell test" and also request that your chairs are not plastic wrapped for delivery.Avoid all synthetic fabrics whether in furnishings or clothing and cottons with a synthetic finish.

Plants, such as the spider plant, can be a good source for removing formaldehyde.

If you react to print - peg newspapers/magazines etc out on the line or in the shed/garage.

When buying new clothes wash them three or four times before wearing.

If you remove all the pollutants you may not need to invest in an air filter but if you do ensure that it is one with a charcoal filter.

Decorating

• Always try to decorate during the summer when you can have the windows and doors open.
• Do not sleep in the room that you are decorating until the smell has gone which might be several weeks.
• Try to avoid using vinyl wallpapers
• Use low odour/no odour paint
• Add 2 teaspoonful of bicarbonate of soda to paint to reduce odour
• Use plain wallpaper paste. You can add borax as a mould retardant. Or use a solvent free all-purpose adhesive
• Avoid using timber treatments and wall insulation.

General

Where you live can be very important. People with chemical sensitivity should not (if possible) live near an airport, on a main road or near a chemical plant or factory. Avoid low-lying areas if possible. The countryside also presents problems with crop spraying and the use of pesticides. The ideal locations are on the west side of the country (where the prevailing winds from the Atlantic will not have picked up pollution), coastal areas (on-shore breezes tend to keep pollution further inland) and higher, windy areas.

Avoid very new and very old houses if possible; new houses are too well insulated, have too little ventilation and a high chemical load; very old houses have usually been treated with timber treatments and need too much remedial work. 'Middle aged' houses with chimneys and floorboards are usually best.

Unfortunately chemical sensitivity is still not widely understood or in some cases even heard of by the majority of the general public. This places people who are chemically sensitive at a dreadful disadvantage. Simple everyday tasks, which involve visiting public areas such as theatres, halls, schools, supermarkets, using public transport or travelling by air for some people, is impossible. All of these areas could, if they wished, address the issue and reduce the illness inducing chemicals that they use in cleaning and air-conditioning. Products are available to achieve this. Hopefully in the future progress will be made on this front and we will be able to advise chemically sensitive people on 'safe' areas. The greatest campaigners for this are the chemically sensitive themselves.

If our information has helped you please consider helping us to educate and inform the Medical Profession, Government, Industry and very importantly the General Public.

If you would like to speak to one of our Helpline Advisors please ring 01322 619898

Updated 4/2008