Multiple Chemical Sensitivity - Diagnosis

Diagnosis

People who have developed symptoms of MCS have attributed a wide assortment of symptoms to chemical exposure, though symptoms are generally consistent for each individual. The first step in diagnosing a potential MCS sufferer is to identify and treat all other conditions which are present and which often explain the reported symptoms. For example, true allergy, thyroid disorders, orthostatic syndromes, anxiety, and depression need to be carefully evaluated and, if present, properly treated.

The "gold standard" procedure for identifying a person who has MCS is to test his or her response to the random introduction of chemicals the patient has self-identified as relevant, such as scented soaps or dryer sheets. This may be done in a carefully designed challenge booth to eliminate the possibility of contaminants in the room. Chemicals and controls, sometimes called prompts, are introduced in a random method, usually scent-masked. The test subject does not know when a prompt is being given. Objective and subjective responses are measured. Objective measures, such as the galvanic skin response electrodermal response, indicate psychological arousal, such as fear, anxiety, or anger. Subjective responses include patient self-reports. A diagnosis of MCS can only be justified when the subject cannot consciously distinguish between chemicals and controls, and when responses are consistently present with exposure to chemicals and consistently absent when prompted by a control.

Investigators in Japan, Spain, Germany and the United States have used the Quick Environmental Exposure and Sensitivity Inventory (QEESI) as a self-screening questionnaire in their research on MCS. The QEESI is a shortened version of the Environmental Exposure and Sensitivity Inventory developed by Dr. Claudia S. Miller. The QEESI asks individuals to rank their responses to exposures from 0 to 10 in four scales: symptom severity, chemical intolerances, other intolerances, and life impact.