MULTIPLE CHEMICAL-SENSITIVITY SYNDROME - A CLINICAL PERSPECTIVE .2. EVALUATION, DIAGNOSTIC TESTING, TREATMENT, AND SOCIAL CONSIDERATIONS

Multiple chemical sensitivity syndrome (MCS) does not appear to fit es tablished principles of toxicology. Social, political, and economic fo rces are demanding that MCS be defined medically, even though scientif ic studies have failed as yet to identify pathogenic mechanisms for th e condition or any objective diagnostic criteria. Consequently, a work ing definition of MCS can only rely on a person's subjective symptoms of distress and attribution to environmental exposures rather than cur rently measurable objective evidence of disease. Nevertheless, patient s labeled with MCS are clearly distressed and many are functionally di sabled. Without reconciling the different theories of etiology of MCS discussed in Part I of this report, and recognizing that the cause of the syndrome may be multifactorial, strategies are proposed for clinic al evaluation and management of patients with MCS using a biopsychosoc ial model of illness. The social implications of this illness are also discussed.