WHAT CAN RESEARCH CONTRIBUTE TO REGULATORY DECISIONS ABOUT THE HEALTHRISKS OF MULTIPLE CHEMICAL-SENSITIVITY

Multiple Chemical Sensitivity (MCS), which may not be caused by chemic als at all, is a serious medical problem of unknown origin and uncerta in etiology that raises many fundamental science and policy questions. Regulators, for example, are confronted with a dilemma: what, if anyt hing, should be done to protect people from the scientifically uncerta in health risks of exposures to extremely low levels of environmental chemicals. Regulatory agencies, such as the Environmental Protection A gency, do not have the luxury of waiting until conclusive scientific e vidence is available before making a decision; however, our present la ck of scientific understanding about MCS is so acute that it is not po ssible to ascertain whether the cause of MCS-related symptoms is chemi cal, biological, physical, pyschosocial, or some combination thereof. Nevertheless, many MCS sufferers and advocates for the chemically indu ced hypothesis are clamoring for regulatory action to reduce putative health risks from very-low-level exposures to chemicals in the environ ment. Unless steps are taken to improve the quantity and quality of th e existing scientific data base, we cannot, with any acceptable degree of certainty, evaluate the extent to which regulatory decisions about MCS are either protective of public health or cost-effective. This ar ticle examines how research can strengthen the scientific basis for ri sk-related decisions about RIGS, and proposes a framework for establis hing research directions and priorities. It is argued that high-priori ty research on MCS is distinguishable by four attributes: (1) results are valuable for risk-related decisions; (2) findings significantly ad vance scientific knowledge and understanding; and the hypothesis being tested is both (3) biologically plausible and (4) readily testable. ( C) 1996 Academic Press, Inc.