Multiple Chemical Sensitivity

  • Hans DrexlerEmail author
  • Annette Greiner
Reference work entry


Multiple chemical sensitivity (MCS) is an enigmatic term, and although this combination of symptoms has been written about for over 50 years, it is unclear whether this is a disease (a pathophysiological process with a molecular mechanism) or an illness (a subjective feeling of malaise). The Center for Disease Control and Prevention (CDC) does not recognize MCS as a disease (Spencer and Schur 2008). As implied by its name, MCS is a condition in which chemical effects are blamed for causing the subjectively experienced symptoms/complaints. The allergologist Theron Randolph was a major influence in the formation of a movement in the 1950s which called itself clinical ecologists and described for the first time the combination of symptoms which later came to be known as MCS. As he assumed the presence of an allergic pathogenic mechanism, he called this illness the “All Allergy Syndrome.” The idea of an underlying allergic pathogenic mechanism leads the affected persons repeatedly to allergologists, usually after dozens of specialists have already been consulted. Regardless of the diagnostic significance, a patch test using chemical substances is frequently requested. The fact that a positive patch test can only explain an allergic skin reaction and is of no use in explaining other diverse symptoms is often tenaciously ignored by these patients. In addition, these patients also demand specialized allergological procedures such as the lymphocyte transformation test, the histamine release test, or the mast cell degranulation test. The term sensitization has a double meaning in connection with the genesis of MCS. In allergology, sensitization means the immunological processes that are necessary for the immune system to react to an exogenous substance with an allergic reaction. In psychology the term sensitization is used when mental processes recur on repeated exposure after an initial incident. Allergologists and dermatologists are repeatedly confronted by both this conceptualization (sensitization, All Allergy Syndrome) and the wish for clarification by the MCS patients and their ideas about the genesis of MCS.


Multiple chemical sensitivity MCS Idiopathic environmental intolerance IEI 


  1. Anon (1999) Multiple chemical sensitivity: a 1999 consensus. Arch Environ Health 54:147–149CrossRefGoogle Scholar
  2. Berg ND, Berg Rasmussen H, Linneberg A, Brasch-Andersen C, Fenger M, Dirksen A, Vesterhauge S, Werge T, Elberling J (2010) Genetic susceptibility factors for multiple chemical sensitivity revisited. Int J Hyg Environ Health 213:131–139CrossRefGoogle Scholar
  3. Caress SM, Steinemann AC (2003) A review of two-phase population study of multiple chemical sensitivities. Environ Health Perspect 111:1490–1497CrossRefGoogle Scholar
  4. Caress SM, Steinemann AC (2004) A national population study of the prevalence of multiple chemical sensitivities. Arch Environ Health 59:300–305PubMedGoogle Scholar
  5. CDC (2009) “Indoor Environmental Quality Policy”, quoted from: martini a, Iavicoli S, Corso L (2013): multiple chemical sensitivity and the workplace: current position and need for an occupational health surveillance protocol. Oxidative Med Cell Longev 2013:351457Google Scholar
  6. Cullen MR (1987) The worker with multiple chemical hypersensitivities: an overview. Occup Med 2:655–661PubMedGoogle Scholar
  7. Dantoft TM, Andersson L, Nordin S, Skovbjerg S (2015) Chemical Intolerance. Curr Rheumatol Rev 11(2):167–184CrossRefGoogle Scholar
  8. Das-Munshi J, Rubin GJ, Wessely S (2006) Multiple chemical sensitivities: a systematic review of provocation studies. J Allergy Clin Immunol 118:1257–1264CrossRefGoogle Scholar
  9. Graveling RA, Pilkington A, George JPK, Butler MP, Tannahill SN (1999) A review of multiple chemical sensitivity. Occup Environ Med 56:73–85CrossRefGoogle Scholar
  10. Guglielmi RS, Cox DJ, Spyker DA (1994) Behavioral treatment of phobic avoidance in multiple chemical sensitivity. J Behav Ther Exp Psychiatry 25(3):197–209CrossRefGoogle Scholar
  11. Hauge CR, Rasmussen A, Piet J, Bonde JP, Jensen C, Sumbundu A, Skovbjerg S (2015) Mindfulness-based cognitive therapy (MBCT) for multiple chemical sensitivity (MCS): results from a randomized controlled trial with 1 year follow-up. J Psychosom Res 79(6):628–634CrossRefGoogle Scholar
  12. Johnson D, Colman I (2017) The association between multiple chemical sensitivity and mental illness: evidence from a nationally representative sample of Canadians. J Psychosom Res 99:40–44CrossRefGoogle Scholar
  13. Loria-Kohen V, Marcos-Pasero H, de la Iglesia R, Aguilar-Aguilar E, Espinosa-Salinas I, Herranz J, Ramirez de Molina A, Reglero G (2017) Multiple chemical sensitivity: genotypic characterization, nutritional status and quality of life in 52 patients. Med Clin (Barc) 149(4):141–146CrossRefGoogle Scholar
  14. Meulders A, Fannes S, van Diest I et al (2010) Resistance to extinction in an odor −20%CO 2 inhalation paradigm: further evidence for a symptom learning account of multiple chemical sensitivity. J Psychosom Res 68:47–56CrossRefGoogle Scholar
  15. Miller CS (1997) Toxicant-induced loss of tolerance_an emerging therory of disease? Environ Health Perspect 105(2):445–453PubMedPubMedCentralGoogle Scholar
  16. Miller CS, Prihoda TJ (1999) The environmental exposure and sensitivity inventory (EESI): a standardized approach for measuring chemical intolerances for research and clinical applications. Toxicol Ind Health 15:370–385CrossRefGoogle Scholar
  17. Pall ML (2001) Common etiology of posttraumatic stress disorder, fibromyalgia, chronic fatigue syndrome and multiple chemical sensitivity via elevated nitric oxide/peroxynitrite. Med Hypotheses 57(2):139–145CrossRefGoogle Scholar
  18. Pall ML (2003) Elevated nitric oxide/Peroxynitrite theory of multiple chemical sensitivity: central role of N-methyl-D-aspartate receptors in the sensitivity mechanism. Environ Health Perspect 111(12):1461–1464CrossRefGoogle Scholar
  19. Sparks PJ, Daniell W, Black DW, Kipen HM, Altmann LC, Simon GE, Terr AI (1994) Multiple chemical sensitivity syndrome: a clinical perspective. II. Evaluation, diagnostic testing, treatment, and social considerations. J Occup Med 36(7):731–737PubMedGoogle Scholar
  20. Spencer TR, Schur PM (2008) The challenge of multiple chemical sensitivity. J Environ Health 70:24–27CrossRefGoogle Scholar
  21. Wiesmüller GA, Hornberg C (2017) Environmental medical syndromes. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 60(6):597–604CrossRefGoogle Scholar
  22. Wiesner G, Gil FP, Nowak D (2005) Multiple Chemikalienüberempfindlichkeit (MCS) – eine Fallserie. Dtsch Med Wochenschr 130:329–332 (Multiple Chemical Sensitivity (MCS) A series of case histories; German Weekly Medical Magazine 130:329–332)CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Institute and Outpatient Clinic for Occupational, Social and Environmental MedicineFriedrich-Alexander-University, Erlangen-NürnbergErlangenGermany

Personalised recommendations