Classification of Patients Complaining of Sick House Syndrome and/or Multiple Chemical Sensitivity

Abstract

Sick house syndrome (SHS) is a Japanese concept derived from sick building syndrome (SBS), however SHS includes a broader scope of sickness than does SBS. Symptoms of SHS/ SBS disappear after leaving the sick house/building, while symptoms of multiple chemical sensitivity (MCS) are elicited by the chance of chemical exposure after leaving the sick house/building. To establish the concept of SHS, we propose to introduce a new classification for SHS. A total of 214 patients complaining of SHS and/or MCS were independently classified using a new classification by clinical ecologists who are experienced physicians with expert knowledge of clinical ecology and general physicians according to disease pathogenesis from clinical records. The classification is as follows: type 1 (symptoms of chemical intoxication), type 2 (symptoms developed possibly due to chemical exposure), type 3 (symptoms developed not because of chemical exposure but rather because of psychological or mental factors), and type 4 (symptoms developed due to allergies or other diseases). The agreements on the classification made by clinical ecologists and general physicians reached 77.1% (Cohen's kappa = 0.631), suggesting that this new classification was both apt and accurate. Relations between SHS and allergy/MCS were also studied. The cases classified as SHS type 4 more frequently had allergic past histories than did other types. The proportion of possible MCS cases was higher in the chemical induced SHS group (types 1 and 2) than in other types among male patients. For the universal use in clinical practice, it is necessary to prepare helpful diagnostic criteria of this SHS classification based on pathogenesis and carry our study forward all over the country. sick house syndrome; sick building syndrome; multiple chemical sensitivity; Quick Environment Exposure Sensitivity Inventory; allergy

The Search for Reliable Biomarkers of Disease in Multiple Chemical Sensitivity and Other Environmental Intolerances

“…As leading examples, in Europe notably Germany and Austria have listed MCS, FM and CFS under the ICD (International Classification of Diseases)-10 code of the World Health Organization with local modifications [1]. The same occurred in Japan in 2009, where special attention is given to indoor pollution, causing SBS/SHS [152], considered a point of attention also by Canada [153]. Sweden has recently recognized electro-magnetic hypersensitivity as a functional syndrome [142], whereas United States and Australia do not list any form of environmental sensitivity to ICD-10 as yet, though several leading state agencies and medical associations have since long recognized chemical hypersensitivity as a disability deserving deeper investigation [20,154].…”

Fungi Sensitization in Spain: Importance of the Alternaria alternata Species and Its Major Allergen Alt a 1 in the Allergenicity

“…Outdoor spores counting can reach 7500 spores/m 3 of air; indoor counting is about 280 spores/m 3 [ 24 ]. Indoor presence is associated with high humidity, poor air circulation, and the presence of cockroaches or cat dander, linked to the “sick building syndrome” [ 25 ]. A Polish study in adults ( n = 500) correlated a concentration of 80 spores/m 3 with a flare-up of allergic symptoms and levels higher than 300 spores/m 3 are associated with dyspnea [ 26 ].…”

The SNP rs2298383 Reduces ADORA2A Gene Transcription and Positively Associates with Cytokine Production by Peripheral Blood Mononuclear Cells in Patients with Multiple Chemical Sensitivity

“…Despite the absence of validated diagnostic biomarkers, the epidemiological evidence has led the individual countries to at least partially recognize MCS as a pathological state. In Europe, in particular, Germany and Austria classified MCS under the ICD-10 code T78.4 (unspecified allergies, Nitrous Oxide System-hypersensitivity, NOS-idiosyncrasy) [1], while in Japan, where particular attention is paid to environmental pollution, MCS is classified under ICD code T65.9 (unspecified respiratory conditions due to inhalation of fumes, gas, and chemical vapors) [7]. In US and Australia several medical associations have long recognized chemical hypersensitivity as a disability that deserves thorough investigations.…”