Chronic Fatigue Syndrome a medically determinable impairment

One of the battles often fought by persons with CFS trying to obtain Social Security Disability Insurance and SSI benefits was resolved with the adoption of Social Security Ruling 99-2p. In this binding Ruling the Social Security Administration set out guidelines for adjudicators and judges to follow for claims based upon Chronic Fatigue Syndrome. This Ruling removes at least one of the barriers faced by Claimants.

What Was the Issue?

The Social Security Act allows for SSDI or SSI benefits to be paid to persons unable to work by reason of any medically determinable physical or mental impairment (or combination of impairments)….” (emphasis added) The Act and Regulations define the phrase “medically determinable” as a condition that can be established by medical evidence consisting of signs, symptoms and laboratory findings. It cannot be based only on the Claimant’s description of symptoms.

In claims based upon CFS there are obviously a lack of medical signs, symptoms and laboratory findings. Therefore many claims were denied on the failure to prove the existence of a “medically determinable impairment.”

What Does the Ruling Say?

The Ruling states unequivocally that CFS can be a medically determinable impairment. It specifies medical signs and laboratory findings that will now constitute proof of a medically determinable impairment for persons suffering from CFS. However, whether the Claimant is actually “totally disabled” is a separate determination based upon the severity of functional limitations caused by the disease. That is the same as in any claim based upon any other medical problem.

This Ruling requires that any of the following medical signs, which are clinically documented over a period of at least 6 consecutive months, can establish a medically determinable impairment:

• palpably swollen or tender lymph nodes on physical examination;
• nonexudative pharyngitis;
• persistent, reproducible muscle tenderness on repeated examinations, including the presence of positive tender points; or,
• other medical signs consistent with medically accepted clinical practice which are consistent with the other evidence in the case record.

The following laboratory findings can establish a medically determinable impairment for individuals with CFS:

• an elevated antibody titer to Epstein-Barr virus capsid antigen equal to or greater than 1:5120, or early antigen equal to or great than 1:640;
• an abnormal MRI brain scan;
• neurally mediated hypotension as shown by tilt table testing or another clinically accepted form of testing; or,
• other laboratory findings consistent with medically accepted clinical practice such as abnormal sleep studies and abnormal exercise stress tests that are consistent with other evidence in the case record.

Finally, mental impairments documented by mental status examinations or psychological testing can also establish the presence of a medically determinable impairment.

What Evidence Can Be Used to Show these Signs and Findings?

As in any claim for disability benefits the focus is upon the medical evidence, especially the clinical records and test results from treating sources. SSA will try to obtain all medical records, generally beginning 12-months prior to the month of application. The Ruling notes that conflicts in the medical evidence are not unusual in cases involving CFS and clarification should be sought first from the treating sources. Treating source opinions about the severity of the impairment should be given deference if they are well supported by medically acceptable clinical and laboratory techniques and are not inconsistent with other evidence in the records. It is noted that any information regarding functional abilities before and after the onset of the impairment is helpful in evaluating the claim. Finally third-party sources may be useful in determining the credibility of the Claimant.

As in any claim, the focus is upon a longitudinal view of all of the medical evidence. Claimants must be actively treating with medical providers and must be completely describing all symptoms each time they see the doctor. The doctors must keep careful, legible, notes during each visit so that the signs and findings noted above can be documented. In addition, the physician should be willing to provide a written opinion to SSA regarding the patient’s ability to sustain even sedentary work activity on an 8 hour per day, 5 days per week basis.

SSR 99-2p does not provide that every claim based upon CFS should be approved. It does, however, set forth guidelines for evaluation of these claims so that Claimants, physicians and representatives can be assured of a fair evaluation of the impairment and its impact on the individual.

Literature: Jeffrey A. Rabin & Assoc, CFS Finally Recognized As ‘Medical Impairment’ Under Guidelines, 24-7, June 26, 2010

Article provided by Jeffrey A. Rabin & Assoc, Visit at www.rabinsslaw.com

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Related Articles:

• CFS – Chronic Fatique Syndrome: FDA and NIH confirm ‘XMRV findings’
• MCS – Multiple Chemical Sensitivity recognized as physical disease at ICD-10 in Japan
• The Department of Health of the Austrian Government recognizes MCS – Multiple Chemical Sensitivity as a physical disease
• MCS recognized as physical disease in Germany

Scientists and NGOs concerned about the health impacts of bisphenol A

PRESS RELEASE, 23rd JUNE 2010

An unprecedented 60 scientists and international environment, health and women’s organisations from around the globe have jointly written to the European Food Safety Authority (EFSA) stating that

“action is necessary to reduce the levels of Bisphenol-A (BPA) exposure, particularly in groups at highest risk, namely young infants and pregnant mothers.”

[Quotes from some of the participating scientists and NGOs can be found towards the end of this release.]

In total, 41 NGOs and 19 scientists from 15 countries from across the globe (including 9 from the UK) have signed the letter. The letter comes on the eve of a new scientific opinion to be released by the EFSA on the safety of Bisphenol A in food contact materials expected in early July 2010. EFSA was requested by the European Commission to assess the latest science on Bisphenol A, and if necessary, to update the existing Tolerable Daily Intake (TDI) (a specific amount in food or drinking water that can be ingested (orally) over a lifetime without an appreciable health risk).

Bisphenol A is a mass produced chemical used in the manufacture of polycarbonate plastics that are clear and nearly shatter-proof. It can be found in plastics used for food and beverages, such as baby bottles, sports water bottles, as an epoxy resin in canned food and drinks, plastic food storage containers, tableware and in other products, including dental sealants, and has been found to leach into food and drink.

There have been long standing concerns about the health impacts of bisphenol A, due to scientific studies that have shown it has hormone disrupting effects at extremely low levels of exposure. Human bio-monitoring studies have shown that the vast majority of people in developed countries are exposed to Bisphenol-A.

EFSA’s previous opinions in 2007 and 2008 predominantly relied upon a handful of industry backed scientific papers that have expressed no concerns about our levels of BPA exposure. The letter from scientists and NGOs highlights scientific criticism in academic journals regarding these papers as compared to the “several hundred peer reviewed scientific papers have been published that have highlighted potential adverse health effects associated with BPA exposures”

The letter also draws attention to some of the new studies which have raised risks of exposure relating to a potential increased likelihood of developing ‘diabetes’, ‘developmental programming’ and ‘breast cancer’. Bisphenol A exposure at environmentally relevant levels commonly found in the environment in developed countries has also been repeatedly linked by independent university – based scientists to a number of other serious chronic health conditions.

Despite EFSA’s pivotal position in setting chemical food safety levels across the EU, Sweden and Germany have become the third and fourth most recent EU member states, alongside France and Denmark, to take action ahead of the EFSA review.

Andreas Carlgren, Sweden’s Environment Minister stated, on 11th May 2010, that

“If the EU will not quickly forbid the hormone disrupting substance bisphenol in baby-bottles Sweden will precede with a national prohibition.”

The President of the German Federal Environment Agency on the 9th June also broke from EFSA policy by issuing new guidance calling on

“manufacturers, importers and users of bisphenol A to use alternative substances that pose less risk to human health and the environment in all areas of use that significantly contribute to exposure”.

Regulators in Canada and the USA have already taken action to limit BPA exposure, for example in its use in baby bottles. As yet there has been no similar action at the European Union level.

A number of EU member states continue to back a common approach across the EU on bisphenol A. Tim Smith, the head of the UK Food Standards Agency, declared in an internal FSA report on the 12th May, 2010 that he ‘considers it important to have an agreed position across the EU’ and that the FSA will only ‘revise our position in line with it the EFSA Review if it is considered necessary’, despite the action that is being taken elsewhere across the EU.

The EFSA have already delayed publication of its review, as explained on its website:

To give the European Commission an up-to-date overview of the safety of BPA, EFSA will now deliver a scientific opinion in early July rather than end of May. This is due to the need for the Panel to consider hundreds of studies in its review and analysis of the most recent scientific literature.

The letter from scientists and organisations opens by ‘welcoming this announcement’ issued at the 11th hour that EFSA has finally agreed to examine hundreds of non-industry backed scientific papers.

The letter was drafted by Breast Cancer UK and Prof. Fredrick vom Saal, Curators Professor of Biological Sciences, University of Missouri-Columbia who has been awarded by his peers for his work on Bisphenol-A and is a recognised leader in this field. The effort was also coordinated by the Brussels based Health and Environment Alliance (HEAL).

Prof. vom Saal stated in response to the publication of the letter that:

“At the heart of the debate over BPA lies an outdated set of guidelines used by regulatory agencies that are based on approaches to evaluating the safety of chemicals established over 50 years ago. Thus, 21st century research approaches have provided overwhelming scientific evidence of harm in hundreds of published reports, but these findings are being rejected for consideration because they do not conform to the outdated testing guidelines.

“This has left regulatory agencies to rely entirely on industry-funded research that used ‘approved’ testing methods that are crude and insensitive, and it is not surprising that 100% of these industry-funded studies conclude that BPA causes no harm.

“The only rational path for European regulators is to take decisive action to reduce human exposure to BPA. The overwhelming nature of the total scientific evidence mandates this as a priority.”

Clare Dimmer, Chair of Trustees Breast Cancer UK and former breast cancer patient stated:

“Breast cancer is the most common cancer across Europe and has been increasing rapidly regardless of the costly and expensive efforts made by Governments to improve screening, treatment, and increase research. It must now be time that regulators act on the science and begin to take a precautionary approach to hazardous chemicals like bisphenol-A found in our everyday products.”

Lisette van Vliet, Ph.D. the Toxics Policy Advisor at HEAL said:

“It is high time that EFSA caught up to the overwhelming science showing genuine reasons for concern about our daily exposure to BPA.”

Participating scientists and organisations were given the opportunity to provide a quote for this press release; those that responded have been included below. This does not preclude participating organisations providing their own releases, supporting statements and additional comments.

Prof. Andrew Watterson, Occupational and Environmental Health Research Group, University of Stirling, said:

“It’s worrying, considering the weight of the scientific evidence, that strong action to reduce human exposure is yet to be taken. Hundreds of academic studies have explicitly raised the risks of developmental harm to foetuses and young children from exposure to BPA and this should dictate a strong precautionary policy response from European regulators. If this is not forthcoming, the UK Government must intervene as other European countries are already doing so.”

Daniela Hoffmann, Chemicals Expert, GLOBAL 2000/Friends of the Earth Austria:

“EFSA has to finally acknowledge the overwhelming scientific evidence concerning the risk BPA poses to human health.”

Sarah Häuser, Chemicals Expert BUND / Friends of the Earth Germany:

“The existing Tolerable Daily Intake for BPA does not protect human health. In animal experiments and biomonitoring studies, BPA doses much smaller than those estimated as being safe by EFSA were linked to chronic conditions health damages like diabetes and cardiovascular diseases. It’s time to take action now.”

For further information please contact:

Hratche Koundarjian, Campaign Manager, Breast Cancer UK, Charity No: 1088047, T: 07905 911 039, E: hratche@breastcanceruk.org.uk, W: www.breastcanceruk.org.uk / www.nomorebpa.org.uk

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Letter and Signatories:

Prof. Klaus-Dieter Jany, Chair of the CEF Panel

European Food Safety Authority

Largo N. Palli 5/A, 43121 Parma, Italy

23rd June 2010

Dear Prof. Jany,

We are writing to welcome the announcement on the European Food Safety Authority (EFSA) website that the CEF panel will be considering ‘hundreds of studies in its review and analysis of the most recent scientific literature’ in its review of the TDI of bisphenol-A in food contact products.

Over the last decade and a half, a substantive body amounting to several hundred peer reviewed scientific papers, have been published that have highlighted potential adverse health effects associated with BPA exposures, at internal doses relevant to levels of biologically active BPA found in humans.

As a March 2010 Review (Vandenberg et al) of 80 bio-monitoring studies of BPA in Environmental Health Perspectives makes clear;

‘The two toxicokinetic studies performed to date, which suggest that human exposure is negligible, have significant flaws and are therefore not reliable for risk assessment purposes.’

However, in its prior risk assessments of BPA, EFSA only relied on a small number of studies rather than the much larger number that the United States Food and Drug Administration recently recognised as valid and of high utility in its risk assessment of BPA, and which led the FDA to express concern about the health hazards posed by BPA.

Only a tiny minority of studies have articulated that BPA exposure is completely safe, and many of these research papers have been criticised in academic commentaries and responses as having serious flaws, but it is these few flawed studies that EFSA previously relied on to declare BPA safe.

For example, a letter co-authored by 24 scientists published in the February 2010 edition of Toxicological Sciences states;

‘Publishing studies that conclude no harm in response to low doses of endocrine disrupting chemicals, when the studies did not include a positive control (Tyl et al., 2002), included inappropriate doses of positive controls (Ryan et al., 2009; Tyl et al., 2008), or included positive controls that showed no effect (Cagen et al., 1999), is inappropriate in peer-reviewed journals (Myers et al., 2009a,b; vom Saal and Welshons, 2006). Such studies violate basic principles of study design.’

Many scientific studies are now calling into question the safety of BPA. For example, a recent study has highlighted that BPA may contribute to metabolic disorders relevant to glucose homeostasis, and suggests that BPA may be a risk factor for diabetes (Alonso-Magdalena et al., 2010). Moreover, experiments at Yale university report that BPA may induce altered developmental programming (Bromer et al.,2010), and Doherty et al (2010) of Yale university have published a study which raises the concern about epigenetic effects of BPA on the regulation of the mammary gland, with potential implications for breast cancer risk. Endometriosis is also a concern as work by Signorile et al (2010) highlights that pre-natal exposure of mice to bisphenol-A causes an endometriosis-like response in female offspring.

It is therefore our opinion that any objective and comprehensive review of the scientific literature will lead to the conclusion that action is necessary to reduce the levels of BPA exposure, particularly in groups at highest risk, namely young infants and pregnant mothers.

There are an increasing number of countries that are either already committed to this course of action, or have signalled that they will soon be undertaking similar measures.

We share the concerns of these Governments and regulators and believe that reducing BPA exposure to these groups is both scientifically sound and in the best interest of public health.

As such, we call on you as the Chair of the CEF panel and the CEF Committee Members in their ongoing review to include all relevant studies, including bio-monitoring studies, and based on that evidence we conclude that there is a strong scientific mandate for action.

Yours sincerely,

1. Benson Akingbemi, Associate Professor, Department of Anatomy, Physiology and Pharmacology, Auburn University, Auburn, USA.
2. Prof. Dr. Ibrahim Chahoud, Institute of Clinical Pharmacology and Toxicology, Dept. of Toxicology, Charité – Universitätsmedizin Berlin
3. André Cicolella, Dipl Eng chemist-toxicologist.
4. Prof. Patricia Hunt, Meyer Distinguished Professor, School of Molecular Biosciences, Washington State University
5. Prof. Maricel V. Maffini. Ph.D. Research Assistant Professor. Department of Anatomy and Cellular Biology, Tufts University School of Medicine
6. Jane Muncke, Ph.D, Environmental Toxicologist, Emhart Glass SA, Switzerland.
7. John Peterson Myers, Ph.D., Chief Scientist, Environmental Health Sciences, Charlottesville VA.
8. Angel Nadal, PhD, Professor of Physiology, Instituto de Bioingeniería and CIBERDEM, Universidad Miguel Hernández de Elche, Spain.
9. Dr John Newby, Medical Information Scientist for the Cancer Prevention Society and Former Member of the Developmental Toxico-Pathology Research Group, Department of Human Anatomy & Cell Biology, Faculty of Medicine, University of Liverpool.
10. Prof. Jörg Oehlmann, Goethe University Frankfurt am Main, Institute for Ecology, Evolution and Diversity.
11. Prof. Gail S. Prins, PhD, Professor of Physiology, Department of Urology, University of Illinois at Chicago.
12. Prof. Fredrick vom Saal, Curators Professor of Biological Sciences, University of Missouri-Columbia.
13. Prof. Pietro Giulio Signorile, President of the Italian Endometriosis Foundation.
14. Prof. Ana M Soto, MD, Department of Anatomy and Cell Biology, Tufts University, School of Medicine.
15. Prof. Hugh S. Taylor, M.D., Professor of Molecular, Cellular and Developmental Biology, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University.
16. Laura N. Vandenberg, PhD, Postdoctoral Fellow, Center for Regenerative and Developmental Biology, Tufts University.
17. Prof. Cheryl S. Watson, PhD, Professor, Biochemistry & Molecular Biology Dept. University of Texas, Medical Branch, Galveston.
18. Prof. Andrew Watterson, Occupational and Environmental Health Research Group, University of Stirling.
19. Prof. R. Thomas Zoeller, Biology Department, Morrill Science Center, University of Massachusetts.

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1. Action for Breast Cancer, Malta
2. Alliance for Cancer Prevention, UK
3. Arnika, Czech Republic
4. Association for Environmental and Chronic Toxic Injury, Italy
5. Austrian section of ISDE (International Society of Doctors for the Environment), Austria
6. Breast Cancer Fund, USA
7. Breast Cancer UK, UK
8. BUND / Friends of the Earth Germany, Germany
9. Cancer Prevention and Education Society, UK
10. ChemSec –International Chemical Secretariat, International
11. CHEM Trust, UK
12. Chemical Sensitivity Network, Germany
13. Clean Air Action Group, Hungary
14. Comité pour le Développement Durable en Santé, France
15. Danish Consumer Council, Denmark
16. The Danish Ecological Council, Denmark
17. Eco-Accord Program on Chemical Safety, Eastern Europe, Caucasus and Central Asia
18. EcoAid, Germany
19. Ecologistas en Acción, Spain
20. Environmental Health Fund, USA
21. Environment Illinois, USA
22. European Environmental Bureau, EU
23. Finnish Association for Nature Conservation, Finland
24. Friends of the Earth Spain, Spain
25. Global 2000 / Friends of the Earth Austria, Austria
26. Health and Environmental Network, Europe
27. Health Care Without Harm, International
28. Indiana Toxics Action, USA
29. Instituto Sindical de Trabajo Ambiente y Salud, Spain
30. The Irish Doctors’ Environmental Association, Ireland
31. Italian Endometriosis Foundation, Italy
32. Plastic Planet, Austria
33. Rachel’s Friends Breast Cancer Coalition, USA
34. Réseau Environnement Santé, France
35. Society for Sustainable Living, Czech Republic
36. Unison, UK
37. VHUE e.V., Germany
38. Women in Europe for a Common Future, Europe
39. Women’s Environmental Network, Scotland
40. Women’s Voices for the Earth, USA
41. WWF European Policy Office, Europe

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References

• Vandenberg LN, Chauhoud I, Heindel JJ, Padmanabhan V, Paumgartten FJ, Schoenfelder G 2010. Urinary, Circulating and Tissue Biomonitoring Studies Indicate Widespread Exposure to Bisphenol A. Environ Health Perspect :-. doi:10.1289/ehp.0901716
• vom Saal FS, Akingbemi BT, Belcher SM, Crain DA, Crews D, Guidice LC, Hunt PA, Leranth C, Myers JP, Nadal A, Olea N, Padmanabhana V, Rosenfeld CS, Schneyer A, Schoenfelder G, Sonnenschein C, Soto AM, Stahlhut RW, Swan SH, Vandenberg LN, Wang H, Watson CS, Welshons WV and Zoeller RT. 2010. Flawed Experimental Design Reveals the Need for Guidelines Requiring Appropriate Positive Controls in Endocrine Disruption Research. Toxicological Sciences 2010 115(2):612-613; doi:10.1093/toxsci/kfq048
• Alonso-Magdalena P, Vieira E, Soriano S, Menes L, Burks D, Quesada I, et al. 2010. Bisphenol-A Exposure during Pregnancy Disrupts Glucose Homeostasis in Mothers and Adult Male Offspring. Environ Health Perspect :-. doi:10.1289/ehp.1001993
• Bromer JG, Zhou Y, Taylor MB, Doherty L, Taylor HS. Bisphenol-A exposure in utero leads to epigenetic alterations in the developmental programming of uterine estrogen response. FASEB J. 2010 Feb 24. [Epub ahead of print] PubMed PMID: 20181937.
• Doherty L, Bromer JG, Zhou Y, Aldad TS and Taylor HS. In Utero Exposure to Diethylstilbestrol (DES) or Bisphenol-A (BPA) Increases EZH2 Expression in the Mammary Gland: An Epigenetic Mechanism Linking Endocrine Disruptors to Breast Cancer. Hormones and Cancer. DOI: 10.1007/s12672-010-0015-9.
• Signorile PG, Spugnini EP, Mita L, Mellone P, D’Avino A, Bianco M, Diano N, Caputo L, Rea F, Viceconte R, Portaccio M, Viggiano E, Citro G, Pierantoni R, Sica V, Vincenzi B, Damiano G. Mita DG, Baldi F and Baldi A. Pre-natal exposure of mice to bisphenol A elicits an endometriosis-like phenotype in female offspring. General and Comparative Endocrinology. doi:10.1016/j.ygcen.2010.03.030.

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German Translation by CSN:

60 Wissenschaftler und NGOs appellieren an EFSA

First Perfume and Fragrance- free Asthma Conference

The American Environmental Protection Agency is holding a large asthma conference from June 17-19, 2010, in Washington D.C.. For the first time ever, the EPA has a special conference feature which is to renounce fragrances and perfume. Thus, the EPA is sending a signal to indicate the fragrance issue and to provide participants with asthma, the possibility to participate at the 2010 National Asthma Forum. Fragrances are among the principle factors for asthma attacks.

Nearly 300 experts and leaders, whose work is to improve the living conditions of people with asthma, are taking part in this event. Primary decision makers of federal and state authorities, as well as those responsible for guidelines, managers of health authorities, scientists, physicians and leaders of self-help organizations are included in this group. Their goal is to design environments to assist in safe living for all asthmatics.

In order to allow all participants to take part in the conference, meaning a conference free of perfume, aftershave, hairspray, body lotion, fabric softener or scented deodorants, the federal agency sent out the following reminder online:

“Asthma-friendly environments are our business – Please help us to make this a fragrance-free event by using fragrance-free personal care products and avoid perfumes and other irritants.”

This is a very positive step by the EPA. They have removed the largest known barrier for asthmatics and chemically injured people this year for the 2010 National Asthma Forum. World leaders on every continent should incorporate this humanitarian example by the EPA , for those disabled with illnesses affecting the breathing and lung function throughout the world.

Author: Silvia K. Müller, CSN – Chemical Sensitivity Network, 17 June 2010

Translation: Thank’s to Christi Howarth

Related Articles:

• Secret Chemicals revealed in Celebrity Perfumes, Teen Body Spray
• Open Letter: Perfumed Stamps constrain people with disability
• Professor urges us to take people with Chemical Sensibility into Account

The author, Ryozo Tamakoshi is a member of the Japanese organization CACP – Citizens Against Chemicals Pollution.

On February 22, 2010, a conference called “The 1st Meeting for Learning Chemical Policies for Enacting a Basic Chemical Law” was held in the House of Representatives in Tokyo. In view of his chemical and electromagnetic sensitivities, Ryozo Tamakoshi gave a lecture on MCS. This was a matter of particular concern for him, as his health troubles were caused by chemical exposure. The conference focused on the topic ‘Security of Chemicals’ and the need to create a new policy for more careful handling of chemicals – important basic principles for all the Japanese people who have to live with MCS.

Talk of Ryozo Tamakoshi / Citizens Against Chemicals Pollution

As a patient with multiple chemical sensitivity, I must share with you some important things.

I have multiple chemical sensitivity and electromagnetic sensitivity. The onset of multiple chemical sensitivity begins differently among individuals as do the corresponding symptoms. In my case, I gradually became chemically sensitive. I think my symptoms are relatively mild compared to others with this condition. Some patients are seriously compromised and can hardly leave their homes to participate in a meeting like this one. I have some risks going out in public, but think it my duty as one who can actually attend a meeting like this one, to enlighten others regarding this condition called multiple chemical sensitivity or MCS. Therefore, I would like to express my gratitude for your allowing me the opportunity to speak to you today. Thank you. I would like to discuss seven points. As you listen, please consider that my findings are based on personal experiences.

1. One cause of multiple chemical sensitivity is the toxic effect of extremely low levels of chemical substances.

On October 1, 2009 in Japan, the Medical Information System Development Center (MEDIS-DC) – a subsidiary organization of the Ministry of Health, Labor and Welfare (MHLW) – registered “multiple chemical sensitivity” as “ICD-10 Japanese standard disease master”. Multiple chemical sensitivity was classified in Japan into ICD-10 code T65.9 – “Toxic effect of unspecified substance, Poisoning NOS”.

Please look at the following material (1)(2).

From these references, it is well understood that multiple chemical sensitivity is classified into “Toxic effect of substance”

(1) T65.9 ICD-10 WHO

Chapter XIX: Injury, poisoning and certain other consequences of external causes (S00-T98)

T51-T65: Toxic effects of substances chiefly non-medicinal as to source

T65 Toxic effect of other and unspecified substances

T65.9: Toxic effect of unspecified substance Poisoning NOS

(2) The Japanese name of diseases classified into “ICD10 code T65.9″

The Japanese name of diseases

1. multiple chemical sensitivity
2. systemic poisoning
3. poisoning
4. accidental poison ingestion
5. attempted suicide by taking poison

In Japan, it is clearly thought that the cause of multiple chemical sensitivity is a “Toxic effect of chemical substances” . And frankly speaking, this means that if there were no chemicals which had toxic effects, people wouldn’t become chemically sensitive.

As you can see, I cannot live without a double gas mask now. (VOC mask and activated carbon mask) Especially in winter, I cannot take this mask off even when I sleep at night because the heating machine in the nearby greenhouse operates at night and gases are released. The manufacturer of the heating machine writes in the catalog on the internet as follows, “Flue gases are extremely harmful to human health and crops. Please be sure to release them outdoors”. Why is it allowed to release such harmful gases outdoors?

My biggest fear in winter has been these gases. When the gases are released, suddenly I smell burning, start coughing, phlegm occurs, and my eyes become painful. Furthermore, my mouth becomes bitter, I have tongue numbness, and I feel poisoning (discomfort) of the internal organs, especially to the digestive organs. Then, I have strong fatigue throughout my body so I lie on the floor and sleep eventually.

I cannot prevent the bad influence of these gases now, even if I have on a gas mask and use air purifiers in my home. When my house is in the upwind side of the greenhouse, I am relatively safe. But when I am downwind, I am always pushed into the hell. To avoid these gases, I often sleep in my car, away from my house, or sometimes in a rice field or on a mountain. This is just one example of the difficulties I face with multiple chemical sensitivity.

For me, the current world, no matter where I live and go, is a toxic or poisonous world. The toxicity of substances at the level of ppm and ppb has a big influence on my health. My daily health disorders due to the exposure of many harmful chemicals cannot be simply explained by an allergic reaction any longer. The doctors who examined my symptoms only from the perspective of immune disorder failed to make proper diagnosis of my symptoms.

I think that it is impossible to understand the essence of multiple chemical sensitivity without focusing on the complexity of many chemical toxicities and patients’ symptoms.

I do not use the word “poison” (toxic effect) emotionally. I only use the word “poison” (toxic effect) to explain daily, normal phenomena, because I cannot live without a gas mask.

2. The reality of multiple chemical sensitivity is the result of complex toxic effects of many chemicals and it is spreading out all over the world.

Modern society is full of so many chemicals. Life without chemicals is no longer a possibility. Of course there exist many chemicals with toxic effects. We are living with the complex pollution of them. New chemicals have been produced one after another without enough consideration of the influence of chemicals on ecosystems and without confirming whether those are safe for human beings and creatures. Thus, the “toxic world” has been spread globally.

I have been in contact, via the internet, with international patients who have multiple chemical sensitivity and environmental illness. I have come across sorrowful cries of patients, warm words of empathy to comfort one another, and powerful protests and demands against our “toxic world”. Moreover, I’ve received a lot of essential information about MCS and environmental illness which is reported on the internet to the entire world. Complex chemical pollution has now spread out all over the world.

3. Multiple chemical sensitivity cannot be separated from other developmental and chronic multisystem illnesses caused by the environment.

Multiple chemical sensitivity cannot be separated from other environmental illnesses such as sick building syndrome, allergic diseases and electromagnetic hypersensitivity. We must not only focus on the chemical pollutants, but must also look at other environmental factors such as biological infectious agents and electromagnetic fields. Many patients with MCS also have allergic diseases and electromagnetic hypersensitivity. This condition is a complex one.

Consider expanding your perspective on developmental disorders. In Japan, developmental disorders mean a pervasive developmental disorder, high-functioning autism, Asperger syndrome, a learning disorder (dyslexia) or attention deficit hyperactivity disorder (ADHD), etc. Currently, there are a lot of research papers detailing that environmental factors (chemicals) may cause the appearance of those developmental disorders. The increasing number of these reports is more and more available.

I have been supporting two children with developmental disorders at home while considering chemical pollution as the cause of these types of disorders. People around them don’t understand them, which gives the children worries and suffering. Their situation seems to be similar to ours. Supporting their study is my pleasure.

4. Some common effects can be seen in MCS, but each person has different symptoms. Therefore, there are various difficulties and disabilities due to MCS. Comprehensive supports are needed for the various difficulties and disabilities.

I think it very important to understand the individual symptoms in connection with various difficulties and disabilities in life. I strongly wish industrial accident authorization and disability authorization would reflect precisely the situation of the patient and be performed promptly. It is positive that industrial accident authorization and disability authorization of MCS have been actually recognized in Japan. However, the form of documents for disability authorization is partly inappropriate, so the paperwork can’t be filled out precisely. I think the forms and documents should be immediately edited and improved.

Guaranteed rights of medical care, welfare, labor, housing and pension corresponding to the state of every person are written in Japan’s Constitution.

5. To protect patient’s lives and health, to treat symptoms, and to recover health, should be top priority, in addition to avoiding exposure to toxic substances and ensuring safe and secure places to live.

For patients with MCS, the most important thing is to avoid exposure of toxic substances.

In particular, ensuring emergency evacuation of patients has become an urgent issue.

But it is very difficult to secure a safe place by one’s own effort. To reduce a heavy personal burden, some support by the authorities is absolutely necessary for the patient. In addition, it should be emphasized to make available all correct information about harmful chemicals to all citizens.

6. We have a serious problem. We are often attacked by the feeling of isolation, loneliness, anxiety, fear, and helplessness.

This is one of the most serious and important problems. MCS patients around the world, just like us, worry and suffer. Sadly, there are still some people who commit suicide in despair. When people around me, including my family, can’t understand my physical and mental state, I have a terrible feeling of loneliness.

Continuous bad health conditions, anxiety and fear of a sudden chemical attack, and isolation from participation in society, leaves me with a feeling of helplessness and despair. To break this ongoing cycle, mutual support among friends and society is needed. The social recognition and the social support are absolutely necessary.

When exposed to toxic chemicals, I get irritated, impatient and sometimes get in a bad mood. I cannot smile. Unfortunately, these behaviors are not viewed as a result of the individual’s chemical poisoning but instead a problem with the individual’s heart, which is not the case. In order to prevent the unfortunate misunderstandings like these, it is very important that we spread correct information regarding this condition and strive for the recognition of MCS. We must support those who are apt to have low self-esteem and affirm those with chemical sensitivity so they may live freely in peace, and participate in society with more pride.

7. The eight basic principles of “Basic Law on Chemicals Policy” that ChemiNet has proposed should be respected.

All the basic principles listed below are very important.

The many problems regarding multiple chemical sensitivity will be solved fundamentally in the process of policy formulation and implementation of the comprehensive chemicals on these basic principles:

1. Production and use of chemicals for a sustainable society (The reduction the amount of chemicals)
2. No Data, No Market principles
3. Consideration must be given to the people ( fetus / child) who are most vulnerable and also to the ecosystem
4. Lifecycle management must be initiated (From research and development to production, use, recycling and disposal
5. The precautionary principle must be respected
6. Alternative principle must be initiated
7. The participation of all people concerned. The collaboration principle must be implemented
8. International cooperation must occur

Author: Ryozo Tamakoshi

Thanks to Christi and Larry for reading correction.

Related Articles about MCS in different countries:

• Multiple Chemical Sensitivity recognized as physical disease at ICD-10 in Japan
• Spanish Workgroup met with Ministery of Health to create a MCS Consensus Document
• Italian Parties united under MCS cause
• The Department of Health of the Austrain Government recognizes MCS as a physical Disease
• German federal institute for occupational safety and occupational medicine mentioned Multiple Chemical Sensitivity at Thesaurus Safety and Health at Work
• MCS registered as physical disease at ICD-10 in Germany

MCS - Multiple Chemical Sensitivity / Photo © Loli Vicente

Photos requested for Collage about living with MCS

A few days ago, Lola Vicente, a Spanish woman with MCS, shared an inspiring photo on Facebook. When I saw her picture I had the idea to make a collage with pictures of people with MCS to post it on NO FUN, because lately my blog is having a lot of visits (more than 3.000 the day that I was interviewed at national radio RNE or the day that MCS was featured on popular TV show in Spain) and many of the readers aren’t people with MCS. I thought that it would be a great moment to show to the society that there are a lot of people living with MCS and nobody will manage to silence us. I proposed this idea on Facebook and it was well received.

I have named the project “Multiple Chemical Sensitivity uncovered”. NO FUN, my window to the outside world, opens to people with MCS from all around the world so we can show that there are a lot of people living with MCS.

I would like to take this opportunity to tell you that, as some of you know, I have recently closed my personal Facebook account so that I can focus on my health. You can still stay in touch with me through my blog NO FUN and my 2 Facebook pages: for my blog and for my book.

If you suffer MCS and you want to join this project, you can send your photo (with your country and your name or pseudonym), before September 30th to this email account fotos.sqm@hotmail.es (this account has been created exclusively for receiving the pictures and it will be closed once the project ends). The photos can be you with a mask or without a mask but where MCS can be identified. More than photographic quality, I’m looking for the visual impact of all the pictures together.

I hope you like the project and you join it!

NOTE: I’m open to share the collage with any other blog or website from all around the world that wants to post it.

Eva Caballé, No Fun Blog, June, 9, 2010

More Articles from Eva Caballé:

• Manifesto: We know they are lying to us
• One of the most popular TV Channels started the News with a report about Chemical Sensitivity
• Metamorphosis inside Multiple Chemical Sensitivity
• Interview with Eva Caballé about MCS and her book
• The naked truth about MCS, including foreword about German Situation