In several countries EHS, MCS and fibromyalgia are already classified as functional disabilities

Several experts from different European countries agree that Electromagnetic Hypersensitivity is a real, physical illness and for some of them this condition seems to be strictly related to Multiple Chemical Sensitivity (MCS). This is what came out of the congress “Mobile Telephony, Wi-Fi, Wi-Max: Are there Health Risks?”, held at Palazzo Marini – Chamber of Deputees in Rome on 14 June 2011. The event, organized by the Association for Environmental and Chronic Toxic Injury (A.M.I.C.A.), was meant to give an overview on the health dangers linked to the use of wireless devices.

Prof. Dominique Belpomme, Oncologist, Professor of the Centre Hospitalier Universitaire Necker-Enfants Malades, Chairman of Research for Anti-Cancer Therapeutics (ARTAC), in his lecture “Diagnostic and Therapeutic Protocols for Electromagnetic Fields Intolerance”, showed the results of a clinical observation on more than 450 patients enrolled from 2008 to 2011. He and his team use a new technique to make the diagnosis to people reporting reactions to electromagnetic fields, a condition that he prefers to define as “Electromagnetic Fields Intolerance” or “EFI Syndrome” rather than “Electromagnetic Hyper-Sensitivity”.

The new technique is the “Pulsed Eco-Doppler” of the brain that combines the eco-doppler with a computer to evaluate brain perfusion. Unlike some other methods, this one is not dangerous and it does not involve any ionizing radiation. The results show that people with Electromagnetic Fields Intolerance have a reduced perfusion in the brain, particularly in the left part of the limbic area of the brain, compared to the control group. This is a very particular area, because it is the “ancient” part of the brain that controls many body functions.

“These results are very important – Belpomme said at the congress – because for the first time we are able to define the Electromagnetic Fields Intolerance as a physical illness based on objective tests”.

His team uses also other tests, such as the dosage of histamine, of protein S100B, and of heat shock proteins hsp70 and hsp27 in the blood. The 70% of the group of patients observed showed a serious reduction of vitamin D, about 1-2% of the patients showed an increase of proteins hsp27 and hsp70, while more than the 40% of the sample had increased histamine, a fact that is fully compatible with a physiological interpretation of this syndrome.

About 10% of the patients had an increased protein S100B, which is a marker for Blood Brain Barrier (BBB) permeability. In one third of the sample, a reduction of melatonin in urine was found, and this can explain symptoms such as fatigue, insomnia and depression in these patients.

These alterations are quite similar to the ones found in patients with Multiple Chemical Sensitivity (MCS), particularly regarding the brain perfusion reduction, the neurogenic inflammation, the oxidative stress increase, and the reduction of the defense mechanism. The fact that EMF induces the opening of the BBB may interfere with the brain protection from toxic chemicals. It is not uncommon, in fact, that patients with EFI Syndrome have MCS symptoms, while many patients with MCS also react to EMF.

The increase of oxidative stress in electrosensitive patients was found also by Dr. Valeria Pacifico, who lectured in Rome about “Metabolic biomarkers of oxidation-reduction imbalance and susceptibility to non-ionizing radiation”. She works in the team of Dr. Chiara De Luca at the Experimental Laboratory BILARA at Istituto Dermopatico of Immaculata in Rome that published several works on the role of oxidative stress in environmental sensitivities. (1, 2)

“To make a diagnosis of this syndrome we need to listen first to patients and we need to verify if the symptoms improve or disappear when they stay away from EMF sources”, Prof. Belpomme explained. In order to demonstrate if the electromagnetic fields were the real cause of the alterations found in these patients, the patients had to repeat the tests before and after a period of avoidance of EMF for three months. The results show that after the period of avoidance the levels tend toward the normal standard.

Given the strong correlation found by six epidemiologic studies on EMF exposure and Alzheimer Disease (AD), Prof. Belpomme believes that any electrosensitive patient with memory dysfunctions should be evaluated also for AD. He stresses the fact that AD is a loss of long term memory while EFI Syndrome often involves the loss of short term memory, but this symptom may be considered as a pre-Alzheimer condition.

Prof. Olle Johansson, Assoc. Prof., The Experimental Dermatology Unit, Department of Neuroscience, Karolinska Institute; Professor, The Royal Institute of Technology, Stockholm, talked in Rome about “The precautionary principle: from Bioinititive to the Seletun consensus”. He dedicated his lecture to people affected by EHS and MCS because “they have a very difficult life”.

He is one of the most dedicated scientists in the promotion of new biologically-based safety guidelines for EMF. He was in Benevento for the ICEMS resolution in 2006, then in London in 2007 for a new resolution, and he was also member of the group of independent scientists that published the famous Bioinitiative Report in 2007, which had strong ecological concern in the political agenda. Thanks to this report, in fact, the European Parliament signed a resolution on September 4, 2008 to state that the actual safety limits for EMF are obsolete and to warn EU governments about the increase of new environmental illnesses such as EHS, MCS and Dental Amalgam Mercury Syndrome.

More recently, Prof. Johansson was part of the group of scientists who prepared the Seletun Consensus, published last February in Reviews on Environmental Health (3). It states that present standards do not protect global human population from electromagnetic fields and all EMF should be reduced now instead of waiting for a definitive proof of danger. It also states that people reporting EHS symptoms should be considered as having a functional disability.

In Sweden, for example, EHS, MCS and fibromyalgia are already classified as functional disabilities. This means that people affected by these conditions are not considered patients, but it’s the environment that creates limitations for them so it’s the environment that has to be changed. This kind of classification represents the full concretization of the UN Convention on the Rights of Persons with Disabilities, signed by governments on March 30, 2007. This convention should be enough to push all governments to find the right accommodation and the best welfare strategies for people with environmental sensitivities, and put an end to discrimination.

Author: Francesca Romana Orlando, journalist and Vice President of A.M.I.C.A.

Literature:

1. De Luca C. et al., Biological definition of multiple chemical sensitivity from redox state and cytokine profiling and not from polymorphisms of xenobiotic-metabolizing enzymes, Toxicology and Applied Pharmacology, YTAAP-11818; No. of pages: 8; 4C.
2. De Luca C. et al., The Search for Reliable Biomarkers of Disease in Multiple Chemical Sensitivity and Other Environmental Intolerances, Int. J. Environ. Res. Public Health 2011, 8, 2770-2797; doi:10.3390/ijerph8072770
3. Fragopoulou A ed al., Scientific panel on electromagnetic field health risks: consensus points, recommendations, and rationales, Rev Environ Health. 2010 Oct-Dec; 25(4):307-17.

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Whilst facing a worldwide fast increase of food and environmental allergies, the medical community is also confronted with another inhomogeneous group of environment-associated disabling conditions, including multiple chemical sensitivity (MCS), fibromyalgia, chronic fatigue syndrome, electric hypersensitivity, amalgam disease and others. These share the features of poly-symptomatic multi-organ cutaneous and systemic manifestations, with postulated inherited/acquired impaired metabolism of chemical/physical/nutritional xenobiotics, triggering adverse reactions at exposure levels far below toxicologically-relevant values, often in the absence of clear-cut allergologic and/or immunologic involvement.

Due to the lack of proven pathogenic mechanisms generating measurable disease biomarkers, these environmental hypersensitivities are generally ignored by sanitary and social systems, as psychogenic or “medically unexplained symptoms”. The uncontrolled application of diagnostic and treatment protocols not corresponding to acceptable levels of validation, safety, and clinical efficacy, to a steadily increasing number of patients demanding assistance, occurs in many countries in the absence of evidence-based guidelines.

De Luca et. al. revised available information supporting the organic nature of these clinical conditions. Following intense research on gene polymorphisms of phase I/II detoxification enzyme genes, so far statistically inconclusive, epigenetic and metabolic factors are under investigation, in particular free radical/antioxidant homeostasis disturbances. The finding of relevant alterations of catalase, glutathione-transferase and peroxidase detoxifying activities significantly correlating with clinical manifestations of MCS, has recently registered some progress towards the identification of reliable biomarkers of disease onset, progression, and treatment outcomes.

Literature:

De Luca C, Raskovic D, Pacifico V, Thai JC, Korkina L., The search for reliable biomarkers of disease in multiple chemical sensitivity and other environmental intolerances, Tissue Engineering & Skin Pathophysiology Laboratory and 2nd Dermatology Division, Dermatological Research Institute (IDI IRCCS), Via Monti di Creta 104, Rome 00167, Italy; Int J Environ Res Public Health. 2011 Jul;8(7):2770-97. Epub 2011 Jul 1.

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• Research on Multiple Chemical Sensitivity (MCS)
• Study could not confirm link between mental illness and chemical sensitivity
• Predictions of Multiple Chemical Sensitivity Mechanism Confirmed by Roman Study

Let me live!

Patrick is 19. His American football gear is in his closet, and in the corner of his room his electric guitar lays on the shelf next to the brilliant lyrics he wrote. His songs have a meaning, not just modified, banal versions of some well-worn songs that were eventually on the top of the charts. No way. Patrick’s music gets down to business and strongly suggests that the songwriter is not a wimp, but instead confident and that he has something significant to say. When Patrick wrote the songs/music, he went to high school, which earlier posed no problem for him, and he enjoyed a life outside of school as well. His buddies were always with him. Life then was to be lived! But now the American football equipment, the guitar, the unfinished recordings, and song books remain on the dusty shelves.

Those were the times

When Patrick lies on his bed in his room it seems like decades since he was with his band buddies on the stage. Sometimes he has flashbacks where he again sees the faces of the girls in front row of the stage, glowing, looking reverently up and so moved by the band’s damn good music. When these flashbacks return, Patrick is reminiscent of the life he used to live. Patrick would like to scream really loud so everyone can hear:

“My body and my pain hold me prisoner. I cannot leave and live like others. A broken body makes me a cripple. It forces me to not always do things that I would like to do. But I want to live.”

Causes and effects

Patrick is sick from chemicals and his body has developed an extreme form of chemical sensitivity (MCS). Some chemicals have the capacity to sensitize the body. In medicine, this is well known that some chemicals like formaldehyde, isocyanates, and some pesticides are able to cause illness. Everything has played a role in Patrick’s current condition. His father was a chemist and had 30 years of contact with chemicals which are capable of damaging genes. No one can define precisely the effects of the countless years of exposures from the not so harmless chemical cocktails where Patrick’s father worked. The fact is, that Patrick’s father, because of work-related health issues, no longer has his health and is seriously ill. Perhaps the house where the family lived also played a role in the illness. Seven times they had high water which left mold on the walls. The walls were washed extensively with chlorine, a highly toxic chemical. Also the wood preservatives in the house could have played a part in Patrick’s state of health.

Others have lived at least

The average age of people who are chemically sensitive, is from 35-45 years, according to studies. There are also sufferers who are much older and some who are still toddlers, but the majority of sufferers had a life before MCS. For Patrick, it’s different:

“Excuse me, I don’t want to offend the others, but the other MCS sufferers were allowed to enjoy prior life experiences (youth, school, training, travel, friends, partnership, etc.), but I was denied everything from the beginning. The best time of life, my youth, has not been granted to me. On the contrary, I am going through hell, but no one is interested, because they do not believe me.”

Ciao buddy

After Patrick broke down completely, the compassion of his buddies and classmates was just great. They came to visit him and provided him with information from school. That gave him the opportunity to continue his school for awhile. When that was no longer possible, he tried getting his education on the internet, via a correspondence school. But now that is over. No more calls, no more visits. Patrick experiences unbearable pain as he feels like he too is covered in dust like his guitar. The girlfriend he had whom he wanted to build a life with, now also lives a life without him, perhaps with someone else. Patrick experiences pain on another level besides just the excruciating physical pain of the illness. He is furious and says:

“I cannot believe that since I’m not out there, I must not be forgotten and do not exist. My struggle must not be in vain.”

“It is hard to accept that everything I have achieved to this point is destroyed.”

“I have resigned myself that I will probably always remain living alone. There is no compassion for this disease. In fact, on the contrary, I am immediately excluded. What girl or young woman is prepared to make such a sacrifice, and how will I even find a person when I need to live a life of isolation? Forget it. This also applies to other friendships as well. ”

“Although various people helped me earlier, now only two friends remain – I’ve always given everything and now … I’m just dropped, since I cannot keep up and have become too annoying or too complicated to all the others.”

To go out at least once

Besides all the bad luck Patrick and his parents experienced in the past, they also lost their most faithful companion too. So Patrick’s mother bought a new dog so that her son has some life in the house and finds some comfort through the love of an animal. The decision was good for the dog and he is very fond of Patrick:

“As much as I would love to be in nature for a couple of hours with our dog for training or just playing only with him, I am not even granted this.”

Simply cut the strings and let the frustration out

If Patrick was frustrated, it was hard to miss. He grabbed his guitar and the sparks were flying as he sang until the walls shook. That has not happened often, but when it did, everyone in the house knew after two minutes. Music is life and a way to express yourself, to let out what the mind has suppressed. But even allowing the frustration and the anger to be let out, is no longer possible for Patrick:

“Playing guitar and singing means so much to me, but my damn body does not even allow that. The muscle weakness and pain again slow me down, and of course, my dream of American football is over.”

MCS means in the worst stage of a “life” in total isolation

Patrick is one of the MCS patients who having a life outside the four walls is impossible. It should not be confused that these people do not want to be, among others, but on the contrary, the wish and desire to do something with other people remains every day around the clock. It is not a psychological problem or fear of people. The body simply gives up when exposed to chemicals. Car exhaust, heater exhaust gases, perfumed people, houses, from which wafts the cleaning products. All chemical cocktails present a difficulty for chemically sensitive people to have a chance to move about.

A short contact with the outside world means having extreme pain, seizures, difficulty breathing, collapse, or unconsciousness. The same applies for visiting. If someone comes to visit, the joy for Patrick can quickly lead to disaster. The deodorants or residues from the dry cleaners in the jacket, fabric softeners, which cannot be totally washed out will make the visit impossible. Utter nonsense? Not at all. Who will make the effort to find appropriate ingredients for “everyday products” that will bring about severe consequences for a man whose body is hypersensitive? What companies will makes the effort to accommodate hypersensitive individuals as they produce products? Not even most doctors will attempt to understand this chemical hypersensitivity. This is due partly out of ignorance, because they have never heard of the disease, and simply because they lack time to investigate further. And if doctors are not smart and declare the disease as a quirk of convenience, how can ordinary people understand those with MCS?

Patrick’s opinion on MCS:

“MCS is the worst disease out there; sometimes I wish I was a paraplegic. I know this sounds harsh, but I would not be so isolated, left alone, not credible, and would have no pain. I could travel in spite of this handicap, going almost everywhere, going to concerts, meeting friends, and possibly make training, and, and. “

The whole family is ruined

Patrick’s parents are willing to do anything for their son, so he can have his life back. But MCS is too complex to just fight the disease with medicine and a few natural remedies. One must start by establishing a clean living environment. Patrick and his father would need a living space that is chemical-and mold-free as much as possible. But how do you implement that? The house in which they have is hard to change due to the financial loss due to his father’s illness.

Help from authorities? No

Patrick should actually have a good case for the authorities to help, but because he has no education, there is no funding, no basic security, which is humiliating for the young man. His mother says:

“We get help from nowhere, in fact, it is quite the opposite. We are harassed by authorities and they make demands on Patrick which he cannot satisfy. Anyone who can count to three must see that. But nobody takes the trouble to look at the misery, instead, decisions are made that are devoid of any humanity. Yes, Patrick virtually exists only on the card. This illness ruined my two men and those who might know how to help and change things for us, look away too easily! ”

“Many people ask me, how has this total isolation been for over the last two years? They say to me, “I would go mad …. I would go crazy … I imagine the bad, and, and …” They also ask, “Where does Patrick, or where do you get the strength to keep going?”

The response from Patrick’s mother: “You can see that Patrick lives and we also manage. Somehow we are probably fighting spirits and do what we try to be bold, brave, and strong willed to survive. The struggle for justice makes us stronger. “That’s what Patrick’s mother says to the outside world, but inside she often thinks, how long does will the body last, like the heart muscle. Every day she must be available around the clock for her men. Every day is actually a struggle for survival, for Patrick, as well as his father.

Optional: a human decision

That which was given to Patrick and his parents since March 2009, is staggering. His parents submitted an application to determine his level of disability. Now a court ruling says that the 19-year-old man who is suffering from unbearable pain all day, and reactions to chemicals must go into a hospital. The hospital has assured the court that it is equipped for emergencies so there shouldn’t be any problems.

• What if he’s there and collapses completely? Who bears the responsibility for him then?
• Who pays to stay in a hospital environment abroad, because in Germany there is no help?
• Can a normal emergency procedure help him to bounce back?
• What if not?

There are no environmentally controlled hospitals for MCS patients in Germany. No hospitals can assure a complete freedom from chemical exposures at all. The hospital rooms discussed in a previous CSN article which are in Hamburg for the environmentally ill, are still not in full operation and they are also only for medical intervention, not for environmental treatment. Thus Patrick’s health would possibly be further compromised by this current court ruling the way it now stands.

So far, instead of support costs caused

Administrative expenses have already cost a fortune for Patrick, a 19 year old, with unbroken will to live. Legally, there is the possibility of seriously ill people remaining in their homes, and being examined within the safety of their own four walls. For Patrick, allowing this would be an act of humanity. This young man wants nothing more than for his disability to be determined. His disability and disease are detected nowhere better than in his own home where everyone can see with their own eyes what the illness actually means for Patrick and his family.

Authors: Silvia Müller and K. Kira, CSN – Chemical Sensitivity Network, 9 July 2011

Translation: Christi Howarth

Note: Patrick’s documents are complete before CSN.

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The Markingson Files: Why health writers should track the money behind medical studies

One of the biggest oversights a health writer can make is to cover a scientific study and not talk about its funders.

Funding with strings attached can affect a study’s outcomes. In 2003, a study in the British Medical Journal found that “Studies sponsored by pharmaceutical companies were more likely to have outcomes favouring the sponsor than were studies with other sponsors.”

This can be as a result of researchers working hard to please their funders and keep the money spigot open. It also can be because of pressure from the drug companies – even subtle pressure – to generate positive results.

In October 2009, AstraZeneca agreed to pay $520 million to settle federal investigations and whistle-blower lawsuits over the company’s marketing practices for the antipsychotic drug Seroquel, including allegations that the company had manipulated research data for marketing purposes. As the New York Times wrote at the time, “Seroquel was the top-selling antipsychotic drug in America. It had $17 billion in sales in the United States since 2004, according to IMS Health, a research firm.”

An after-market clinical trial for Seroquel, called the CAFE study, was conducted at the University of Minnesota to prove that Seroquel was better than its competitors, and one of the trial participants, Dan Markingson, killed himself during the trial.

Carl Elliott, a bioethicist at the University of Minnesota, documented some of this alleged manipulation by using records he found in lawsuits against the company.

The pressure to make Seroquel look superior began as early as 20 years ago, when the drug was still in its early stages.

In the late 1990s, a multi-center clinical trial, known as Study 15, failed to show that Seroquel was better than Haldol, or haloperidol, an older antipsychotic that has been on the market since the 1960s. By some measures, Seroquel performed worse than Haldol. Making matters worse, the study showed that Seroquel boosted the risk of weight gain and diabetes. Internal correspondence repeatedly referred to Study 15 as a “failed study,” and company officials discussed ways to spin it or bury it.

In the Seroquel Strategic Plan 1997-2001, the company wrote on Page 17, “With the failure of Study 15, the Strategy Team reevaluated the Phase IIIB program and determined that the level of risk had to be reduced, as failure of another large scale trial, eg treatment resistance, would result in significant damage to the brand’s market perception if there weren’t other trials successfully completed in parallel.”

Referring to Study 15, Richard Lawrence, a senior Astra Zeneca official, wrote in February 1997 memo, “I am not 100% comfortable with this data being made publicly available at this time…however I understand that we have little choice….Lisa has done a great ‘smoke-and-mirrors’ job!”

Lisa Arvanitis, another AstraZeneca official, was CC’d on the memo, as was AstraZeneca’s Don Stribling. Lawrence also wrote, “Adopting the approach Don has outlined should minimize (and dare I venture to suggest) could put a positive spin (in terms of safety) on this cursed study.”

In November 1997, an AstraZeneca physician wrote an email to a researcher explaining why the company could not fund his study. “R and D is no longer responsible for Seroquel research,” he wrote. “That’s the responsibility of sales and marketing.” He also noted that funding would be more likely if the study could show a “competitive advantage for Seroquel.”

In a May 1999 email, John Tumas, an AstraZeneca publications manager, wrote that he was worried that the company was “cherry-picking data.”

“We’ve buried trials 15, 31 and 56, and now we’re considering CoStar,” he wrote. “How are we going to face the outside world when they criticize us for suppressing data?”

Apparently looking for new ways to highlight the benefits of Seroquel, the company’s Commercial Support Team performed a meta-analysis of a number of other studies. This meta-analysis did not raise Seroquel’s status over Haldol. Instead, the team’s technical document from March 2000 concluded, “In terms of generating positive claims for Seroquel these analyses seem to be somewhat disappointing.”

This analysis came at a very bad time for AstraZeneca. Dr. Charles Schulz at the University of Minnesota was working with the company on preparing a presentation on Seroquel data for the American Psychiatric Association (APA) annual conference in Chicago less than two months later.

In an email from March 2000, Tumas wrote:

The data don’t look good. I don’t know how we can get a paper out of this. My guess is that we all (including Schulz) saw the good stuff, ie the meta analyses of responder rates that showed we were superior to placebo and haloperidol, and then thought that further analyses would be supportive and a paper was in order. What seems to be the case is that we were highlighting only the good stuff and that our own analysis support the ‘view out there’ that we are less effective than haloperidol and our competitors. Once you get a chance to digest this, let’s get together (or teleconference) and discuss where to go from here. We need to do this quickly, because Schulz needs to get a draft ready for APA and he needs any additional analyses we can give him well before then.

Schulz must have received the data he needed, because he presented a summary of the AstraZeneca data as a poster at the May conference, claiming that Seroquel was “significantly superior” to Haldol.

Documents filed as part of the lawsuits against AstraZeneca suggest that AstraZeneca was hoping to market Seroquel, possibly, off-label, to “first-episode” subjects such as those that the CAFE study enrolled. This group would have included Dan Markingson.

The Seroquel Strategy Summary from 2000 said that the company should establish “Seroquel as atypical of choice in first-episode patients – this has a halo effect as these patients are particularly sensitive to EPS and weight gain.” It also listed as an objective broadening “Seroquel use on and off-label. Utilise whole selling team, educational programs to share off-label data.”

In 2007, the American Journal of Psychiatry published the results of the CAFE study, which were positive for Seroquel.

The authors claimed that the CAFE study showed Seroquel to be of “comparable effectiveness” for first-episode patients in comparison to Zyprexa and Risperdal.

Among the 18 “serious adverse events” recorded for the 400 subjects in the study were five suicide attempts, including two completed suicides, both by patients taking Seroquel. One of them was Markingson, although the paper did not name him.

According to the study authors, the suicides occurred “despite the close attention provided in clinical research aftercare programs.”

Author: William Heisel, May 27, 2011

Original article

Copyright: University of Southern California, Annenberg School for Communication & Journalism

Read more articles from William in his Blog William Heisel’s Antidote: Investigating Untold Health Stories

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Meeting at WHO: in a few years MCS and EHS may be included in the International Classification of Diseases (ICD11)

Madrid, May 18, 2011. The National Committee for the Recognition of Multiple Chemical Sensitivity (MCS) and Electromagnetic Hypersensitivity (EHS), on 13rd May 2011, met Dr. Maria Neira, Director of Public Health and Environment of the WHO and other WHO officials. During the meeting, the WHO responsible for the development of the International Classification of Diseases (ICD) admitted that there was a controversy regarding the updating procedure of this classification.

Dr. Neira and her team explained that, up to the release of ICD 10, the National delegations from the Health Ministries were the only one engaged in the revision of the classification, but now the revision is open to public comment and anyone can actively participate and submit scientific evidence to promote new classifications of diseases for the ICD 11, which will be released in 2015. The WHO official also announced that the very first draft of the ICD 11 was going to be released on Monday 17th May.

The WHO created a virtual platform to engage the scientific community and the NGOs in the revision of the ICD 11 and this is supposed to guarantee a full transparency throughout the revision process. This new openness by WHO was applauded by the National Committee for the Recognition of MCS and EHS.

In order to get the inclusion of these two environmental disease in the new classification , the WHO officials pointed out that it is essential to present clear evidence about the diseases: etiology, pathophyisyology, diagnostic tests, etc.

Jaume Cortés, lawyer from the association Colectivo Ronda, explained on behalf of Committee, the evidence given by more than 200 legal compensation sentences won by MCS and EHS patients.

Dr. Julian Marquez, a neurophysiologist with extensive experience in these cases, presented a dossier about the scientific studies on MCS and EHS published in the recent years.

The Committee will actively participate in the platform created by WHO in order to get an ICD code for EHS and MCS, considering that the national versions of ICD 10 in Germany, Austria, Luxembourg and Japan already assigned a code to MCS.

For more information contact Sonia Ortiga: mail environmentalhealthcampaign @ gmail.com and telephone 645803417.

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