Pyrethrins are the insecticidally active components of pyrethrum extract, derived from flowers of Chrysanthemum cinerariifolium and used in commercial and consumer insecticide products. Most dermal testing performed with pyrethrum extracts was done before current refined pyrethrum concentrate became available (before 1967).

A group of  Scientists analyzed presently commercially available pyrethrum allergen extracts to determine the concentration of pyrethrins and the putative sensitizer pyrethrosin.

Six commercial pyrethrum allergen extracts were purchased from four major allergen suppliers and analyzed for pyrethrin I and pyrethrosin by using a capillary gas chromatograph equipped with a flame ionization detector.

The commercial pyrethrum allergen extracts contained no detectable pyrethrins or pyrethrosin. In comparison, the pyrethrum standard provided by the McLaughlin Gormely King Company, a major refiner of pyrethrum, contained 20% pyrethrins and 0.49% pyrethrosin. No compounds observed in the chromatogram of the refined pyrethrum concentrate were present in the allergen extracts.

Caution should be used when interpreting the results of tests performed with current pyrethrum allergen extracts because pyrethrins and pyrethrosin may not be present. Moreover, unknown components such as high-molecular-weight proteins or other impurities that may cause dermal reactions could be present in significant amounts.

Literature:

Osimitz TG, Franzosa JA, Maibach HI., Pyrethrins and pyrethrosin content in commercial allergen extracts, Dermatitis. 2009 Dec;20(6):338-40.

The occurrence of gluten intolerance in the Finnish population has doubled in the past twenty years. In the early 1980s, about one per cent of adults in Finland had gluten intolerance, but the figure has since gone up to two per cent by the 2000s.

“We’ve already seen a similar trend emerge earlier on where allergies and certain autoimmune disorders are concerned. Screening has shown that gluten intolerance occurs in 1.5 per cent of Finnish children and 2.7 per cent of the elderly. The higher figure for older people is explained by the fact that the condition becomes more frequent with age,” says Professor Markku Mäki. Mäki has set up an internationally acclaimed research team on gluten intolerance, developing screening tests for gluten intolerance. Mäki is head of a research project in the Academy of Finland’s Research Programme on Nutrition, Food and Health (ELVIRA).

According to Mäki, gluten intolerance may often be symptom-free, and people may be unaware that they have the condition if their symptoms are mild or atypical. Three out of four people with gluten intolerance have not been diagnosed, which also means that they are as yet going without treatment.

Better diagnosis methods needed

Mäki’s research team has concluded that the criteria for diagnosing gluten intolerance must be rewritten, since early stages of the condition do not meet the criteria, yet is important to treat. The current criteria for diagnosis focus on damage to the intestinal villi and the small intestine, established in a tissue sample from the small intestine. However, early stages of gluten intolerance are not identifiable from tissue samples.

People may suffer from gluten intolerance, yet have no intestinal symptoms. They may, however, have symptoms unrelated to the intestinal tract. Serious problems with nutrient absorption have become rare; instead, sufferers generally have anaemia due to iron deficiency or folic acid deficiency as their main symptom. If researchers manage to develop sensitive, accurate antibody tests, it will become possible to identify people with early stages of gluten intolerance, who are in need of further treatment. At present, there is no single test to reliably identify early stages of gluten intolerance.

Sufferers are hoping for a diagnosis method that does not involve endoscopy. Researchers are hard at work, looking for new and better markers for gluten intolerance to allow for easier diagnosis of the condition.

Patients are also hoping for an ‘anti-gluten pill’. Mäki says that some form of pill with enzymes that break down gluten may prove feasible in the future.

Literature: Academy of Finland, Gluten intolerance in Finland has doubled, March 5, 2010

Study shows need for action to promote ecological recycling

More than 155,000 tonnes of what is sometimes hazardous electronic waste are exported annually from Germany to non-European destinations, a volume which includes some 50,000 tonnes of PC and television monitors alone. The latter often contain metals as well as flame-retardant bromide compounds such as hazardous polybrominated diphenyl ether (PentaBDE). Even defective appliances are often re-classified as “functional”, then usually shipped to Asia and Africa where they are only rarely recycled ecologically. These are the findings of a new study commissioned by the Federal Environment Agency (UBA), which was presented at CEBIT in Hannover.

Federal Minister for Environment Dr. Norbert Röttgen said, “The study illustrates the scale of illegal export of WEEE while also pointing out that further measures to solve the problem are necessary. The Federal government is calling for a decisive regulation at the European level by which exporters must provide proof that exported devices are in working order and not in fact waste, and for exporters to bear the costs of periodic checks”. The appropriate authorities in Germany must step up monitoring of collection points and exports so as to curb the detrimental impact on environment and health of criminal trade.

“Not only do many hazardous materials leave the country in used electronic equipment, but valuable raw materials such as gold, copper, platinum or indium are also exiting the raw materials cycle here at home”, said UBA President Jochen Flasbarth. “As long as ecological recycling is technically and satisfactorily possible in Europe or similar regions only, equipment and its components should be reused here. It makes economic sense to recycle valuable raw materials appropriately, especially many metals, considering the rise in global market prices”, continued Flasbarth.

UBA’s President also made an appeal to continue improvement of recycling standards in Asia and Africa through technology transfer. Producers of new equipment are also called upon to design products more ecologically.

In their one-and-a-half-year-long study experts from the Hamburg Institute for Environmental Strategies (Ökopol) compiled the most solid information as yet on the origin and volume of exported devices. The equipment came from flea markets, second hand shops or were retrieved from junk yards. From there it is often transported via collection points for export, usually by sea. Besides harmless metallic raw materials, WEEE also houses a host of hazardous materials which must be recycled properly to avoid harming human health and the environment. An old computer contains more than 100 different materials, and conventional monitors contain lamps which must also be disposed of professionally.

The study findings are to be forwarded to affected stakeholders, in particular the concerned federal ministries, municipal umbrella organisations, environmental and economic associations, and the European Commission.

The “Optimierung der Steuerung und Kontrolle grenzüberschreitender Stoffströme bei Elektroaltgeräten/Elektroschrott” study (in German with English-language summary) is available as a free download at www.umweltbundesamt.de. A background paper is available at www.bmu.de (in German).

Literature: Umweltbundesamt, BMU – German Federal Ministry for Environment, Nature Conservation and Nuclear Safety, Export of waste electrical and electronic equipment (WEEE): plenty of gold, and poison, too, Press release No. 029/10, Berlin, 04.03.2010

California’s dirty air caused more than $193 million in hospital-based medical care from 2005 to 2007 as people sought help for problems such as asthma and pneumonia that are triggered by elevated pollution levels, according to a new RAND Corporation study.

Researchers estimate that exposure to excessive levels of ozone and particulate pollution caused nearly 30,000 emergency room visits and hospital admissions over the study period. Public insurance programs were responsible for most of the costs, with Medicare and Medi- Cal covering more than two-thirds of the expenses, according to the report.

“California’s failure to meet air pollution standards causes a large amount of expensive hospital care,” said John Romley, lead author of the study and an economist at RAND, a nonprofit research organization. “The result is that insurance programs — both those run by the government and private payers — face higher costs because of California’s dirty air.”

While much work has been done previously to catalog the economic impact of air pollution across California, the RAND study is the first to quantify the cost of hospital-based medical care to various payers caused by the failure to meet federal clean air standards across the state. More people in California live in areas that do not meet federal clean air standards than in any other state.

Romley said the findings show that private insurers, employers and public insurance programs all have a financial stake in improving California’s air quality.

“These costs may not be the largest problem caused by dirty air, but our study provides more evidence about the impact that air pollution has on the state’s economy,” Romley said.

Researchers used records from air pollution agencies and hospitals to estimate how failing to meet federal and state standards for particulate matter and ozone would affect private and public insurer spending for hospital admissions for respiratory and cardiovascular causes, and emergency room visits for asthma throughout California from 2005-2007.

Researchers say the most common hospital-based medical care triggered by elevated air pollution levels are emergency room visits for asthma among children aged 17 and under, with more than 12,000 visits over the three-year study period.

The most costly conditions examined by researchers were hospital admissions triggered by air pollution for acute bronchitis, pneumonia and chronic obstructive pulmonary disease. Those conditions accounted for nearly one-third of the $193 million in health care spending documented over the study period.

Nearly three-quarters of the health events identified by researchers were triggered by high levels of fine particulate pollution — tiny pieces of soot that can lodge deep in lungs. The health events examined in the study were concentrated in the San Joaquin Valley and the four-county South Coast Air Basin.

The cost of treating health events caused by air pollution is equal to the expense of providing flu vaccines to 85 percent of California children under age 15, according to the report.

Researchers say their study provides a conservative estimate about the costs of medical care triggered by air pollution because it does not include outpatient care provided in clinics or medical offices. Details about that type of medical care are not routinely reported to state agencies and thus could not be analyzed.

The study also includes case studies of individual hospitals in Fresno, Lynwood, Palo Alto, Riverside and Sacramento. That analysis demonstrates that costs and types of illness reported vary by region.

To conduct the study, researchers used epidemiological studies that link elevated pollution levels to respiratory and cardiovascular illnesses, and compared that information to pollution levels measured across the state from 2005 to 2007 by various public agencies. Researchers also reviewed detailed records hospitals report to the state about the patients they treat, the illnesses diagnosed and who pays for that care.

Literature:

RAND Corporation*, Study finds dirty air in California causes millions worth of medical care each year, March 2, 2010

*The RAND Corporation is a nonprofit research organization providing objective analysis and effective solutions that address the challenges facing the public and private sectors around the world.

Yale scientists show how bisphenol A induces epigenetic changes in pregnant mice that cause hormonal imbalance in the later life of female progeny

Here’s more evidence that “safe” plastics are not as safe as once presumed: New research published online in The FASEB Journal suggests that exposure to Bisphenol A (BPA) during pregnancy leads to epigenetic changes that may cause permanent reproduction problems for female offspring. BPA, a common component of plastics used to contain food, is a type of estrogen that is ubiquitous in the environment.

“Exposure to BPA may be harmful during pregnancy; this exposure may permanently affect the fetus,” said Hugh S. Taylor, Ph.D., co-author of the study from Yale University School of Medicine in New Haven, Connecticut. “We need to better identify the effects of environmental contaminants on not just crude measures such as birth defects, but also their effect in causing more subtle developmental errors.”

Taylor and colleagues made this discovery by exposing fetal mice to BPA during pregnancy and examining gene expression and DNA in the uteruses of female fetuses. Results showed that BPA exposure permanently affected the uterus by decreasing regulation of gene expression. These epigenetic changes caused the mice to over-respond to estrogen throughout adulthood, long after the BPA exposure. This suggests that early exposure to BPA genetically “programmed” the uterus to be hyper-responsive to estrogen. Extreme estrogen sensitivity can lead to fertility problems, advanced puberty, altered mammary development and reproductive function, as well as a variety of hormone-related cancers. BPA has been widely used in plastics and other materials. Examples include use in water bottles, baby bottles, epoxy resins used to coat food cans, and dental sealants.

“The BPA baby bottle scare may be only the tip of the iceberg.” said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. “Remember how diethylstilbestrol (DES) caused birth defects and cancers in young women whose mothers were given such hormones during pregnancy. We’d better watch out for BPA, which seems to carry similar epigenetic risks across the generations. ”

Author: FASEB* – Federation of American Societies for Experimental Biology, Why BPA leached from ’safe’ plastics may damage health of female offspring, 25-Feb-2010.

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* FASEB comprises 23 societies with more than 90,000 members, making it the largest coalition of biomedical research associations in the United States

ST. LOUIS — The extract from a vegetable that is common in India and China shows promise in triggering a chain of events that kills breast cancer cells and prevents them from multiplying, a Saint Louis University researcher has found.

Ratna Ray, Ph.D., professor in the department of pathology at Saint Louis University and lead researcher, said she was surprised that the extract from the bitter melon she cooks in stir fries inhibits the growth of breast cancer cells.

“To our knowledge, this is the first report describing the effect of bitter melon extract on cancer cells,” Ray said. “Our result was encouraging. We have shown that bitter melon extract significantly induced death in breast cancer cells and decreased their growth and spread.”

Ray said she decided to study the impact of bitter melon extract on breast cancer cells because research by others have shown the substance lowers blood sugar and cholesterol levels. Bitter melon extract is commonly used as a folk medicine to treat diabetes in China and India, she said.

Ray conducted her research using human breast cancer cells in vitro – or in a controlled lab setting. The next step, she says, is to test bitter melon extract in an animal model to see if it plays a role in delaying the growth or killing of breast cancer cells. If those results are positive, human trials could follow.

While it’s too early to know for sure whether bitter melon extract will help breast cancer patients, the question is worth studying, Ray said.

“There have been significant advances in breast cancer treatment, which have improved patient survival and quality of life. However women continue to die of the disease and new treatment strategies are essential,” Ray said.

“Cancer prevention by the use of naturally occurring dietary substances is considered a practical approach to reduce the ever-increasing incidence of cancer. Studying a high risk breast cancer population where bitter melon is taken as a dietary product will be an important area of future research,” Ray said.

She cautioned against seeing bitter melon extract as a miracle cure for breast cancer.

“Bitter melon is common in China and India, and women there still get breast cancer,” Ray said.

Reference: Saint Louis University, Bitter melon extract attacks breast cancer cells, 23-Feb-2010

Picture: St. Louis University

Indigenous people, diabetes and the burden of pollution

Diabetes is now widely regarded as the 21st century epidemic. With some 284 million people currently diagnosed with the disease, it’s certainly no exaggeration-least of all for Indigenous people.

According to the State of the World’s Indigenous Peoples Report by the United Nations, more than 50 per cent of Indigenous adults over the age of 35 have Type 2 Diabetes, “and these numbers are predicted to rise.”

Diabetes is referred to as a “lifestyle disease,” its rampant spread believed to be caused by obesity due to our increased reliance on the western diet (also known as the “meat-sweet” diet) and our avoidance of regular exercise.

While these may certainly be contributing factors, there is growing evidence that diabetes is closely linked with our environment. More than a dozen studies have been published that show a connection between Persistent Organic Pollutants (POPs) including polychlorinated biphenyls (PCBs); carcinogenic hydrocarbons known as Dioxins; and the “violently deadly” synthetic pesticide, DDT and higher rates of the disease.

“If it is the POPs, not the obesity that causes diabetes, this is really striking if true,” says Dr. David O. Carpenter, director of the Institute for Health and the Environment at the University of Albany.

One out of four Indigenous adults living on reserves in Canada have been diagnosed with Type 2 Diabetes, the most common form of diabetes. The prevalence of the disease appears to be so great that the number of new cases being diagnosed in Canada may exceed the growth of the Indigenous population. It’s no longer uncommon to find children as young as three with the disease. According to government statistics, 27 per cent of all Indigenous people in Canada will have Type 2 Diabetes in the next ten years.

Sandy Lake First Nation, in the Sioux Lookout Zone of northern Ontario, has all but met the mark. A March 2009 study co-authored by Dr. Stewart Harris found that 26 per cent of the community has the disease, the highest recorded rate of diabetes in Canada. With a population of 2,500, the northern Cree community was recently described as an “epicentre” of the epidemic.

There has been little research on the levels of persistent organic pollutants in Sandy Lake; however, according to the First Nations Environmental Health Innovation Network, several neighboring communities who also have high rates of diabetes, like Kitchenuhmaykoosib Inninuwug First Nation, are known to have elevated levels of PCBs in their blood.

The Mohawk community of Akwesasne has its own conflict with diabetes and exposure to POPs. Located across the New York-Ontario-Quebec borders along the St. Lawrence River, three aluminum foundries upriver from the reserve dumped PCBs into the river for decades, contaminating the water, soil, and vegetation.

For many years, Dr. Carpenter has been involved in the study of Adult Mohawks at Akwesasne. Most recently, in 2007, he took part in a study to examine the diabetes/pollution link in the community.

“Our study of adult Mohawks showed a striking elevation in rates of diabetes in relation to blood levels of three persistent organic pollutants, DDE, the metabolite of DDT, hexachlorobenzene and PCBs,” Dr. Carpenter explains. “Our results are quite compatible with those of Lee et al.”

In 2006, Dr. Dae-Hee Lee and her colleagues showed that people with the highest rate of exposure to POPs were roughly 38 times more likely to have diabetes than those with the lowest rate of exposure. Further, “they showed that people who were obese but did not have high levels of POPs were not at increased risk of developing diabetes,” continues Dr. Carpenter. “Probably the reason most people get obese is that they eat too many animal fats, and this is where the POPs are.”

The dietary source of POPs was confirmed by the US Environmental Protection Agency in their Draft 1994 Dioxin Reassessment, which has never been formally released to the public. According to the Draft Reassessment, 93 per cent of our exposure to Dioxin comes from the consumption of beef, dairy, milk, chicken, pork, fish, and eggs; in other words, the western diet.

A May 2001 study published in the Journal of Toxicology and Environmental Health drew similar conclusions to the EPA Reassessment. In addition, the study found that “nursing infants have a far higher intake of dioxins relative to body weight than do all older age groups,” and that human breast milk was twice as toxic dairy milk. It also found that vegans had the overall lowest rate of POPs in their bodies.

According to an October 2009 paper by the Research Centre for Environmental Chemistry and Ecotoxicology at Masaryk University, another major source of POPs, specifically DDT, is the world’s oceans. The paper also found that despite restrictions placed on the use of DDT more than 30 years ago, concentrations of the toxin are on the rise.

Indigenous people carry an unequally high proportion of this global toxic burden. For instance, according to Environment Canada’s National Pollutant Release Inventory (NPRI) there are 212 Indigenous communities in Canada living near or downstream from pulp mills and other facilities that produce dioxins and furans. One striking example is the old Dryden pulp mill near Grassy Narrows which, according to the Grassy Narrows and Islington Bands Mercury Disability Board, dumped tonnes of dioxin-laced mercury wastewater into the English-Wabigoon River system from 1962-70.

Forty years later, the poisonous waste continues to pose a “serious health threat” to Grassy Narrows and the Wabaseemoong First Nations, says the Disability Board. No formal steps have been taken toward remediation by federal or provincial governments.

The Tohono O’odham Nation’s experience bears a close resemblance to Grassy Narrows: the world’s highest rate of diabetes can be found in the southwest Arizona nation. According to Tribal health officials, nearly 70 per cent of the population of 28,000 has been diagnosed with the illness. The O’odham People make up the second largest Indigenous Nation in the United States.

Lori Riddle is a member of Aquimel O’odham Community and founder of the Gila River Alliance for a Clean Environment (GRACE).

GRACE was instrumental in the 10 year struggle against a hazardous waste recycling plant that operated without full permits on O’odham land for decades. Owned by Romic Environmental Technologies Corporation, the plant continuously spewed effluents into the air until it was finally shut down in 2007.

The Romic plant was not the first contributor to the O’odham’s toxic burden, explained Riddle. Looking back to her childhood, she recalled: “For nearly a year, [when] a plane would go over our heads, you could see the mist. We never thought to cover our water. The chemicals just took over and they became a part of us.”

From the early 1950s until the late 60s, cotton farmers in the Gila River watershed routinely sprayed DDT onto their crops to protect them from bollworms. According to the Agency of Toxic Substances and Disease Registry (ATSDR), each and every year, the farmers used roughly Twenty-three pounds of DDT per acre.

In 1969, the State of Arizona banned the use of DDT; by this time the river was gravely contaminated. According to the ATSDR, farmers then switched to Toxaphene, a substitute for DDT-until it was banned by the US government in 1990.

Because of these chemicals, Riddle explains, the O’odham were forced to abandon their traditional foods and adopt a western diet. Farms also went into a recession, forcing many families to leave their communities. Companies, such as Romic, began moving on to their territory, exasperating the situation. “It’s taken a toll on our quality of life,” she says. “I’ve cried myself to sleep.”

The O’odham are dealing with what Riddle terms “cluster symptoms” including miscarriages, arthritis in the spine, breathing problems, unexplainable skin rashes, and problems regenerating blood cells. This in addition to diabetes, which frequently leads to renal failure, blindness, heart disease, and amputations.

More and more studies are being published that show the link between diabetes and persistent organic pollutants like DDT-stemming from the landmark “Ranch Hand” study. In 1998, the study found a 166 per cent increase in diabetes (requiring insulin control) in US Air Force personnel who were sprayed with the herbicide and defoliant Agent Orange during the Vietnam War. The study also found that as dioxin levels increased so did the presence and severity of Type 2 diabetes, the time to onset declined following a similar trend.

However, Dr. Carpenter notes that because of the widely-endorsed belief that diabetes is a life-style disease related to diet and exercise, the link is gaining little attention by governments, news agencies, or by any of the hundreds of non-profit diabetes foundations around the world. “[It] hasn’t even made it into the medical community at this point,” Dr. Carpenter adds. “It takes a long time to change both medical and public opinion.”

“Clearly one thing everyone can do is to eat less animal fats,” suggests Dr. Carpenter. Several Indigenous communities in northern Manitoba and British Columbia have begun to do this, planting their own gardens and building greenhouses; returning, in a traditional sense, to some of the foods that sustained them for millennia. Others are turning to exercise, which plays a vital role not just in the prevention of diabetes, but in their overall health.

“Also, we must find ways of getting the POPs out of the animals that we eat. That is not going to be easy, given how contaminated we have made the world,” adds Dr. Carpenter. For this, Lori Riddle, who is herself a diabetic, points to the Tribal Council and the Federal Government.

Author and Copyright:

John “Ahniwanika” Schertow is an Indigenous rights advocate and author of the blog, Intercontinental Cry. / Contact

In an international newsgroup for activists and scientists which looks into the topic of environmental related diseases, toxic caused illnesses and chemical sensitivity, a posting about the ICD-10 concerning MCS was issued by a German activist (see appendix). She presented a written answer from the DIMDI, which she received in response to a question she wrote. She misinterpreted the answer of the DIMDI, in parts she mistakenly translated from German to English, and furthermore left out important points.

E.g. the term “quality assurance” mentioned in the letter of the DIMDI was left out. But the importance of it is essential, as only quality assurance by the means of proper clinical diagnostics after international recognized criteria can lead to an adequate therapy. In the context of “QM” (quality management) the German Medicine focuses on this. So the readers who could not read the original German letter were totally confused and misinformed about the importance of the ICD-10 for MCS in Germany.

Dr. Tino Merz, legal expert for Environmental issues gives his view:

PART I - Artificial Confusion about the ICD-10

It is fascinating to watch all the possibilities of misinterpretation again and again. In order to avoid all incorrect interpretations, we published the “Information’s for Physicians”. The ICD-10 Classification of the WHO and the diagnosis criteria for MCS, CFS, FM and TE can be found in it, without much comment. But as shown, even that can be confuscated.

ICD 10 – List of Diagnosis

Thus and because it is not the first time that wrong conclusions were drawn from wrong ideas, in absolute clear words: the international classification of diseases, 10th edition (since 1992) is a list of about 70.000 diagnosis, which are divided into 22 chapters. The diagnosis to be included are recognized and, due to that, legal diagnosis. That’s important for jurisprudence. The medical Definitions (e.g. diagnostic criteria) are not listed there.

Talking the ICD-10 to Death: Off Topic

Because of this, we included both in the information’s for physicians. The diagnostic criteria are for matters of diagnose, the ICD-10 term is for the legal classification. “T78.4… allergy, unspecified” lists MCS under external injuries, namely as acquired immune deficiency in the characteristic of an unspecified allergy or hypersensitivity. Already earlier an activist lady supposed this to be insufficient. She provided scientific arguments to justify it. Well, that’s off topic. The ICD-10 is a formal [schematic] classification. The phrase “T78.4 does not recognize “MCS” as a medical diagnosis.” is entirely wrong. The ICD-10 list does exactly this: It recognizes MCS as a defined diagnose.

Self-made artificially produced Confusion causes Damage

Since it is this way, in coincidence with the classification as physical and external injury, the attempts don’t stop, which want to relativize what has been scientifically decided for a about a decade. The reinterpretation as “IEI” was rejected by the WHO in 1996. The psychogenic thesis was not phrased until the international discourse was resolved just with the ICD-10 entry. The trick applied is genial. As chemicals harm the mental functions, exactly this is turned against the harmed. The psychogenic thesis swaps cause and effect. This allows to misinterpret any study as wrong as desired. This has nothing to do with science (see blog entry: Erlanger Fake (German only). Nevertheless this allows to create confusion. It is combined with loudness and intimidation. The apodosis from the DIMDI shows that the official tried to avoid trouble. The activist made the classic mistake: “Never ask something, if you don’t know the answer in detail”. Now the asking activist also wrongly judges: she suggests a new finding (“eye-opening”) to be that the ICD-10 does not list recognized diagnosis. What else then? This is the genuine purpose of the ICD. Even those who propagate the psychogenic thesis don’t dare something like this. Therefore, such nonsense is extremely helpful, but only for confusion and to cause damage to the afflicted.

No Question: Environmental related Diseases are recognized long ago

Nobody can deny seriously that environmental related diseases have been recognized long ago. But it is possible to achieve nearly everything with half-truths and prevarications if the afflicted don’t inform themselves. So the others get them where they want them to be.

As legal expert I often have to experience lawsuits that fail, because clients decide wrong, following their view, as they do not know the legal background and the legal interpretation of the scientific knowledge and ignore the advice.

Author: Dr. Tino Merz for CSN – Chemical Sensitivity Network, January 29, 2009

Additional information’s (German only):

• www.dr-merz.com
• Strategy Paper for MCS (pdf)
• Information for physicians about MCS, CFS, EMS, TE (pdf)

–

APPENDIX:

The activist’s newsgroups posting from early January:

The German ICD-10 Coding Guidelines have taken on an important role in Germany since 2002. Because of the cross mapping from the German payment system (known as the Fallpauschale [FP] and Sonderentgelt [SE]) for the hospital inpatient billing requirements to the implementation of the German DRG (G-DRG) payment system, an increasing awareness for the necessity of correct coding could be seen. As of August 15, 2003, Germany named the ICD-10 version ICD-10-GM (German Modification). Usage of the ICD-10-GM: In Germany, the practicing physician is legally responsible for documenting and coding patient charts that are seen in his/her office, and the hospital physician is legally responsible for documentation and coding of the hospital inpatient/outpatient admissions.

Multiple Chemical Sensitivity (MCS) has been formally registered as a physical illness by the German Institute of Medicine, Documentation and Information, and is classified within the German version of the World Health Organization (WHO) International Classification of Diseases ICD-10-GM, Code T 78.4… allergy, unspecified.

For clarification whether MCS has been recognized as a physical illness or not, I wrote to Dr. Ursula Kueppers at the DIMDI. On December 22, 2009 she sent the below reply. An eye-opener to me are the last sentences of her e-mail:

“The ICD-10 can only partly be helpful in deciding the obviously unsolved controversy whether a disease like MCS is to be listed under physical illnesses or mental (psychogenetic, psychiatric) disorders. The facts of this issue have to be discussed by medical experts and can only be answered by them.”

The essence of her statement is that ICD-10-GM, code T78.4 does not recognize “MCS” as a medical diagnosis. The German government simply put “MCS” into the index of the German ICD-10-GM for different purposes (statistics, payment, etc.) in the National Health Care System.

Best to everyone,

xxx

Cited written reply from the DIMDI*

Dear Ms. XXXX

I apologize for not answering your question earlier.

The ICD-10-GM serves in the Germany Federal Republic for different purposes in the public health (amongst others for the billing system, quality assurance, statistics). The ICD-10-GM is based on the ICD-10 edition of the World Health Organization (WHO).

Normally, the ICD-10 (-GM) does not define diseases, but classifies illnesses in Chapters and Groups etc. considering specified criteria. This structure of the ICD-10 (-GM) has its roots in history. You can read more about that in Volume 2 (Instruction Manual) of the WHO’s ICD-10 edition. [English WHO version ]

As to MCS the status quo is that MCS is actually coded in the ICD-10-GM under “T78.4… allergy, unspecified” and thus it is not assigned to Chapter V – Mental and behavioral disorders. From my point of view the explanation text there provides a good reason for the coding under T78.4. “This category is to be used as the primary code to identify the effects, not elsewhere classifiable, of unknown, undetermined or ill-defined causes. For multiple coding purposes this category may be used as an additional code to identify the effects of conditions classified elsewhere.”

For the final judgment of the obviously not cleared matter of dispute, whether such a disease like MCS has to be seen as a physical or mental illness, the ICD-10 help is limited. This question has to be discussed on its merit by medical experts and only they can answer it.

Yours sincerely,

p.p.

Dr. Ursula Kueppers

DIMDI – German Institute for Medicinal Documentation and Information

Medical Classifications

The DIMDI is an Institute of the German Federal Ministry of Health’s (BMG) Portfolio.

* (Translated by BrunO)

PART II - Update: Emotionality and Misinformation do damage to MCS sufferers

In his previous blog post Dr. Merz wrote how activists and support groups generate artificial confusion about the code for MCS in the ICD-10. For about three years some patient “advocates” apply to put this diagnostic-key forcefully into question or even deny its existence, which describes MCS as an organic disease. Though CSN has spread a non-ambiguous letter from the DIMDI, these attacks don’t stop. And actually, there is no comprehension. The circulation of misinformation organized by an activist even on national and international levels continues. For weeks she is posting falsifying information’s about the ICD-10 concerning MCS in various newsgroups. She tries to morally legitimate her behavior which is harmful to all MCS suffers in one of the recent posts by mentioning her own failed lawsuit.

The Opinion about the MCS ICD-10, spread by an Activist Lady:

According to Dr. Kueppers at the DIMDI (German Institute of Medicine, Documentation and Information – medical classifications), the purpose of the ICD-10-GM classification system is only medical billing, statistics. She wrote that the ICD-10 (-GM) does not as a rule define illnesses.

Despite the ICD-10-GM classification system, code 78.4… allergy, unspecified, MDs, psychiatrists, psychologists, medical experts still can assign the dx “mental”, “psychogenetic”, “psychosomatic” disorder for our illness, if they want to do so.

To offer evidence for this sad truth, I would like to inform you on my own experience with the German legal system. In April 2002 I went to court. In a lawsuit at the regional court Bonn, the expert witness, a respected professor and director of the university hospital in Cologne stated the below in evidence, though he had to be familiar with the ICD-10 classification system:

>> As to conventional (orthodox, traditional) medicine, a clinical syndrome such as “MCS” is not known and recognized. “Multiple Chemical Sensitivities” as the plaintiff translates the term for the illness do not have any influence on the therapeutic procedure within the limitations of conventional medical treatment. “MCS” is a matter of non-medical practitioners (homeopaths, and others).>>

This lawsuit caused a kind of “PTSD” in me. So if I stumble across articles “GERMANY IS THE FIRST COUNTRY TO RECOGNIZE MULTIPLE CHEMICAL SENSITIVITY ( MCS) AS A PHYSICAL DISEASE”, for instance, the one by Christiane Tourtet it still hurts, and I swallow my anger about the experienced injustice.

Best from Germany,

XX

*Note: DIMDI’s name in not translated correctly. DIMDI means “German Institute for Medicinal Documentation and Information”. It is not an Institute for Medicine; it is not called “German Institute of Medicine, Documentation and Information”.

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Dr. Tino Merz about the restated Misinterpretations of the Activist:

You have to start reading the text of the activist from the end. The writer is hurt and annoyed about an expert opinion, which says MCS does not at all exist in traditional medicine. Instead of figuring out how to counteract such nonsense effectively – if the professor does not know the ICD, he may be incompetent or prejudiced – she swallows her anger.

Well, she is unable and unwilling to believe what Dr. Kueppers wrote in her precise letter to Silvia Mueller. Probably she asked if it really was true. That’s the old truth: “If you ask long enough …”. Meanwhile pressure was put on Ms. Dr. Kueppers. So she backpaddles and our writer presents her the opportunity to buckle.

At last, our writer teaches the world and proclaims the sad truth, that there are no diagnoses in the ICD and the physicians do not have to pay any regard to it.

This activity shows how those, which – knowing the truth – deny the state of science, succeed to turn an immense whole scientific literature into garbage, as seen by presenting their pseudo science as new scientific finding (Erlanger Fake Method: swap cause and effect), apostrophizing it as traditional medicine correctness and demanding above all, to accept it as “serious”. Obviously they succeed in making many support groups to accept it. I point to a quote in my strategy paper about “the belief in science”. An activist lady states in it non-acceptance of MCS is due to journalists and politicians belief in science. Thus the activist accepts MCS is scientifically unexplained. In consequence, the sad truth is that such support groups assist to dig their own grave.

Author: Dr. Tino Merz for CSN – Chemical Sensitivity Network, February 5, 2009

Translation: BrunO with help of John. Thank you to both of them!

During our lives we suffer several metamorphoses, some are painful, others are positive, chosen or not. The experience, the life itself, makes us change and evolve.

My story is not different, although my most radical metamorphosis was when I fell ill with Multiple Chemical Sensitivity. But although I got sick suddenly, the process itself happened slowly. I was preparing for MCS for many years before I was aware of it. My body was warning me repeatedly without my understanding what it wanted to tell me. But how could I know that everything happening to me was the prelude to MCS? It’s almost impossible to know since information about MCS is kept secret from the public and when anyone dares to raise a voice, they are automatically silenced by those who say MCS is all in the minds of the patients.

It’s not easy to understand what happens to you as you search for a diagnosis, all the while trying not to fail during the long journey while you are riddled with attempts to damage your self-esteem as you struggle with a more diminished health status every day. The last stage of this particular metamorphosis happens when you finally know what it is happening: you have MCS. And then you start to reconsider the life you have known before in order to adapt yourself and to survive into the future.

All of us have gone through the stage of crying over things that we have lost, to hate what we have become. Where is that tireless and impulsive person who took the world by storm? It’s a natural, healthy and necessary stage. But oddly, then comes the most difficult thing: to find our place in this new world in which we’re doomed to live.

And surprisingly, when I thought that my life couldn’t be more foreseeable and monotonous, from the prison that my house has become, another metamorphosis started, this time deeper and visceral. This time my metamorphosis was chosen.

The need to communicate, to let the world know that I’m still alive, to cry out for my own rights and the rights of millions of people who suffer MCS in the whole world, led me to write. My timid voice started to be heard on my blog, No Fun, and then gathered strength thanks to Delirio’s articles, which were translated into several languages. And the first of them, “The Naked Truth about MCS,” was read on the Spanish Radio 3 program Carne Cruda. It was then that I finally dared to do something I had never imagined I would ever do: to write a book.

The extremely reserved person that I used to be has disappeared, in order to be able to tell my story to the world, as I dig into the deepest places of my being. Missing: A Life Broken by Multiple Chemical Sensitivity is a fulfilled wish as I report the situation in which we live. It’s my metamorphosis inside the metamorphosis of living with MCS. It’s my testimony, my life, my reflections. It’s also my contribution to the fight we’re doing at an international level to have MCS fully recognized. My book is the clearest proof that MCS didn’t take away my essence or my attitude; MCS didn’t steal my dreams but rather it changed my dreams so that I could help others.

My wish is that a lot of books will be written by people who are “missing” because of MCS so that the public knows we exist. We are ill, but no one will silence us.

Author: Eva Caballé / No Fun Blog, published at Delirio 2010.

Translation: Oscar Varona (from Delirio’s team) and Eva Caballé with help from Susie Collins.

Japanese and German versions are following soon.

Related Articles:

• Interview with Eva Caballé about Multiple Chemical Sensitivities and about her Book
• Naked Truth about MCS
• Meeting betweenMinistry of Health and Multiple Chemical Sensitivity Associations in Spain

On February 4th 2010 at 12:00h has been held the meeting with Ministry of Health to state the situation of Multiple Chemical Sensitivity sufferers in Spain.

Mr José Martínez Olmos, Secretary General of the Ministry of Health, Mr Alberto Infante Campos, General Director of Professional Planning, Cohesion of SNS and High Inspection and Mr Francisco Valero Bonilla have attended to the meeting representing the Ministry of Health. One person by almost each MCS association has attended to the meeting and also Jaume Cortés, lawyer of Colectivo Ronda, and Dr. Pablo Arnold, immunologist specialized in MCS.

• ACAF: Cristina Montané
• AFCISQUIM: María Roldán
• Alas de Mariposa- SQM: Tránsito Rodríguez
• ALTEA – SQM: Cristobalina Bejarano
• APQUIRA: Mª Carmen Gómez de Bonilla
• AQUA: Mario Arias
• ASQUIFYDE: Francisca Gutiérrez
• AVASFASEM-AVASQ: Francisca García
• ENA: Laura Domínguez
• MERCURIADOS: Mª Carmen Miravete
• Plataforma Estatal Contra la Contaminación Ambiental: Minerva Palomar
• PLATAFORMA PARA LA FM ,SFC, SQM, reivindicación de derechos, Asociación Nacional: Elena Navarro

A petitions document done by MCS associations under David Palma coordination has been submitted. This document has been signed by:

• ABAF: Margarita Pascual
• ACAF: Maite Ribera
• AFCISQUIM: María Roldán
• Alas de Mariposa- SQM: Irene Escudero
• ALTEA – SQM: Cristobalina Bejarano
• APQUIRA: Mª Carmen Gómez de Bonilla
• AQUA: Mario Arias
• ASQUIFYDE: Francisca Gutiérrez
• AVASFASEM-AVASQ: Francisca García
• ENA: Rosa de Gabriel
• MERCURIADOS: Servando Pérez
• Plataforma Estatal Contra la Contaminación Ambiental: Minerva Palomar
• PLATAFORMA PARA LA FM ,SFC, SQM, reivindicación de derechos, Asociación Nacional: Elena Navarro
• Eva Caballé

Also a copy of Desaparecida: Una vida rota por la Sensibilidad Química Múltiple (Missing: A life broken by Multiple Chemical Sensitivities) has been hand delivered on behalf of Eva Caballé, who couldn’t attend to the meeting, as an example of what MCS sufferers have to go through in Spain.

The meeting with Ministry of Health has meant an agreement on minimum standards by the Ministry, but a big hope for all MCS sufferers.

Representatives of Ministry of Health have committed to contact MCS associations within 2 weeks to jointly agree on experts to form a Scientific Committee to create a document of consensus on the MCS. They have stated that this is the first step to make possible the inclusion of the MCS in ICD-10, i.e. its official recognition as disease in Spain. They have demonstrated that later there would be necessary to start creating the guidelines.

All people who have been part of this process are thrilled by the result of the meeting, because doors have opened us to obtain the recognition of the Multiple Chemical Sensibility in Spain and to achieve that MCS sufferers have the same rights as the other chronically ill people.

Authors: Eva Caballé, David Palma, NoFun, February 4, 2010