Avoidance, aka Environmental Control: Board-certified doctors' orders.

The AMA, the American Academy of Allergy Asthma and Immunology
(the AAAAI), and the American Lung Association (the ALA) have all
acknowledged the following:

They acknowledged the existence of Chemical Sensitivity as it applies
to Asthma and Asthma-like conditions, as well as sinusitis and adverse
skin conditions such as dermatitis and urticaria (rashes.)  This includes

1}  Occupational Asthma due to Low Weight Molecular Agents,
2}  Irritant-associated Vocal Cord Dysfunction.
3} Reactive Airways Dysfunction Syndrome,
4)  Irritant-induced Asthma, .
5} Small Airways Disease.

All three associations have acknowledged that chemical-bearing agents can
trigger asthma attacks in susceptible persons. This includes chemically laden
fragrance products.  In as much everyone on earth needs air to breath.  No one
needs vain and gluttonous amounts of artificial fragrances products.

Each organization advocates the practice of Environmental Control; 
of avoiding airborne agents which trigger one's asthma.   In fact, the
AMA has formally referred to Avoidance as "Control of Factors Con-
tributing to Asthma Severity."   In French medical Literature, avoid-
ance is known as "Strict Eviction."  

Examples of recognized asthma triggers in the chemical category
include:

[A] "NO2" from gas stoves and fireplaces,  fumes from
        kerosene heaters, and volatile organic compounds
        from carpeting, cabinetry, plywood, particle board,
         and fumes from household cleaning products."

[B] "Air pollutants such as tobacco smoke, wood smoke,
        chemicals in the air and ozone"

      "Occupational exposure to vapors, dusts, gases or fumes"

      "Strong Odors or sprays such as perfumes, household clean-
        sers, cooking fumes (especially from frying), paints, or var-
        nishes"

[C] "Perfume, paint, hair spray, or any strong odors or fumes."

http://www.epa.gov/asthma/chemical_irritants.html

http://asthma.about.com/od/asthmatriggers/qt/chemictriggers.htm

http://www.aaaai.org/patients/publicedmat/tips/occupationalasthma.stm

http://www.lungusa.org/healthy-air/home/resources/cleaning-supplies.html

http://www.lungusa.org/lung-disease/asthma/about-asthma/understanding-asthma.html

http://www.lungusa.org/lung-disease/asthma/living-with-asthma/take-control-of-your-asthma/asthma-triggers.html

An American Lung Association already stated:

"Perfume, room deodorizers, cleaning chemicals, paints, and
  talcum powder are examples of triggers that must be avoided
  or kept at very low levels."

The same American Lung Association furthermore states:

"These 'triggers' can set off a reaction in your lungs and   other 
  parts of your body." Now, place an emphasis on "other parts
  of your body," and keep in mind that:

Avoidance also applies to Anaphylaxis, Chemically-induced Hepatitis,
Irritant Rhinitis, Dermatitis, Urticaria (rashes), Irritant-associated Vo-
cal Cord Dysfunction, Reactive Airways Dysfunction Syndrome, etc.

The AMA's Admitting to the Converse Relationship Between 
Pollution Levels and Hospital Admissions Due to Asthma

Five to six thousand people die each year from asthma, in the United
States alone, and one of the highest asthma-related death rates has
been in Harlem, NY, as well as Detroit.   Ever so coincidentally, the
environs of Harlem are venues for NYC waste sites. Concerning this,
the AMA has expressly stated that:

"fluctuations in the levels of air pollution correlate with asth-
 ma symptoms and hospital admissions."   [Report 4 of the AMA's
 Council on Scientific Affairs (A-98)]
===============================================

The segment posted below appears in another Atlantic America article.
This means that it might look familiar to you.  In fact, the information in
quotations, as well as the asthma chart, was provided by the American
Academy of Allergy Asthma and Immunology, in its publican information
literature.  Needless to say, charts can be invaluable for individuals seek-
ing to learn fact. 

The AAAAI's public education material 
on the subject of Occupational Asthma

Concerning the AAAAI that Barrett cited in his campaign to convince
mankind that Environmental Illness is merely a matter of mental illness,
it published an instructional website about Occupational Asthma.  The
AAAAI has already acknowledged that Occupational Asthma can be
caused by a number of chemicals at nontoxic/ambient levels, afflicting
a number of  workers employed in a number of  industries.

     Acrylates  . . . . . . . . . . . . . . . . . . . Adhesive handlers
     Amines  . . . . . . . . . . . . . . . . . . . .  Shellac & lacquar handlers
     Anhydrides . . . . . . . . . . . . . . . . . . Plastic, epoxy resin users
     Chloramine-T . . . . . . . . . . . . . . . . Janitors, cleaning staff
     Dyes . . . . . . . . . . . . . . . . . . .  . . . . Textile workers
     Fluxes   . . . . . . . . . . . . . . . . . . . . . Electronic workers
     Formaldehyde/glutaraldehyde . . .  Hospital staff
     Persulfate  . . . . . . . . . . . . . . . . . . . Hairdressers
     Isocyanates . . . . . . . . . . . . . . . . . . Spray painters, Insulation
                                                               installers; plastic, rubber,
                                                               foam manufactory workers.

         The same public education material of  the AAAAI states:

          "The cause may be allergic or nonallergic in nature,
            and the disease may last for a lengthy period in some  
            workers, even if they are no longer exposed to the
            agents that caused their symptoms."

           "Inhalation of  some substances in aerosol form can
            directly lead to the accumulation of  naturally oc-
            curring chemicals in the body, such as histamine or 
            acetylcholine within the lung, which in turn lead to 
            asthma."

            "For example, insecticides, used in agricultural work,
            can cause a buildup of  acetylcholine, which causes
            airway muscles to contract, thereby constricting air-
            ways."

           "Allergic occupational asthma can occur in workers
            in the plastic, rubber or resin industries following
            repeated exposure to small chemical molecules in 
            the air."

          "If occupational asthma is not correctly diagnosed
           early, and the worker protected or removed from the
          exposure, permanent lung changes may occur and 
          asthma symptoms may persist even without exposure."

          "Up to 15% of  asthma cases in the United States may
           have job-related factors."

          "Isocyanates are chemicals that are widely used in many 
           industries, including spray painting, insulation installa-
           tion, and in manufacturing plastics, rubber and foam.
           These chemicals can cause asthma in up to 10% of ex-
           posed workers."

The aforementioned illustrates that Chemical Sensitivity, as it applies to
asthma and rhinitis, is acknowledged as valid and authentic by the same
AAAAI that Barrett elected to use, in order to support his assertion that
chemical sensitivity is merely a psychological illness.

Conclusion

Stephen Barrett can mock the diagnostic title, Multiple Chemical Sensi-
tivity, all that he wants to.  It will not take away the fact is that chemical
sensitivity has already been recognized in case specific form.  Nor will
it take away the fact that the sufferers of those case-specific forms of
chemical sensitivity need to avoid the chemicals which exacerbate their
medical conditions.
_________________
The following quote is
directly from the AMA 

Avoidance and AMA (CSA) Report 4 (A-98)

Avoidance is not 'detrimental.'  Nor is it nonsense.  Avoidance is a
medical necessity.  And as it applies to asthma, the AMA has stated:

   Regardless of the efficiency of clinician assessment and pa-
   tient self-monitoring, if the patient's exposure to irritants
   or allergens to which he or she is sensitive is not reduced 
   or eliminated, symptom control and exacerbation rate may
   not improve.  Formerly titled 'Environmental Control,' the
   key points in this area logically include efforts by clinicians
   to pinpoint causative agents and to provide specific advice 
   on how to avoid or reduce exposures to environmental or
   dietary triggers and drugs that may provoke or exacerbate 
   symptoms." AMA Report 4, Council on Scientific Affairs (A-98)
   ============================================

A 1999 AAAAI Position Statement on Multiple Chemical Sensitivity contrasted with chemically-triggered Occupational Asthma

Stephen Barrett is co-author of "Chemical
Sensitivity:  the Truth about Environmental
Illness."  Of course, the truth is missing from
the book.  The book was an attempt to  con-
vince mankind that Chemical Sensitivity is
mental illness.  This is in contradiction to
Barrett's own writings, being that he once
stated that there are legitimate cases where
repeated chemical exposure caused harm.

None the less, the campaign of Barrett and his associates lost its last ves-
tige of credibility with the 911 clean-up crew members who developed
Small Airways Disease and Reactive Airways Dysfunction Syndrome.
Concerning this, the experts at Mt. Sinia in NYC discovered that it was
the pulverized concrete dust, with all its alkalinity, which caused those
specific respiratory diseases to develop.  Those diseases consisted in
sensitivity to a plurality of synthetic chemicals and naturally occurring
ones, as well.

In Barrett's relentless campaign which has shown itself  to have been
solely a money-making venture, he cited a 1999 position statement
issued by the American Academy of Allergy Asthma & Immunology.
The position statement is titled Idiopathic Environmental Intolerances,
and the title refers to the claim that Environmental illness has no identi-
fiable cause.  This is deceptive, because Occupational Illness has easily
identifiable causes, namely the chemicals, molds, and irritants in one's
place of work.  Needless to say, the symptoms of Occupational Illness
are often the same as the ones involved in Environmental Illness.

In contrast to the chemical attacks of WWI, 21st Century mankind under-
goes a pernicious, execution style chemical attack, with tens of thousands
of synthetic chemicals used in commerce and industry with such prevalence
that those  chemicals reach the common household, even its drinking water.

The odd thing about the AAAAI position statement is that it admits to the
authentic existence of specific environmental illnessess.  Yet, it denies the
existence of Multiple Chemical Sensitivity so much so that its author(s)
changed the name of the illness to Idiopathic Environmental Intolerance.
However, IEI did not replace MCS at Johns Hopkins, Mt. Sinai, Central
New York Occupational Clinic, Marshall University, and Cambridge
Hospital.

Perhaps Barrett Should Have Read 
the Entire Text Before Citing It

As I previously stated, the irony to Barrett's citing of the 1999 text, in
order to strengthen his anti-MCS assertion, consists in the fact that the
1999 position statement expressly recognizes the existence of "true en-
vironmentally caused diseases." 

Within that same published text appears examples of such true envi-
ronmental illnesses.   The examples in the text include:

1) "hypersensitivity pneumonitis,"
2) "sick building syndome,"
3) "reactive airways dysfunction syndrome."

[The aforementioned diseases appear by name at the section nearest to
the Summary.  That section is titled,"Comparison with Other Illnesses."]

In as much:

1)  Stephen Barrett called Sick Building Syndrome "a fad diagnosis."
     The AAAAI did not do so.

2)  Reactive Airways Dysfunction Syndrome (RADS) is regarded by
     the AMA as "a subset of Irritant-induced Asthma."   It's a chemical
     sensitivity disease and a form of environmental illness.   Yet, has the
     never-board-certified Stephen Barrett and his fellow propagandists
     ever acknowledged the existence of this particular form of chemical
     and irritant sensitivity disease in their writings?

3)  Furthermore, a subset of Hypersenstivitiy Pneumonitis is Chemical 
     Worker's Lung.  Now, the Stephen Barrett who has absolutely zero 
     experience in internal medicine,  zero experience in dermatology,
     zero experience in cytopathology, zero experience in immunology,
     and zero experience as a biochemistry professional has mocked the
   "Multiple Chemical Sensitivity" by name.   But has he ever acknowl-
     edged that there exists Chemical Worker's Lung ... or Occupational
     Asthma due to Low Weight Molecular Agents?

The Chemical-bearing Agents that MCS patients Avoid Are the 
Same Ones which the AMA, AAAAI, and ALA Recognize as the
Triggers of Asthma and Rhinitis

4) The 1999 position statement acknowledged the following:

       "Certain environmental irritants, including some of
         those mentioned above, are recognized as triggers
         for patients with asthma and rhinitis."

[The above-cited quote appears at the section titled, "Clinical
 Description of IEI."]

The environmental irritants mentioned in the same section of the
AAAAI's 1999 position statement are:

   - "perfumes and scented products, pesticides, domestic and
      industrial solvents, new carpets, car exhaust, gasoline, 
      diesel fumes, urban air pollution, cigarette smoke, plas-
      tics, and formaldehyde."

   - "certain foods, food additives, and drugs"

   - two things not claimed to trigger asthma and/or rhinitis. 

In order to confirm that the above-mentioned things are recognized
as asthma triggers by mainstream medical science, see:

Cleaning Supplies and Household Chemicals

http://www.lungusa.org/healthy-air/home/resources/cleaning-supplies.html

Understanding Asthma - American Lung Association

http://www.lungusa.org/lung-disease/asthma/about-asthma/understanding-asthma.html 

Chemical Asthma Triggers and Irritants

http://asthma.about.com/od/asthmatriggers/qt/chemictriggers.htm 

Asthma Triggers: Gain Control (EPA site)

http://www.epa.gov/asthma/chemical_irritants.html

The above-cited web addresses are those of the American Lung Asso-
ciation, the AMA, and the same AAAAI Barrett elected to use in his
campaign to convince mankind that Chemical Sensitivity is nothing more
than a psychological illness.   In as much, count the number of chemical-
bearing agents that the three mainstream associations regard as asthma
triggers.

The AAAAI's public education material 
on the subject of Occupational Asthma

Concerning the AAAAI that Barrett cited in his campaign to convince
mankind that Environmental Illness is merely a matter of mental illness,
it published an instructional website about Occupational Asthma.  The
AAAAI has already acknowledged that Occupational Asthma can be
caused by a number of chemicals at nontoxic/ambient levels, afflicting a
number of  workers employed in a number of  industries.

     Acrylates  . . . . . . . . . . . . . . . . . . . Adhesive handlers
     Amines  . . . . . . . . . . . . . . . . . . . .  Shellac & lacquar handlers
     Anhydrides . . . . . . . . . . . . . . . . . . Plastic, epoxy resin users
     Chloramine-T . . . . . . . . . . . . . . . . Janitors, cleaning staff
     Dyes . . . . . . . . . . . . . . . . . . . . . . . Textile workers
     Fluxes   . . . . . . . . . . . . . . . . . . . . . Electronic workers
     Formaldehyde/glutaraldehyde . . .  Hospital staff
     Isocyanates . . . . . . . . . . . . . . . . . . Spray painters, Insulation
                                                                installers; plastic, rubber,
                                                                foam manufactory workers.
     Persulfate  . . . . . . . . . . . . . . . . . . . Hairdressers

     The same public education material of the AAAAI states:

          "The cause may be allergic or nonallergic in nature,
            and the disease may last for a lengthy period in some  
            workers, even if they are no longer exposed to the
            agents that caused their symptoms."

           "Inhalation of  some substances in aerosol form can
            directly lead to the accumulation of  naturally oc-
            curring chemicals in the body, such as histamine or 
            acetylcholine within the lung, which in turn lead to 
            asthma."

            "For example, insecticides, used in agricultural work,
            can cause a buildup of  acetylcholine, which causes
            airway muscles to contract, thereby constricting air-
            ways."

           "Allergic occupational asthma can occur in workers
            in the plastic, rubber or resin industries following
            repeated exposure to small chemical molecules in 
            the air."

          "If occupational asthma is not correctly diagnosed
           early, and the worker protected or removed from the
          exposure, permanent lung changes may occur and 
          asthma symptoms may persist even without exposure."

          "Up to 15% of  asthma cases in the United States may
           have job-related factors."

          "Isocyanates are chemicals that are widely used in many 
           industries, including spray painting, insulation installa-
           tion, and in manufacturing plastics, rubber and foam.
           These chemicals can cause asthma in up to 10% of ex-
           posed workers."

The aforementioned illustrates that Chemical Sensitivity, as it applies to
asthma and rhinitis, is acknowledged as valid and authentic by the same
AAAAI that Barrett elected to use, in order to support his assertion that
chemical sensitivity is merely a psychological illness.

Conclusion

Stephen Barrett can mock the diagnostic title, Multiple Chemical Sensi-
tivity, all that he wants to.  It will not take away the fact is that chemical
sensitivity has already been recognized in case specific form.  Nor will it
take away the fact that the sufferers of those case-specific forms of chem-
ical sensitivity need to avoid the chemicals which exacerbate their medical
conditions.

Avoidance and AMA (CSA) Report 4 (A-98)

Avoidance is not 'detrimental.'  Nor is it nonsense.  Avoidance is a
medical necessity.  And as it applies to asthma, the AMA has stated:

   Regardless of the efficiency of clinician assessment and pa-
   tient self-monitoring, if the patient's exposure to irritants
   or allergens to which he or she is sensitive is not reduced 
   or eliminated, symptom control and exacerbation rate may
   not improve.  Formerly titled 'Environmental Control,' the
   key points in this area logically include efforts by clinicians
   to pinpoint causative agents and to provide specific advice 
   on how to avoid or reduce exposures to environmental or
   dietary triggers and drugs that may provoke or exacerbate 
   symptoms." AMA Report 4, Council on Scientific Affairs (A-98)
   ============================================

Staudenmayer's erroneous test conclusion, concerning Multiple Chemical Sensitivity patients

Whenever you scald your tongue on
hot tea, your tongue will still feel the
scalding sensation, even if you drink
cool water shortly after having been
scalded.  Well, there is a very similar
phenomenon in the lives of chemical
sensitivity patients. It's called masking.

The failure to consider this phenome-
non was the fatal error in a 1980s test
that ended up being obsessively used
in the anti-MCS propaganda of retired
psychiatrist, Stephen Barrett, MD.  He
once said that he was the media,  even
though he was never a household name.

It's important to keep in mind that the blatant attack dog of Big Pharma,
namely retired psychiatrist Dr Stephen Barret, MD, never worked in the
field of Occupational & Environmental Medicine.  Therefore, he has no
professional experience with those suffering from Chemical Allergies
and/or Irritant-induced illnesses.  Such conditions include Reactive Air-
ways Dysfunction Syndrome, Occupational Asthma due to Low Weight
Molecular Agents, Irritant-associated Vocal Cord Dysfunction, etc.  In-
cidentally, low-weight molecular agents are more commonly known as
chemicals.
_________________________________________________________

In his attempt to convince mankind that Chemical Sensitivity is merely
a mental illness, the Stephen Barrett who never examined any chemical
sensitivity patient repeatedly cited a "research undertaking" which was
conducted in Denver during the 1980s.  The test is formally titled:

Double-blind provocation chamber challenges in 20 patients presenting 
with "multiple chemical sensitivity."   The article which detailed the re-
search undertaking was published on August 18, 1993.

The research team who conducted that test consisted in psychologist
Herman Staudenmayer (Ph.d),  allergist John Selner (MD), and chem-
ist Martin P. Buhr (Ph.d).  I was told by someone very well known in
the Chemical Sensitivity world that Herman Staudenmayer appeared
as a brooder, to state it politely.

The title of the test is misleading, in that it was not based on standard
challenge testing, such as the methacholine challenge test which mea-
sures changes in  FEV1.   Rather, the Staudenmayer test was subject-
ive testing;  the type of testing that Barrett condemned as invalid.   So,
we see another instance of hypocrisy in the psychiatrist of early retire-
ment.

Incidentally, FEV1 is the measurement of Forced Expiratory Volume
after one second of exhaling.  In addition, pulmonary experts, from my
experience, will not allow severely sensitive people to take the metha-
choline challenge test, in fear that they "might not recover" the ability
to breath.  For example, an Ivy League trained pulmonary expert for-
bid me to take the test.  In the State where I was at the time, the law
only permitted pulmonary specialists to order methacholine testing.    

Background in Brevity

1) The test consisted in 145 occasions where a test subject had sent in-
     to into his/her chamber an injection of air.  The test subject was then
     instructed to discern if whether or not the injected air was accompa-
     nied by a chemical agent.  Each of the twenty test subjects participat-
     in at least one "provocation challenge." 

2) The challenges were divided into two types:

a) active challenges, 
b) sham challenges. 

Eighty-eight of the provocation challenges were categorized as "sham"
challenges, and they were recorded as injections of chemical-free air.
The other fifty-seven challenges were defined as "active" challenges,
each of which was recorded as the injection of chemical-bearing air.

3) The sham challenges came in two forms:

a) clean air injected alone,
b) clean air accompanied by an aromatic agent.

4) The active challenges also came in two forms:

a) the injection of an airborne chemical alone,
b) an airborne chemical accompanied by an aromatic agent.

5) The aromatic agents were called "maskers."

Maskers used in the "Staudenmayer Test" included:

a) anise oil,
b) cinnamon oil,
c) lemon oil,
d) peppermint spirit (10% oil and 1% leaves.)

4) The overall result of the test, as recorded by the research team, goes
     as follows:  "Individually, none of these patients demonstrated a re-
     liable response pattern across a series of challenges."  The conclu-
     sion was that persons diagnosed with Multiple Chemical Sensitivity
     are merely psychologically ill.

The Invalidating Feature of that Test

The maskers that Barrett cited in his anti-MCS propaganda as having
been used in the "Herman Staudenmayer Test" are known triggers of
adverse reactions in susceptible persons.   That is to say, the maskers
were chemical-bearing agents.

Concerning anything aromatic, keep in mind that the AMA, the world-
renown Mayo Clinic, the American Lung Association, and the Ameri-
can Academy of Allergy, Asthma, & Immunology each recognize, in
publicly accessible print, that "strong odors" can be triggers of adverse
upper and/or lower respiratory reactions in susceptible people, simply
because they are strong odors.   This has included anise oil, cinnamon
oil, lemon oil, and peppermint spirit.

The Chemical Ingredients in the Sample List of Maskers
Used in 'the Staudenmayer Test' that were Alleged to be
Chemical-free

Concerning the sample list of maskers used in the "Staudenmayer Test,"
observe the following:

Anise Oil:

- An active ingredient in it is anethole.
- Anethole's chemical composition is C10H12O.
- Its CAS No. is 104-46-1.
- It is a known trigger to those adversely reactive to it.
- In fact, Anethole is known as p-1-propenylanisode.
- It is also known as 1-methoxy-4-(1-propenyl)benzene.
- Thus, anise oil is a chemical-bearing agent.

In all occasions where anise was used as a masker in a clean air inject-
ion, a chemical-bearing agent was being injected into the test subject's
chamber.   Therefore, to have recorded such an injection as one of
chemical-free air was to have recorded a falsehood.

Cinnamon Oil:

Along with being a "strong odor," cinnamon oil is a bearer of aldehyde.
In fact, the naturally occurring trans-cinnamaldehyde unassistedly be-
comes benzaldehyde in the presence of heat.

In as much, to have recorded a cinnamon oil air injection as a chemical-
free one was to have recorded yet another falsehood.  Cinnamon oil is
a chemical-bearing agent.

Lemon Oil:

The most prevalent constituent in lemon oil is the monoterpene, limo-
nene, aka 4-isopropenyl-1-methyl-cyclohexene.   Limonene de-
velops a potent sensitizing capacity when oxidized, and it's a reputed
skin sensitizer.   In addition, a Swedish research undertaking record-
ed the following:   "Bronchial hyperresponsiveness was related to in-
door concentrations of limonene, the most prevalent terpene."  Lemon
oil also includes the same alpha-pinene that was implicated in oil of
turpentine allergy.

Peppermint:

This aromatic agent is the bearer of Methyl Salicylate, and as is shown
below, it is among the salicylate allergy triggers.   It's also the bearer of
the following sensitizing agents:   (a) alpha-pinene, (b) phellandrene,
and (c) limonene.   It's also the bearer of (d) methone, (e)  mentho-
furane, (f) and methyl acetate.

Now, as far as concerns methyl salicylate, Supplement 5 of the Journal
of the American Society of Consultant Pharmacists, 1999 / Vol. 14,
states:

"Of note, methyl salicylate carries the same warnings as oral 
salicylates and has the potential to cause Reye's Syndrome in 
children with flu-like symptoms, as well as adverse reactions in
those with aspirin allergy, asthma, or nasal polyps."

In as much, to record an airborne injection of peppermint spirit as a
chemical-free one, is to record yet another falsehood.

Dephosphorylation

The research team gave no consideration to the the masking of sensi-
tivity responses; a phenomenon attributed to the involvement of Ca2+
calmodulin phosphatase calcineurin and the ensuing dephosphorylation
that it induces.  Phosphorylation is explained in the following text:

http://www.chemicalsensitization.com/2011/01/proposed-mechanism-for-mcs.html

Barrett's Predictable Response to the Test

As is to be expected, in an article written by him, Barrett recommended
that clinical researchers conduct more tests likened to the one conduct-
ed by Staudenmayer and his colleagues; anise oil, cinnamon oil, and all. 

You should be able to conjecture why he advocated Kangaroo Court
research.
_____________________________________________________