to create “safe zones” free of dangerous chemicals.3
A strategy of avoidance based on escape and one based on changing habits, ordinances, or the materials of production are effectively redrawing the boundaries between safe and dangerous places, though with varying social and political effects. Families who leave Los Angeles and move high into the Sierra Madres to escape a chemically saturated world are building alternative, “ecologically safe” communities; they are not, however, directly challenging society to change. A wife who refrains from wearing a “toxic scent,” an employer who moves an offending copying machine from a nearby office, and a county board of supervisors that passes an ordinance establishing a “fragrance-free zone” in the local courthouse are examples of social and legal accommodations to the environmentally ill who petition others to change. When others change, the environmentally ill stand a chance of living within society rather than merely surviving by escaping from it.
Whether they manage their symptoms by escaping society or challenging it, or some combination of the two, the environmentally ill are forced to carve up the meaning of space in a manner unfamiliar to most people. Thus, while their behavior can appear strange and untoward, perhaps insulting, to others, for them it is a reasonable response to the management of their symptoms.
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The exact number of people who claim to be environmentally ill is not known. The U.S. Department of Health and Human Services admits it cannot estimate their numbers (Samet and Davis 1995). Commonsense comparisons, speculation, and anecdotes are the fallback strategies for calculating the scope of the problem. The Labor Institute of New York notes: “While it is clear that a significant portion of the population is sensitive to irritants such as cigarette smoke, the percentage of individuals who are significantly affected by multiple chemical sensitivities appears to be much smaller” (Pullman and Szymanski 1993, 18).
Though it does not use the term multiple chemical sensitivity, environmental illness, or any of the other variants, the National Academy of Sciences (1987) suggests that between 15 and 20 percent of the U.S. population is allergic to chemicals commonly found in the environment, placing them at increased risk of contracting a debilitating illness. The National Research Council’s Board on Environmental Studies and Toxicology (1992) reports that “patients have been identified with a condition of multiple and often diverse symptoms that have been attributed to chemical agents in the environment” (5), though it does not specify how many.
Complementing this anecdotal approach to determining the breadth of the problem are several additional facts and figures that suggest that EI is more than a minor medical annoyance. A nonrandom survey of people who identified themselves as having MCS found sixty-eight hundred respondents (quoted in Ashford and Miller 1991, 5). The Chemical Injury Information Network lists multiple support groups for people with EI in forty-four of the fifty states. Support groups also meet in Finland, Germany, Australia, Canada, Denmark, New Zealand, France, Mexico, Belgium, and the Bahamas. We identified twenty-nine newsletters circulating in the United States devoted to chemicals, bodies, and the environment.
The range of demographic groups reporting the symptoms of MCS suggest it is a pandemic problem:
A review of the literature on exposure to low levels of chemicals reveals four groups or clusters of people with heightened reactivity: industrial workers, occupants of “tight buildings,” … residents of communities with contaminated soil, water, and air, and individuals who have had… unique exposures to various chemicals. (Ashford and Miller 1991, 3)
This list implies that everyone is susceptible to the ravages of MCS. There is some evidence to support this unsettling idea.
Industry groups estimate that over a third of new and remodeled office and storage buildings harbor indoor air pollutants sufficiently toxic to increase employee absenteeism by as much as 20 percent (Molloy 1993, 3). In addition to the building materials themselves, the Occupational Safety and Health Administration counted a minimum of “575,000 chemical products … used in businesses throughout the U.S.” (Duehring and Wilson 1994, 4; see also U.S. Department of Labor 1988). In 1989 the U.S. Environmental Protection Agency estimated that employers lose approximately sixty billion dollars a year to absenteeism caused by building-related illnesses (cited in Molloy 1993, 3). Not every victim of a “sick building” becomes environmentally ill, of course, but “bad air” at work is a common explanation for the origin of chemical reactivity among the environmentally ill.
But the workplace is not the only source of EI. Aerial pesticide spraying, incineration practices, and groundwater contamination are among the causes of MCS in neighborhoods and communities (Ashford and Miller 1991). In addition, the U.S. Environmental Protection Agency reported that one in four people in the United States live on top of, adjacent to, or near an uncontrolled hazardous waste site (1980; see also Szasz 1994).
Finally, consider a series of troubling statistics culled from several sources:
• In 1940 the annual production of synthetic organic chemicals in the United States was 2.2 billion pounds. By 1991 it had increased to over 214 billion pounds, an increase of 200 percent in fifty years (National Research Council 1991, 21).
• “The EPA’s Office of Toxic Substances is called upon to review approximately 2000 new chemical products a year” (Duehring and Wilson 1994, 4).
• The EPA can ensure the safety of only six out of six hundred active pesticide ingredients under its control (Duehring and Wilson 1994, 10).
• Less than 10 percent of the seventy thousand chemicals now in commercial use have been tested for their possible adverse effects on the nervous system and “‘only a handful have been evaluated thoroughly,’ according to the National Research Council” (Duehring and Wilson 1994, 4).
• The EPA has identified over nine hundred volatile organic chemicals in ordinary indoor environments including offices and houses (reported in Delicate Balance 1992, 9).
• Finally, an EPA Executive Summary on chemicals in human tissue found measurable levels of styrene and ethyl phenol in 100 percent of adults living in the United States. The Summary also found 96 percent of adults with clinical levels of chlorobenzene, benzene, and ethyl benzene; 91 percent with toluene; and 83 percent with polychlorinated byphenols (Stanley 1986).
There is, in short, ample opportunity for individual exposure to a seemingly endless parade of chemicals whose effects on the body are simply not known.
While it is not possible to know with any certainty how many people claim to suffer from MCS, it is reasonable to assume the number is substantial and growing. At the very least, it is possible to imagine how a person might link an array of bizarre and debilitating symptoms to a disease theory based on a premise that the body is exposed to an extraordinary number of chemically saturated environments.
EI and the Profession of Medicine
People with MCS are theorizing what makes them sick, how specifically their bodies are changed (immune system, limbic system, and so on), and what can be done to decrease or manage their symptoms. When they speak of MCS, there is often a tone of certainty in their voices. While certain, they are not arrogant, however. The surety of knowing is typically accompanied by self-doubt, anger, fear of the future, and other troubling emotions. While a chemically reactive person is reasonably confident in his theory of what is wrong with his body, why, and how he can manage his symptoms, MCS is not recognized by the profession of medicine as a legitimate physical disorder.
Indeed, medical professionals are likely to admit that currently what they do not know about MCS is considerably more than what they know. A physician’s report
