Issues Paper -

TOWN HALL MEETING ON MULTIPLE CHEMICAL SENSITIVITIES

June 24, 1996, Santa Fe, New Mexico

ISSUES PAPER

by Ann McCampbell, M.D.

September 1996

INTRODUCTION TO MULTIPLE CHEMICAL SENSITIVITIES

Multiple Chemical Sensitivities (MCS) is a medical condition characterized by adverse health reactions occurring in persons exposed to certain chemicals at levels that ordinarily do not affect others.

MCS occurs in people of all ages, races, and socioeconomic backgrounds. Women are affected more frequently than men. The exact prevalence of this condition is not known, but the incidence of MCS is thought to be increasing. In 1987, the National Academy of Sciences estimated that 15% of the population may be experiencing increased allergic sensitivity to chemicals (1). This was corroborated by preliminary results of a 1995 California Department of Health Services study that found in a random survey that 16% of the study population reported chemical sensitivities and 7% said they had been diagnosed with MCS (2).

Substances which frequently cause symptoms in chemically sensitive persons include pesticides, new building materials, new carpets, glues and solvents, paint, perfume, many laundry and personal care products (detergent, fabric softeners, shampoos, hairsprays, mousse, soaps, lotions, deodorants, etc., tar and asphalt fumes, smoke, many cleaning products, vehicular and industrial exhaust fumes, fresh ink, new plastics, and synthetic clothing and furnishings. Heightened reactions to electromagnetic and nuclear radiation have also been reported.

The severity of the illness varies greatly from those mildly affected to those who are severely disabled. The symptoms of MCS also vary greatly and are unique to each person. The severity of symptoms range from being mild to life-threatening, and can be provoked by even minute amounts of substances being inhaled, ingested, or absorbed through the skin.

Common symptoms of MCS include, but are not limited to, headache, fatigue, rashes, heart palpitations, respiratory difficulties, joint and muscle pain, nausea, diarrhea, weakness, poor coordination, and seizures. In addition, disorientation, memory loss, poor concentration, and difficulty thinking and speaking are common. Food intolerance is also common and may be severe.

MCS is thought by many to result from exposures to toxic chemicals, although the exact etiology of MCS is unproven and the mechanism of the illness is not known. The EPA stated in the 1987 TEAM study that chemical sensitivity is one of the chronic health effects that can be caused by chemical exposures in [air] tight buildings (3). Some people develop MCS after a single major chemical exposure, like an industrial accident, while others become ill seemingly as the result of the cumulative exposures of daily life. Many people become sick after moving into a newly built home, working in a recently remodeled office, or following a pesticide exposure.

THE IMPACT OF MCS ON THE INDIVIDUAL AND SOCIETY

In its worst form, MCS can be a devastating disabling chronic illness which forces people to alter every aspect of their lives. Many lose their jobs, homes, careers, families, and friends, and some commit suicide as a result. Some chemically sensitive people are housebound while others are homeless. Severe and devastating isolation is a frequent accompaniment of this illness. Because of chemicals that are present, many chemically sensitive people are unable to go into most buildings, including stores, banks, libraries, theaters, restaurants, motels, place of worship, etc. Even outdoor gatherings of people are problematic because of the frequent presence of perfume, BBQ or fireplace smoke, vehicle exhaust, and sunscreen fumes. And those who wear respirators and/or use oxygen in public are often subjected to stares and rude comments.

The impact on society is no less severe. There is a tremendous price being paid in lost worker productivity and the cost of supporting those disabled with MCS. The EPA has said that poor indoor air quality (which can be 100 times worse than outdoor air quality) is costing the nation tens of billions of dollars a year due to direct medical costs for people whose health is affected by poor air quality, lost productivity from absences due to illness, decreased efficiency on the job, and materials and equipment damage due to air pollutants (4).

The Occupational Safety and Health Administration estimates that over a million buildings in this country quality as “sick” and are affecting the health of 20 to 70 million people (5). Improving indoor air quality can reduce serious illness, employee absenteeism, and eventual Workers’ Compensation and other disability related costs and lawsuits, while improving access for people with MCS and boosting overall productivity and morale.

Therefore, it greatly behooves government entities to learn more about this illness, find ways to keep chemically sensitive people working or get them back to work, and develop a preventive strategy. One such effort is the federal Interagency Work Group on Chemical Sensitivity that is being led by the Agency for Toxic Substances and Disease Registry (ATSDR). They are expected to issue a report later this year.

MCS AND THE AMERICANS WITH DISABILITIES ACT (ADA)

Although the medical establishment has been slow to accept MCS as a “real” illness, it is recognized a a potentially disabling condition by the Social Security Administration, U.S. Department of Housing and Urban Development (HUD), the Environmental Protection Agency (EPA), and the National Academy of Sciences. People with MCS have won Workers’ Compensation cases and received disability insurance benefits. The Justice Department and courts, on a case-by-case basis, have upheld chemically sensitive persons’ rights to safe housing, work places, and schools. The Americans with Disabilities Act (ADA) guarantees people with disabilities reasonable accommodations and access to public facilities, housing, education, employment, and transportation. MCS meets the ADA’s definition of a disability when it causes substantial limitations in one or more of an individual’s major life activities. This definition is easily met by many people with MCS.

It is not necessary to resolve all the medical questions about the condition of MCS in order to recognize that an individual who has such a disabling condition may require accommodations. The presence of chemicals which prevent access for chemically sensitive people is analogous to physical barriers which block access for people who use wheelchairs.

Reasonable accommodations for people with MCS can be approached in the following general way:

Education of those whose services and cooperation are needed by those with MCS (awareness and understanding tend to breed compassion and cooperation, while discrimination is often rooted in ignorance).
Identification of chemical barriers that are a hazardous to people with MCS (bear in mind that individual sensitivities vary in severity and with regard to what substances are most troublesome).
Elimination, mitigation, or circumvention of the chemical barriers.

People with MCS have often been likened to “the canaries in the mine” who are serving to warn others that the world has become dangerously polluted. Removing chemical barriers not only provides accommodations for chemically sensitive persons, but helps protect the health of all.

MEETING TOPICS

HOUSING

“When you’re sick, you want to go home; but home may be what made you sick”

Nancy Berryman, Santa Fe

“We can choose to build healthier buildings. With the dollar cost of illness and

the priceless cost of lost health, can we afford not to?”

Paula Baker, Architect, Santa Fe

Lack of adequate housing is consistently identified as the number one problem among people with MCS. Having a safe haven where one is protected from chemical exposures is crucial to stabilizing one’s health and beginning the recovery process. Yet, finding suitable housing is extremely difficult because chemically sensitive people do not tolerate most standard housing because of its poor indoor air quality. The location of much housing also makes it inaccessible because outdoor air pollution leaks into homes and prevents necessary ventilation with clean air. As a result, many people with MCS live in their cars, yards, and campgrounds. Even people with MCS who have housing are frequently forced to evacuate it — temporarily or permanently — because of neighborhood activities (e.g., construction, pesticide use, new industry) or unavoidable repairs or modifications to their homes (e.g., paint or sealant use, tar roof application).

There is a need for long and short term housing, as well as accessible emergency shelters and retirement homes. Wealthier individuals tend to fare the best at creating safe homes, but success is not guaranteed. Newly ill people with MCS often have a particularly difficult time finding housing because they are frequently very ill and don’t yet know enough about their illness to choose housing wisely.

Barriers to Housing

In the unit:

Off-gassing from new construction or remodeling materials (including paints)
Urea formaldehyde insulation
New carpet
Pesticide residues (or proposed pesticide applications)
Natural gas or propane utilities
Mold
Residue from previous animal occupants
Residual fumes from incense, tobacco smoke, air “fresheners,” and scented laundry or other strongly fragranced products
Residual fumes from strong and/or scented chemical cleaning products
Residual fumes from disinfectants
Electromagnetic fields

Location of unit:

Poor outdoor air quality due to:
Vehicle exhaust (particularly diesel exhaust)
Industrial/commercial fumes (e.g., petroleum refineries, dry-cleaners)
Pesticide spraying (e.g., farms, golf courses, neighbors, roadsides, and mosquito abatement)
Wood smoke
Laundry product fumes (especially scented dryer strips)
Other air pollution, such as paint fumes, BBQ’s, construction, etc.
Electromagnetic fields from high tension electric lines
Zoning ordinances that prevent trailer living

Cost of unit:

Unaffordability due to disability income
The best locations for people with MCS are often in outlying areas that are still not too far from stores, doctors, and other services. These areas are often more expensive than in more densely populated neighborhoods or extremely isolated areas
Difficulty of sharing housing to reduce costs because of differing sensitivities and tolerances
Cost of suitable housing exceeds upper limit for HUD Section 8 housing programs

Suggestions for State Action Regarding Housing

1. Provide or create more housing (new construction or adapting existing structures) with the following characteristics:

Built with less-toxic materials, or with a vapor barrier to wall off construction materials, or structure at least six years old
No recent panting or remodeling
Electric utilities (heat may be provided by piped hot water which has a combustion heat source in an area that is separate from the living space)
No pesticide use
No mold
No carpeting
No smoke or fragrance residues
Located where there is good outdoor air quality
These are general guidelines for creating healthier housing, but individual sensitivities and severity of disease will determine whether a specific unit is suitable for a particular person with MCS.

Housing and/or shelter could be provided for people with MCS by:

Creating halfway houses where homeless chemically sensitive persons, newly diagnosed persons with MCS, and those being discharged from a treatment center could stabilize and receive guidance
Providing camping areas that have electricity, accessible restrooms, and are free of smoke, pesticides, and generator exhaust; extending length-of-stay options and having these accessible camping areas available in case of emergencies
Relaxing zoning requirements to allow alternative structures, such as trailers or multi-unit buildings, and affordable lot sizes for people with MCS
Providing porcelain trailers or older aluminum trailers (that have been adapted for use by chemically sensitive people) and land to put them on
Providing accessible public housing (example: Barrhaven project in Canada)
Supplementing Section 8 housing allowances
Providing incentives for the private sector to build less-toxic housing
Creating standards for less-toxic building
Creating experimental communities for people with MCS in less polluted areas
Educating landlords and building managers about MCS
Educating directors of emergency and homeless shelters, shelters for battered women, and the Red Cross about the needs of people with MCS
Providing funds to retrofit housing (i.e., take up carpets, install less-toxic heating systems, etc.) or supply adaptive equipment such as air filters
Supporting or expanding programs that help disabled people purchase homes

2. Improve general outdoor air quality by:

Strengthening state authority in regulating outdoor air quality
Reducing pesticide use
Reducing or banning chimney, fireplace, and BBQ smoke (propane BBQs are OK)
Reducing or banning BBQ lighter fluid
Enacting tougher vehicle emissions standards and exploring alternative power sources for vehicles
Examining the health problems associated with various gas additives

3. Expand disaster preparedness plans to take into account the needs of people with MCS.

EMPLOYMENT

“We who have MCS are also valuable resources – we have a disability and we need to make a living”

Paulette Johnston, Santa Fe

“Better environments are good for employees, good for the work place, and the right things to do”

Will Pape, Fortune 1000 Business Executive, Los Ojos

Some chemically sensitive persons are too ill to work, but many others would like to work if a job and work space could be found that would not worsen their health. Those chemically sensitive people who do have jobs often live in fear that some environmental change in their work place will force them to quit. Removing chemical barriers not only improves access for chemically sensitive employees, but helps protect the health of all.

Employment Barriers

1. Unfortunately, office spaces are often inaccessible because of the presence of:

New construction or remodeling materials
New carpets, drapes, and upholstered furniture
Pesticides
Maintenance and cleaning products (containing phenol, ammonia,chlorine, and/or solvents)
Perfume, cologne, and other scented products on occupants
Air “fresheners” (e.g., bars, sprays, plug-in devices, and potpourri)
Computer and copy machine fumes
Office supply fumes (carbonless copy paper, correction fluids, marking pens)
Fluorescent lighting
Tobacco smoke
Electromagnetic fields

Poor ventilation worsens all of the above problems (except electromagnetic radiation)

2. Hostile or uncooperative responses of management and co-workers are another significant barrier to employment.

3. Industrial, commercial, and agricultural work places are usually inaccessible for people with MCS because of the presence of chemicals (e.g., restaurants with gas stoves, arts/crafts shops with solvents, truck driving with exhaust fumes).

4. Penalties for working when on disability programs, such as Social Security or Supplemental Security Income (SSI), and variable levels of health and energy are also disincentives to employment.

Suggestions for State Action Regarding Employment

1. Inform employers and employees of their obligations and rights under federal and state laws for people with disabilities.

2. Insure a rapid, knowledgeable, and effective governmental response to worker complaints of possible low and high level chemical injuries occurring in the the work place. Protect workers who speak out about hazardous work place conditions from retribution from their employers.

3. Provide work place accommodations for state employees with MCS. Educate other employers about MCS and encourage them to do the same. Reasonable work place accommodations for employees with MCS might include any or all of the following:

Educating co-workers about MCS and the need for their cooperation
Improving ventilation by opening windows or increasing the amount of outside air entering the building through the Heating, Ventilation, and Air Conditioning (HVAC) system
Banning smoking in and around the work space and building
Adopting an Integrated Pest Management (IPM) program for pest control to reduce or eliminate the use of pesticides
Adopting a fragrance-free policy
Eliminating air “fresheners” from work places (including in restrooms)
Venting copying fumes to the outside and/or putting the machine in a separate room
Venting computer fumes to the outside
Providing a computer with a low electromagnetic field
Removing carpet
Providing low-emission furniture made of metal, glass, or other materials that are older and have been aired out
Using less-toxic cleaning products
Providing daylight or incandescent lighting
Limiting remodeling
Providing adequate notice when a problematic substances is to be used (and no acceptable substitute can be found)
Providing an air filter
Permitting flexible work scheduling
Permitting work in an alternate space (e.g., moving to an office with an operable window or working at home)

4. Help people with MCS develop home businesses or help them identify other employment options. Some examples are phone work, proofreading, computer work, and childcare or camp counseling in a controlled environment.

Injured Workers

“Why do the laws not protect us?”

Maria C. Chavez, Albuquerque

Many people develop MCS as a result of chemical exposures in their work place. It appears that improvement in work place environments could help prevent this illness in some cases.

Workers at increased risk are farm workers (pesticides), microelectronics workers (solvents), health care workers (disinfectants), construction workers, industrial/commercial cleaners, salespeople in carpet and furniture stores, pesticide applicators, auto mechanics, computer operators, cosmetic salespeople, and beauticians. Also, anyone working in a building which has been newly built or remodeled is an increased risk, especially if the windows do not open.

Though injured workers have sometimes won Workers’ Compensation, Vocational Rehabilitation, Disability Insurance, and Social Security cases to obtain benefits, the process is often long, grueling, and expensive.

Suggestions for State Action Regarding Injured Workers

5. Recognize MCS as a potentially disabling medical condition that can be work related, and establish diagnostic criteria.

6. Coordinate tests and paperwork for disability evaluations to integrate the application for Workers’ Compensation, state, and federal disability benefits.

7. Workers’ Compensation Administration should educate its employees, especially safety specialists, about MCS and include MCS and related health concerns in its written materials.

8. Expand Vocational Rehabilitation services for people disabled by MCS.

9. Insure that injured workers are not exclusively sent to doctors who are biased against the diagnosis of MCS when being evaluated for conditions that include chemical sensitivities.

Suggestions for State Action to Prevent Injury of Workers

10. Evaluate work place environments of State employees, identify workers at risk, and educate them about MCS and ways to protect themselves.

11. Post warning signs of MCS along with an “800” Hotline number in work places.

12. Provide or support education of businesses and state departments by workers who have been injured working in the same field.

13. Provide healthier work places for state employees by:

Establishing fragrance-free policies
Prohibiting smoking near building entrances, openable windows, and air intakes
Adopting an Integrated Pest Management plan
Using less toxic cleaning products
Venting computer and copy machine fumes to the outside
Providing adequate ventilation
Run heating, ventilation and air conditioning systems in State buildings at least at American Society of Heating, Refrigeration, and Air Conditioning Engineers (ASHRAE) minimum standards, service them regularly, and make logs and schedules readily available
Use least toxic remodeling materials (e.g., no glued down carpet) — do work when employees are not present, ventilate well and provide alternative work spaces until individuals can safely return to their original work site

14. Encourage business to learn about the benefits of healthier work places.

15. Encourage reductions in insurance premiums for businesses providing healthier environments for their employees.

16. Consider revising or adding standards to deal with the hazards of chronic low-level exposure to chemicals, with the understanding that some chemicals should be restricted to parts per billion, rather than parts per million, and others banned outright.

HEALTH CARE

“Insurance tends to cover doctors, treatments and medications that don’t help, and not pay for those that do”

Pat Shirley, Questa

Barriers to Health Care

People with MCs often do not receive adequate health care because:

Most doctors and other health professionals do not know how to help chemically sensitive people, and may inadvertently harm them instead. Some health care workers are overtly hostile and abusive.
Hospitals, clinics, ambulances, and doctors’ offices are usually inaccessible because of the presence of many of the substances mentioned in the Housing and Employment sections, plus the presence of sterilizing chemicals.
Third party payers resist paying for tests and treatments that may be required for people with MCS. Many chemically sensitive patients cannot tolerate traditional medications, but are helped by “alternative/complementary” treatments that are not usually covered by insurance.

Suggestions for State Action Regarding Health Care

1. People with MCS have the right to see their own doctors who are knowledgeable about their condition. If a managed care program or company doctor is not qualified to treat someone with MCS, then the patient should be referred out. If a company approved doctor is similarly not qualified, then the patient should be referred to a more knowledgeable one.

2. Schools training health professionals should include MCS in their curriculum. Continuing education on this subject should also be provided.

3. The State should sponsor a conference on MCS for health professionals stressing the need for compassion and respect of MCS patients.

4. In-service education about MCS should be required of all medical personnel.

5. Doctors and clinics should be encouraged to make their offices more accessible by banning pesticides and fragrances, using less toxic cleaning products, avoiding carpets, banning smoking near their building, and opening the windows when asked.

6. Doctors and other health care practitioners should be encouraged to provide services outside of their office environment by talking to patients with MCS on the phone, meeting them outside, or making house calls.

7. Hospitals should be encouraged to create accessible rooms or wings for people with MCS (example: Holy Cross Hospital in Taos). The needs of chemically sensitive people should also be considered during the administration of medical tests and treatments, and the performance of surgery.

8. Emergency personnel should be educated about the needs of people with MCS regarding emergency services (e.g., personnel free of fragrances and tobacco smoke residue, inert oxygen tubing and masks, and ambulance engines turned off as much as possible).

9. Educate patients with MCS, and emphasize to Emergency Medical Services personnel, that patients always have the right to refuse transportation to the hospital whether or not they have been treated in the field.

10. Health insurance benefits should be expanded to cover the health care needs of people with MCS, at least to include coverage for nutritional supplementation, desensitization and detoxification therapies, and supplemental oxygen, as indicated. Hospitalization in facilities with services and environments suitable for people with MCS should also be covered. Increased coverage for “alternative/complementary” treatments, such as acupuncture and homeopathy, is also recommended.

11. Encourage a cooperative relationship between the New Mexico Medical Board, insurance carriers, and doctors who treat chemically sensitive patients.

12. Institute a pilot program to fund treatment for people with MCS.

13. Educate the public about MCS by:

Developing brochures and pamphlets
Making public service announcements
Holding public forums to increase public awareness of MCS
Creating and maintaining an “800” Hotline number to call for MCS information and referrals

14. Provide support groups for people with MCS and resource guides on food, housing, cleaning products, doctors, etc.

15. Increase the use of patients’ homes for providing health care services (e.g., exams, tests, treatments, nursing). Provide appropriate attendant care when needed.

16. Design and conduct a prevalence study to determine the extent of MCS in New Mexico. Also, investigate other research which would shed light on the nature and mechanism of MCS and lead to better treatments for it.

DENTAL CARE

Barriers to Dental Care

Many people with MCS do not receive necessary dental care. There are very few dentists who understand MCS. Additionally, dental care is fraught with potentially harmful exposures from:

1. The usual building and office substances (see Housing and Employment sections)

2. Fumes from disinfectants and other dental chemicals

3. Substances put in one’s mouth:

Dental products (e.g., amalgams, adhesives, etching and bonding agents, crowns, teeth cleaning products, and X-ray materials)
Instruments with chemical residues from chemical sterilization
Latex gloves on dental workers
Chlorinated water to rinse mouth

4. Anesthetics

Despite the hazards, many chemically sensitive people require extensive dental work to remove problematic substances from their mouths and treat infections. This can be very expensive and many persons with MCS cannot afford it.

Suggestions for State Action Regarding Dental Care

1. Encourage dentists to:

Learn about MCS
Have an understanding and flexible attitude when treating people with MCS, work with individuals according to their specific needs
Provide more accessible offices and/or make home visits
Use the least toxic dental materials, and test materials on each MCS patient before using

2. Encourage dental plans to raise the limit for covered dental care for people with MCS or provide dental subsidies.

3. Loosen regulations to allow dental hygienists to make home visits for routine dental care.

MENTAL HEALTH

“It’s like moving a mountain daily”

Becky Sanchez, Albuquerque

“Many mental health problems can be avoided with adequate support

in the form of safe housing, employment, and health care”

Susan Schmall, Ph.D., Psychotherapist, Santa Fe

Barriers to Mental Health Services

People with MCS most often requiret mental health services for supportive counseling to deal with the tremendous stress that results from having this illness. Living with MCS has been likened to living in a chemical war zone with a good part of each day spent searching for safe shelter, food, air, and water. Add to this the suffering from often being misunderstood and occasionally maligned, and it is not surprising that chemically sensitive people can experience anxiety and depression. People with MCS need access to environmentally safe counseling offices and compassionate services.

Evaluating psychological symptoms in people with MCS is a complex and challenging task. For instance, many psychiatric symptoms are the result of chemical exposures and will clear when an individual is returned to a pollution-free environment. Admission to a typically polluted mental health facility can, therefore, exacerbate rather than help alleviate symptoms.

Suggestions for State Action Regarding Mental Health Services

1. Educate mental health professionals about the evidence for the physiological basis of MCS, the relation of psychiatric symptoms to chemical exposures, and the need for accessible counseling offices and compassionate services for chemically sensitive persons.

2. Provide financial assistance for mental health services for people with MCS.

3. Provide reasonable accommodations for chemically sensitive patients in mental institutions.

4. Consider the prohibition of committing chemically sensitive persons against their will (if suicidal or for another reason that does not threaten others), unless a pollution-free environment will be provided.

PESTICIDES

“We have the right to be in our yards and homes and not be exposed

to something we don’t want to be exposed to”

Cecilia, Albuquerque

“My life was sacrificed for a tree”

Louise Wohl, Rio Arriba County

Pesticides — A Major Access Barrier

Chemical pesticides are arguably the number one menace of chemically sensitive people. In a survey of persons with MCS could identify a precipitating event, 60% reported they became ill following a pesticide exposure — National Foundation for the Chemically Hypersensitive, 1989 (6). Pesticide exposures, including exposures to herbicides and insecticides, are also known to trigger particularly severe symptoms in chemically sensitive people and to lead to prolonged relapses.

Because the use of pesticides is so widespread, their presence is a major contributor to access barriers for people with MCS. At the state level, its use limits access to State buildings, grounds, parks, and roadways. It also makes many businesses, work places, and houses inaccessible.

Many pesticides are known to be neurotoxic and, though registered by the EPA, are not necessarily safe. “Inert” ingredients, which can account for up to 99% of a product, are frequently solvents, which are also neurotoxic. Manufacturing impurities as well as otherwise banned substances may also be present in a pesticide, since “inert” ingredients are not regulated. All classes of pesticides — including organochlorines, organophosphates, pyrethroids, fumigants, and herbicides — are hazardous to people with MCS. Even exposure to minute amounts of pesticides from, for example, pesticide drift, being in a house that was sprayed with pesticides years earlier, or eating food with pesticide residue can cause serious health problems for someone who is chemically sensitive.

There is growing concern that pesticides may be adversely affecting the general population, too. Pesticides are ubiquitously found in air, water, and food, and can persist in the environment for long periods. They also can accumulate in animal and human fat. DDT, which has been banned from use in the United States, is believe to be carried in the tissues of every living thing on earth (7).

Pesticides are also known to have estrogen-like effects. In a recent study, some combinations of estrogen-mimicking pesticides were found to be 1000 times more potent than any pesticide tested alone (8). This supports the concern that the endocrine-disrupting effects of pesticides may be much greater than previously thought and might be related to the alarming increases in breast and testicular cancer. Other synergistic and cumulative effects of pesticides have not been adequately studied, nor is enough known about the ability of pesticides to damage the immune and nervous systems.

An alternative to chemical pesticide use is to adopt an Integrated Pest Management (IPM) program to control pests. In this approach, pests are managed by the use of physical barriers, traps, improved sanitation, and natural predators, without using chemical agents or using them only as a last resort. The federal government has successfully adopted an IPM program for its Washington D.C. office buildings. A manual is available describing their program, “Integrated Pest Management: Desk Guide for Facility Managers.”

Suggestions for State Action Regarding Pesticides

1. Strictly enforce existing pesticide regulations, including the prohibition against advertising a pesticide as “safe”.

2. Examine the pesticide regulation and enforcement process with the goal of safeguarding against conflicts of interest and increasing citizen participation.

3. Reconsider what are acceptable levels of pesticide, taking into account the hazards of low-level exposures, the cumulative and synergistic effects, and the lack of regulation of inert ingredients.

4. Require full disclosure of pesticide ingredients.

5. Repeal state prohibition of local pesticide regulation.

6. Recognize pesticide drift as a nuisance and encourage local ordinances to regulate it.

7. Require adequate notification of pesticide use by professional applicators, businesses, and government entities before, during, and after application.

Pre-notification should include the name of the pesticide(s) and the area where they are planned to be used, plus the anticipated date of application. A week or longer warning time is preferred, but in no case should notification be given less than 24 hours before pesticide use. In addition to posting signs, notification in newspapers and calls to certain individuals may be necessary in some situations. Signs with information about a previous application should be left up for at least a week. Information regarding anticipated or past pesticide use should be easily available by phone.

8. Provide sufficient funds to enforce pesticide notification regulations.

9. Adopt an IPM program for pest management in State buildings, grounds, and parks. Use the least toxic chemical pesticides or none at all. Do cost analysis to compare IPM with conventional pest control methods.

10. Educate institutions, maintenance personnel, property and apartment managers, and the general public about the hazards of pesticides and less-toxic alternatives.

11. Ban or reduce pesticide use on roadways.

12. Encourage and support organic farming and gardening. Strictly limit the level of pesticide residues in foods receiving New Mexico organic certification.

13. Establish a pesticide injury reporting system.

14. Establish an appeals process to evaluate pesticide complaints that are not satisfactorily resolved by regulatory entities.

15. Provide legal aid for people with MCS who are being harmed by pesticide exposures and cannot afford a lawyer.

16. Hold pesticide users, including government entities, responsible for the harm caused by their use of pesticides. Pesticide users should provide financial aid to pesticide victims for health care, relocation, cleanup, and the cost of replacing contaminated belongings.

17. Encourage building materials and practices that are more termite resistant.

18. Work on the national level to develop a pesticide hazard sign.

19. Consider the creation of a registry of chemically sensitive persons for the purpose of notification of pesticide and other toxic chemical use, and to aid in disaster preparedness. Provide protection for those registered, including maximum confidentiality, to reduce the chances that they will be harassed or sued. (In Florida, some pesticide sensitive people who were registered to be notified prior to pesticide applications near their residence were sued by pest control associations to prove that these exposures would harm them.”)

SCHOOLS

“It’s time to expand our idea of what constitutes a safe school.”

Nancy Carroll, Santa Fe

“My teacher told me to drop out, that there was no hope for me,

and that I didn’t know what I was talking about.”

Francesca Bottos, Santa Fe

Barriers in Schools

Students of all ages may be chemically sensitive. They often cannot attend public schools, universities, or trade schools because of the presence of chemicals typically found in or around buildings — such as pesticides, cleaning chemicals, perfume, tobacco smoke, carpet fumes, and fumes found in new or remodeled buildings (see Employment section). In addition, toxic art supplies, laboratory chemicals , and diesel exhaust fumes from idling buses may be present. Portable classrooms have high levels of formaldehyde which makes them even less accessible for persons with MCS than permanent classrooms. Fluorescent lights can be intolerable for some chemically sensitive people as well.

Some children with MCS are forced to drop out of school because they become too sick there. When children with MCS do stay in school, they often have learning difficulties and behavior problems because of the school exposures. Eating standard cafeteria food can also contribute to symptoms.

Teachers with MCS are often unable to work because the school environments are inaccessible to them, too. Chemically sensitive parents may not be able to help in their children’s classrooms or participate in other school activities. Uncooperative or hostile attitudes of administrators, students, and teachers are another barrier faced by those with MCS.

Changes made to accommodate chemically sensitive people in schools often improves the overall environment and reduces the chance that others will get sick. Healthy safe school environments benefit all the occupants.

Suggestions for State Action Regarding Schools

1. Encourage local school districts to provide healthy school environments by banning fragrances, enforcing no smoking policies, eliminating fluorescent lights, using IPM programs, less toxic cleaning products, and least toxic building and furnishing materials (e.g., no carpeting). Heavy cleaning or remodeling should be limited to the beginning of vacation periods. A “no fragrance” policy should be considered an extension of the dress code.

2. Limit vehicle and bus idling on school grounds.

3. Limit the use of portable classrooms.

4. Provide accessible classrooms and instructors or tutors for students with MCS, or provide vouchers that would allow students to attend accessible private schools.

5. Provide reasonable accommodations for teachers and other school personnel who are chemically sensitive.

6. Develop model specifications for less-toxic school buildings, and develop a resource guide that includes building professionals experienced in less-toxic construction and sources for materials.

7. Educate — through brochures, technical assistance documents, reference materials, conferences, and in-service trainings — teachers, counselors, administrators, maintenance personnel, school nurses, special education teachers, and school board members about MCS, including the early warning signs of MCS. Expand ideas as to what is a “safe school”.

8. Provide lunches and other food to meet the needs of chemically sensitive students. Consider serving healthy organic food and filtered or spring water to all students.

9. Assist the families of children with MCS to understand this disability and to provide accessible and supportive environments.

OTHER STATE FACILITIES AND SERVICES

Suggestions for State Action

1. Educate all State agencies and employees about MCS and the access needs of chemically sensitive citizens.

2. Create healthier environments in state offices and facilities (See Employment section, Suggestions for State Action to Prevent Injury of Workers).

3. Limit remodeling, but when it must be done, use least toxic building materials and provide adequate notification (through signs and other methods) to the public before, during, and after remodeling is done.

4. Encourage employees to work with chemically sensitive people over the phone or by mail. In addition, a fragrance-free and smoke-free employee knowledgeable about MCS should be designated to meet with people outside.

Restrooms

Finding accessible restrooms is a big problem for persons with MCS. Many restrooms contain air “fresheners,” chemical disinfectants, fragranced soap, and perfume and smoke from other occupants. They are often poorly ventilated as well. Chemical toilets are also inaccessible for chemically sensitive persons.

5. Provide at least one accessible restroom in State buildings and parks. This can be accomplished by removing the above-mentioned substances and replacing them with baking soda or zeolite (to absorb odors), cleaning with unscented and low-toxic cleaning products, and improving ventilation by opening a window or by adjusting HVAC to provide abundant outside air.

6. This restroom should be designated a fragrance-free restroom; anyone wearing perfume or applying hairspray or other scented products should not be allowed there, and should be directed to another restroom.

7. A non-chemical toilet should be made available to chemically sensitive people who are visiting parks.

Public Meetings

An accessible procedure for meeting and communicating with people with MCS is especially important in hearings, public meetings, judicial proceedings, and legislative activities.

8. Create an accessible space that can be used for various public and government meetings.

9. Alternatively, provide access by speakerphone or meet outside. Investigate the possibility of providing interactive video capabilities.

Motor Vehicle Division

10. Allow people with MCS to go to the front of the line or meet outside for services.

11. Develop a clear policy regarding the pumping of gas for self-serve prices for those unable to pump their own gas and make this service available to qualified people with MCS.

Roadways

12. Besides notification regarding pesticide applications, there should be ample notification regarding road work so that a chemically sensitive motorist is not inadvertently stuck in traffic being exposed to tar and asphalt fumes along with the diesel exhaust fumes of repair equipment and vehicles.

Licensing Boards

13. Reasonable accommodations should be provided to chemically sensitive persons needing to take licensing examinations, including the opportunity to use alternate sites (possibly a proctor at home) and the granting of rest periods.

Voting

15. Absentee ballots work fairly well for people with MCS. Another accommodation would be allowing someone to go to the front of the line at polling places.

Product Information

16. Require full product ingredient disclosure.

Fires

17. Provide pre-notification of anticipated controlled burns.

18. Make information readily available to the public regarding the use of fire retardants. A citizen should be able to call for information about which chemicals are being used, where they are being used, when their use began, and when their use has ended.

ENDNOTES

1. Workshop on Health Risks from Exposure to Common Indoor Household Products in Allergic or Chemically Diseased Persons, National Academy of Sciences, July 1, 1987, quoted in Chemical Exposures — Low Levels and Highs Stakes, Nicholas Ashford and Claudia Miller, New York : Van Nostrand Reinhold, 1991, p. xvi.

2. Final Performance Report, letter to panel on “Evaluating Individuals Reporting Sensitivities to Multiple Chemicals,” Richard Kreutzer and Raymond Neutra, California Department of Health Services, Environmental Health Investigations Branch, October 3, 1995.

3. Total Exposure Assessment Methodology Study, “Environmental Monitoring and Quality Assurance,” Lance A. Wallace, U.S. Environmental Protection Agency, Office of Research and Development, Washington D.C., 1987, p. 4, quoted in “Measures Which Will Result in Greater Access for People with Environmental Illness/Multiple Chemical Sensitivities to California’s Publicly Funded Facilities: Steps Toward Regulatory Remedies,” Susan Molloy, 1993.

4. “The Inside Story: A Guide to Indoor Air Quality,” U.S. Environmental Protection Agency, Office of Air and Radiation and U.S. Consumer Product Safety Commission, Washington D.C., 1988, quoted in “Multiple Chemical Sensitivities and the Americans with Disabilities Act,” Human Ecology Action League, Atlanta, Human Ecology Action Leagues, Inc., 1994, p. 3.

5. Ibid.

6. Chemical Exposures — Low Levels and High Stakes, Ashford and Miller, p. 5.

7. “Human Immune Systems May Be Pollution Victims,” Marla Cone, Los Angeles Times, May 13, 1996.

8. “Synergistic Activation of Estrogen Receptor with Combinations of Environmental Chemicals,” John A. McLachlan, et al., Science, Vol. 272, June 7, 1996.

SOURCES

Ashford, Nicholas and Claudia Miller, Chemical Exposures — Low Levels and High Stakes, New York : Van Nostrand Reinhold, 1991.

Greene, Albert, Integrated Pest Management: Desk Guide for Facility Managers, Washington D.C., General Services Administration, 1992.

Human Ecology Action League, “Multiple Chemical Sensitivities and the Americans with Disabilities Act,” Atlanta, Human Ecology Action League, Inc., 1994.

Independent Living Resource Center of San Francisco (ILRC), Focus on Access, “Employing People with Disabilities: A Practical Approach to People with Environmental Illness or Multiple Chemical Sensitivities,” April 1993.

Meggs, William, Ann Davidoff, et al., “Prevalence and Nature of Allergy and Chemical Sensitivity in a General Population,” Archives of Environmental Health, Vol. 51, No. 4, July/August 1996, 275-182.

Molloy, Susan, “Measures Which Will Result in Greater Access for People with Environmental Illness/Multiple Chemical Sensitivity to California’s Publicly Funded Facilities: Steps Toward Regulatory Remedies,” 1993.

Ripple, Joan, California Senate Judiciary Subcommittee on the Rights of the Disabled, “Memorandum — Task Force Recommendations to Advisory Panel on Environmental Illness/Multiple Chemical Sensitivities,” February 8, 1994.