Mrs. Sanders was a forty-four-year-old housewife and former personnel worker. For the previous seven years she had practically been a physical invalid. Since a child she had always suffered from headaches, backaches, stuffy nose, car sickness, and hyperactivity. Her various problems always seemed to get worse in the gas-equipped kitchen of her home. For instance, if she were asked to set the table, she would commonly drop a dish on the way from the kitchen cupboard to the dining room. This would usually trigger an emotional scene in her family. She never learned to cook as a child because of clumsiness, irritability, and crying when in the kitchen. Instinctively, she avoided the house, especially the kitchen, preferring to stay outdoors where, she said, there was «more air.» Her face was commonly red. At school she was often accused of wearing rouge.
When she grew up and married, her problems increased. There was a marked intensification of all symptoms in the fall of 1947 when she painted a large apartment, having used paint and varnish removers freely in addition to being exposed to paint odors over a two-week period. Thereafter interminable colds, nasal stuffiness, and intermittent bouts of bronchitis were attributed to an unknown virus. She became acutely ill each time that she attempted to eat cherries and certain other fruits. Since she enjoyed pottery, she enrolled in a pottery class which was held in a poorly ventilated large room which also contained a gas-fired kiln and which was contaminated by fumes from painting, silk screening, and other art work. These exposures brought on attacks of asthma and were discontinued after two weeks. In the late 1940s she suffered constant attacks of «influenza,» headache, nausea, and vomiting. She found that she could feel better by not eating at all and staying outdoors as much as possible. She lost 25 pounds in a single month and weighed only 85 pounds at one time. Various doctors prescribed one medication after another, but each seemed to make her more sick than the last one. The top of her dresser came to resemble a pharmacist’s counter. She took to drying her hair by the heat of her gas-fired oven, which helped to clear her asthma temporarily but was inevitably followed by severe headache, fatigue, depression, and, sometimes, loss of consciousness. Immediately prior to such acute episodes, her cheeks would turn fiery red, she would stagger around the room, bumping into the furniture. She was living in Arizona by this time, a state to which she had moved on the advice of her physicians. Initially, she felt much better, as long as she remained outdoors. But she was always worse on rainy days; this was attributed to the lack of exposure to Arizona sunshine, instead of to exposures when in her home. With the onset of colder weather in the fall, she became increasingly asthmatic, hyperactive, and confused with episodes of extreme hyperactivity and loss of consciousness.
Because of this strange behavior, her husband and doctor concluded that Mrs. Sanders was a drug addict, and that heroin or some such narcotic was responsible for her behavior. Her husband went so far as to beat her, trying to extract from this terrified woman the location of her «stash.» This interpretation was supported by the fact that she improved when taken to a hospital, only to worsen immediately upon again returning to her home. Finally, her husband and her physician made plans to admit her to a mental institution.
Mrs. Sanders’ brother was a physician who suspected that her illness might be in some way allergy-related. He brought her to me for treatment immediately before she was scheduled to be institutionalized. Upon entering an apartment the first night in Chicago, her brother lighted the gas range to prepare dinner. She immediately complained of the odor of gas, her face became red, her eyes crossed, and she was barely able to speak. Her brother called me in alarm, to explain what was happening to his sister. Suspecting some environmental exposure, I instructed him to remove her immediately. Fortunately, she was taken to a friend’s all-electric apartment. By this time, her head was drawn to one side in a wry neck reaction (acute torticollis), she was confused, disoriented, and slumped into a semi-conscious stupor. This was interrupted by periods of uncontrollable twitching of muscles and flailing of all limbs so violently that she had to be physically restrained. She remained unconscious with intermittent seizures for the following six hours. In a similar attack a few months later, also followed by accidental exposure to gas, she was seen by a neurologist, who diagnosed her condition in these words: «Impression: cataleptic attack. I would strongly suspect hysteria.»
Extensive testing, however, revealed that Ellen Sanders, like Nora Barnes, was highly susceptible to chemical environmental exposures. In particular, she was exquisitely sensitive to utility gas exposures. In retrospect, many of her previous problems, from the time that she dropped plates as a child to her most recent attacks, could be traced to gas exposures. However, she was also highly susceptible to many other environmental chemicals, especially pesticide sprays on foods, aerial spraying for mosquito abatement, automotive exhausts, and many others. Next to the effects of utility gas, pesticide exposures were the most troublesome. As little as half a commercially sprayed peach would induce «drunkenness,» followed by loss of consciousness. But if she ate only so-called «organic» food and avoided chemical exposures, she remained well.
Occasionally, however, during the past 25 years she has had accidentally induced acute reactions of the type described. Upon one occasion, she was accidentally exposed to pesticides when the outside of her apartment was sprayed to control an infestation of spiders. Within minutes after these fumes entered her apartment through an air conditioner, she again lapsed into unconsciousness temporarily. Severe chest pain persisted for several weeks before subsiding. This has happened on a few rther occasions, although electrocardiograms, even after exercise, failed to show any abnormalities. More recently, both exposures to airborne pesticides and automotive exhausts have precipitated bouts of heart irregularity persisting for several hours. Other than for these intermittent exposures, she remains in good general health while following her environmentally restricted medical program.
These two cases opened up the field of chemical susceptibility. Although they are extreme instances, they are hardly unique. An increasing percentage of my patients have this chemical susceptibility problem to varying degrees. Some are aware that they cannot tolerate synthetic substances or combustion products. Others are sick, but do not yet realize why.
To recognize this problem is not to oppose progress. But we must distinguish between what is merely new and what is truly progressive. Since the mid-nineteenth century chemistry has revolutionized modern life. The United States alone produces over 500 billion pounds of chemicals per year. There are now about four million chemicals in the computer register of the Chemical Abstract Service. About 33,000 of these are in common use in the United States,2 and many of these ultimately find their way into our bodies. What are the health effects of these chemicals individually or, more importantly, cumulatively? Despite the Toxic Substances Control Act of 1976, very few of these chemicals have been adequately tested before being introduced into the marketplace.
In the last thirty years copious evidence has accumulated that these chemicals can indeed cause serious health problems for workers and consumers. There are many Nora Barnses and Ellen Sanderses walking around or dragging themselves from one doctor’s office to another.
As with the case of food, a constructive criticism of the chemical industry is sometimes taken as a threat to profit and unreasonably opposed. At the present time, the chemical companies are spending many millions of dollars to convince the public that their products are safe and indispensable. This money would be better spent investigating the actual damage that uncontrolled chemical contamination does and in devising ways to control it.
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