Charitable non-profit organisationCharitable non-profit organisation

Mission: Education, awareness and support for Mission: Education, awareness and support for Environmental Sensitivities (ES)Environmental Sensitivities (ES) 1200+ members across Quebec, including more 1200+ members across Quebec, including more than 50 than 50 groupsgroups

EHAQEHAQ

Environmental Sensitivity is a word that encompasses Environmental Sensitivity is a word that encompasses a range of sensitivities, such as Multiple Chemical a range of sensitivities, such as Multiple Chemical Sensitivity and Electromagnetic Sensitivity, etc.Sensitivity and Electromagnetic Sensitivity, etc.

The word identifies a large number of reactions: The word identifies a large number of reactions: • to chemicalsto chemicals• to electromagnetic radiationto electromagnetic radiation• to other environmental factorsto other environmental factors

At exposure levels usually tolerated by other personsAt exposure levels usually tolerated by other persons

Some persons can be genetically more susceptible to Some persons can be genetically more susceptible to nocive effects at low level exposures to chemical in nocive effects at low level exposures to chemical in the environment because of their reduced capacity to the environment because of their reduced capacity to metabolize common chemicals and medicationsmetabolize common chemicals and medications

McKeown-Eyssen Gail, Baines Cornelia, Cole David EC, Riley Nicole, Tyndale Rachel, Marshall Lynn, McKeown-Eyssen Gail, Baines Cornelia, Cole David EC, Riley Nicole, Tyndale Rachel, Marshall Lynn, Jazmaji Vartouhi.Jazmaji Vartouhi.

Case-control study of genotypes in multiple chemical sensitivity: CYP2D6, NAT1, NAT2, PON1, PON2 and Case-control study of genotypes in multiple chemical sensitivity: CYP2D6, NAT1, NAT2, PON1, PON2 and MTHFR,MTHFR,

International Journal of Epidemiology 2004; 33:1-8International Journal of Epidemiology 2004; 33:1-8

Criteria for ‘cases’ Criteria for ‘cases’ of Environmental Sensitivity of Environmental Sensitivity

19991999 Consensus on Multiple Chemical SensitivityConsensus on Multiple Chemical Sensitivity ((Multiple Chemical Sensitivity MCS)Multiple Chemical Sensitivity MCS), ,

(( ‘Environmental Health’ Archives, 54 (3) May/June 1999) ‘Environmental Health’ Archives, 54 (3) May/June 1999)

• Reproducible symptomsReproducible symptoms• Chronic condition Chronic condition • Low level exposure (lower than previously Low level exposure (lower than previously

or commonly tolerated) causing or commonly tolerated) causing symptoms symptoms

• Symptoms improve or disappear when Symptoms improve or disappear when trigger substances are removedtrigger substances are removed

• Responses to numerous chemically Responses to numerous chemically different substancesdifferent substances

• Many organic systems involvementMany organic systems involvement

Validation of diagnostic criteria Validation of diagnostic criteria agreed to by consensusagreed to by consensus

Mckeown-Eyssen G.E., Baines C.J., Marshall L.M. et al. Multiple Mckeown-Eyssen G.E., Baines C.J., Marshall L.M. et al. Multiple Chemical Sensitivity: Discriminant validity of case definitions, Arch Chemical Sensitivity: Discriminant validity of case definitions, Arch

Environ Health 56 (5) 2001:406-12Environ Health 56 (5) 2001:406-12

ThisThis consensus was validated in 2001 by consensus was validated in 2001 by University of Toronto researchers. They also University of Toronto researchers. They also found additional symptoms common to found additional symptoms common to persons suffering from ES: persons suffering from ES:

• ExacerbationExacerbation of smell of smell• Concentration and memory problemsConcentration and memory problems• Changes in mood and cerebral functionsChanges in mood and cerebral functions..

• Diagnostic checklistsDiagnostic checklists

• Taking an Exposure HistoryTaking an Exposure History

- Webs- Website: ite: Ontario College of Family Ontario College of Family Physicians Physicians www.ocfp.cawww.ocfp.ca click on click on

Environmental Health Committee Environmental Health Committee

and stroll downand stroll down..

‘

Also found in international medical Also found in international medical literature: literature:

• EH often found after acute exposure to EH often found after acute exposure to pesticides, solventspesticides, solvents

• Pain and fatigue can be extremely Pain and fatigue can be extremely disabling disabling

• If exposure is constant, EH can be If exposure is constant, EH can be ‘masked’ and not be recognized until …‘masked’ and not be recognized until …

Toxic Charge – the critical pointToxic Charge – the critical point Cumulative effects of Cumulative effects of contamination reach contamination reach a critical point, as a critical point, as happens in climate happens in climate change.change.

Symptoms of bodily Symptoms of bodily charge and injury charge and injury increase in time.increase in time.

99

As long as your critical point is not reached, you may not feel sick.

Symptoms of ES are personal and may include other s irritants.

A policy on Environmental Sensitivity was approved A policy on Environmental Sensitivity was approved on June 15, in 2007 byon June 15, in 2007 by

• Based on conclusions of its study of scientific literature:Based on conclusions of its study of scientific literature:

http://www.chrc-ccdp.ca/research_program_recherche/esensitivities_hypersensibilitee/http://www.chrc-ccdp.ca/research_program_recherche/esensitivities_hypersensibilitee/toc_tdm-fr.asptoc_tdm-fr.asp

The medical point of view on environmental sensitivityThe medical point of view on environmental sensitivity  

http://www.chrc-ccdp.ca/research_program_recherche/esensitivities_legal_hypersensibilitee/http://www.chrc-ccdp.ca/research_program_recherche/esensitivities_legal_hypersensibilitee/toc_tdm-fr.asptoc_tdm-fr.asp

Accommodation for Environmental Sensitivities: Legal PerspectiveAccommodation for Environmental Sensitivities: Legal Perspective

• Individuals with Environmental Sensitivity experience a Individuals with Environmental Sensitivity experience a variety of adverse reactions to environmental agents, at variety of adverse reactions to environmental agents, at concentration levels lower than those than can affect concentration levels lower than those than can affect the ‘average person’ the ‘average person’

• This medical condition is a disability and persons living This medical condition is a disability and persons living with Environmental Sensitivity are entitled to the with Environmental Sensitivity are entitled to the protection given by the Canadian Charter of Rights, protection given by the Canadian Charter of Rights, which bans discrimination on the basis of disabilitywhich bans discrimination on the basis of disability

• The Canadian Human Rights Commission will accept any The Canadian Human Rights Commission will accept any request and will receive any complaint for a person believing request and will receive any complaint for a person believing that he or she has been discriminated because of that he or she has been discriminated because of Environmental SensitivityEnvironmental Sensitivity

• As with any other disabled persons, individuals suffering from As with any other disabled persons, individuals suffering from Environmental Sensitivity have a right to accommodation Environmental Sensitivity have a right to accommodation under the lawunder the law

• CHRC advises employers and service providers to proactively CHRC advises employers and service providers to proactively acknowledge the need for accommodation by making sure that acknowledge the need for accommodation by making sure that work areas and facilities are accessible to persons involved work areas and facilities are accessible to persons involved with a number of disabilities. with a number of disabilities.

• A successful accommodation for individuals suffering from A successful accommodation for individuals suffering from Environmental Sensitivity requires innovative strategies to Environmental Sensitivity requires innovative strategies to minimize or eliminate exposure to environmental triggers. This minimize or eliminate exposure to environmental triggers. This can include: develop and enforce internal ‘no fragrance’ can include: develop and enforce internal ‘no fragrance’ policies, promote educational campaigns to increase voluntary policies, promote educational campaigns to increase voluntary compliance with such policies, lessen the use of chemicals and compliance with such policies, lessen the use of chemicals and buy less toxic products, advise employees and clients of any buy less toxic products, advise employees and clients of any future construction/renovation/cleaning. future construction/renovation/cleaning.

• Such measures may prevent injuries and diseases, and reduce Such measures may prevent injuries and diseases, and reduce costs and risks to health and safety. costs and risks to health and safety.

History of two members of EHAQ History of two members of EHAQ showing the stakes of Environmental showing the stakes of Environmental

Sensitivity Sensitivity

““Marie”Marie”- 20-year-old Management

student

- At age 14 – sudden onset of multiple symptoms in different body systems

- Parents and brothers also have similar, different symptoms

““Sophie”Sophie”- 26-year-old

physiotherapy student working with handicapped persons

- At age 22, sudden onset of severe symptoms after a round of golf

- Learned afterwards that 2 fongicides were sprayed on course that day

History of two members of EHAQ History of two members of EHAQ showing the stakes of Environmental showing the stakes of Environmental

Sensitivity Sensitivity ““Marie”Marie”

- Subsequent chronic symptoms:

Increased sense of smell

Difficulty to concentrate and memorize

Irritation of sinuses

Swelling, constipation, diarrhea

Fatigue, lethargy

Cold extremities, low blood pressure

Generalized pain in muscles/articulations

““Sophie”Sophie”- Subsequent chronic

symptoms :

Vertigo

Skin eruptions

Red eyes, pain and irritation of eyes, black spots

Dyspepsia, swelling, diarrhea

Severe fatigue

Low blood pressure

Severe and intermittent skin rashes

History of two members of EHAQ History of two members of EHAQ showing the stakes of Environmental showing the stakes of Environmental

Sensitivity Sensitivity

““Marie”Marie”- Worsening of symptoms

after exposure to many petrochemical products, including perfumes

- After 3 years, blood tests show elevated level of chloride pesticides and heavy metals

- Neighbourhood lawns and gardens were often sprayed with Lindane and other pesticides

- Parents looked for and found appropriate medical help on a timely basis

““Sophie”Sophie”

- Worsening of symptoms after exposure to

many petrochemical products, including perfumes

- Doctors could not agree on a diagnosis

- Was told “it’s all in you head “

- Was referred in psychiatry, which did

not help

Health careHealth care “Marie”“Marie” “Sophie”“Sophie”

Medical/nutritionnal help included:

– Advice on how to avoid pesticides and petrochemical products at home, and on how to lower exposure in air to other common irritants such as dust, mold

– Neighbours asked (with help of a doctor) to stop using pesticides, and they agreed

– Biological food– Vitamins et minérals orally

and by IV – Chélation of heavy metals– Help to detoxification

through sauna/exercice– Personnalized

immunotherapy

No medical/nutritionnal help :

- Concerned parents become ill after spending much energy trying to help her

- Parents ask neighbors to stop using pesticides, but they do not

- Became homeless and never can find a safe place to live

- Did not receive accommodation in her work place

- Had no choice but to resign her job

- Had to fight with authorities about diagnosis, insurance, disability, without success

CURRENT STATE OF CURRENT STATE OF HEALTHHEALTH “Marie” “Marie” “Sophie”“Sophie”- Although disabled for 2 Although disabled for 2

years, unable to study or years, unable to study or to leave home without to leave home without becoming very sick, her becoming very sick, her symptoms gradually symptoms gradually diminish diminish

- Now able to study, work Now able to study, work and travel, but needs an and travel, but needs an healthy place to live in healthy place to live in order to keep her health order to keep her health by avoiding exposure to by avoiding exposure to known and suspected known and suspected chemical triggerschemical triggers

- Returned to school in Returned to school in financial management financial management (change in original plans (change in original plans because of disease)because of disease)

- Her symptoms get worse Her symptoms get worse

- Triggers Triggers (hypersensitivities) spread (hypersensitivities) spread from petrochemical from petrochemical products to food, molds products to food, molds and electromagnetic and electromagnetic radiationsradiations

- Remains disabled, unable Remains disabled, unable to perform the profession to perform the profession that she likes and for that she likes and for which she was trainedwhich she was trained

- Very low morale, lives day Very low morale, lives day by day, unable to make by day, unable to make plans for the futureplans for the future

FINANCIAL SITUATIONFINANCIAL SITUATION “Marie” “Sophie”“Marie” “Sophie”- None of her treatments None of her treatments

were covered by health were covered by health insuranceinsurance

- Cost of treatment had to be Cost of treatment had to be paid by her parents paid by her parents

- Federal income tax Federal income tax disallowed her deductions disallowed her deductions for nutritional therapy; for nutritional therapy; Quebec income tax refused Quebec income tax refused to formally accept to formally accept naturotherapynaturotherapy

- She is now able to work She is now able to work and is back to being an and is back to being an active person helpful to active person helpful to society. But she must society. But she must continue to be very careful. continue to be very careful.

- Her savings long gone Her savings long gone and her parents can no and her parents can no longer help her financially longer help her financially

- Survives on WelfareSurvives on Welfare

- She remains homelessShe remains homeless

EHAQ Member Survey 2006 EHAQ Member Survey 2006

Response rate: 58% (129 out of Response rate: 58% (129 out of 224)224)

RespondanRespondantsts

FemaleFemale MaleMale

SexSex 81%81% 19%19%

Average Average ageage

5050 4848

EHAQ Member Survey 2006 EHAQ Member Survey 2006 Marital statusMarital status

MariedMaried 51%51%

DivorcedDivorced 14%14%

SingleSingle 31%31%

EHAQ Member Survey 2006EHAQ Member Survey 2006

EDUCATIONEDUCATION

High schoolHigh school 14%14%

Post-secondaryPost-secondary 10%10%

College College (Cégep)/University(Cégep)/University

57%57%

Post GraduatePost Graduate 17%17%

EHAQ Member Survey 2006 EHAQ Member Survey 2006 OOccupationccupation

Disabled and unable to workDisabled and unable to work 53%53%

Receiving disability paymentsReceiving disability payments 20%20%

Self-employed to better control Self-employed to better control their work environmenttheir work environment

25%25%

EHAQ Member Survey 2006EHAQ Member Survey 2006

Substances perceived as triggers of Environmental SensitivitySubstances perceived as triggers of Environmental Sensitivity

Exposures known and linked Exposures known and linked to workplaceto workplace

26%26%

Exposure to synthetic Exposure to synthetic chemical products chemical products

37%37%

Exposure to pesticidesExposure to pesticides 34%34%

Number of symptoms EHAQ Member Survey 2006

0

10

20

30

40

50

60

1-5 6-10 >10# symptoms

% female

% male

EHAQ Member Survey 2006EHAQ Member Survey 2006 Reported symptomsReported symptomsCentral Nervous Central Nervous SystemSystem

Fatigue, tension, migraines, Fatigue, tension, migraines, confusion, memory loss, confusion, memory loss, depression, hyperactivity, depression, hyperactivity, sleep problems, vertigo, sleep problems, vertigo, excessive salivation, lack of excessive salivation, lack of concentration, neurological concentration, neurological painpain

GastrointestinaGastrointestinall Swelling, nausea, Swelling, nausea, constipation, cramps, constipation, cramps, diarrheadiarrhea

GénitourinaryGénitourinary IncontinenceIncontinence

SkinSkin Eczema, eruptions, red skinEczema, eruptions, red skin

EHAQ Member Survey 2006EHAQ Member Survey 2006 Reported Symptoms Reported Symptoms

RespiratoryRespiratory Frequent colds, bronchitis, Frequent colds, bronchitis, asthma, shortness of asthma, shortness of breathbreath

CardiovascularCardiovascular Rapid and/or irregular heart Rapid and/or irregular heart beats, hypertension, beats, hypertension, migrainesmigraines

Ear, eye, nose, troathEar, eye, nose, troath Ear aches, sinus infections, Ear aches, sinus infections, congestion, tears congestion, tears

MusculosquelettalMusculosquelettal Muscular spasms and/or Muscular spasms and/or pain, swelling and/or pain pain, swelling and/or pain in joints, back pain, in joints, back pain, muscular heat sensation, muscular heat sensation, extreme pain in face and extreme pain in face and jaw, weaknessjaw, weakness

EHAQ Member Survey 2006EHAQ Member Survey 2006 Substances reported as triggers of Substances reported as triggers of symptomssymptomsPesticidesPesticides Vehicle Vehicle

exhaustexhaustGasGas Natural Natural

gasgasDieselDiesel

New New productsproducts

DetergentDetergent Fabric Fabric softenersoftenerss

Perfumed Perfumed productsproducts

Cleaning Cleaning productsproducts

Personal Personal care care productsproducts

CosmeticsCosmetics Baby Baby care care productsproducts

Printing ink Printing ink VOCsVOCs

Building Building productsproducts

RenovatioRenovation productsn products

Wood Wood fire fire smokesmoke

PetrochemiPetrochemical cal productsproducts

ComputerComputerss

EHAQ Member Survey 2006EHAQ Member Survey 2006 Subtances commonly reported as not Subtances commonly reported as not triggering symptoms triggering symptoms

• Non scented productsNon scented products• Non toxic cleaning and personal care Non toxic cleaning and personal care

products (labeled non toxic) products (labeled non toxic) EHANS www.lesstoxicguide.caEHANS www.lesstoxicguide.ca• Construction and renovation Construction and renovation

products that do not emit Volatile products that do not emit Volatile Organic Compounds (VOC)Organic Compounds (VOC)

• Items that have ‘emitted’ for a Items that have ‘emitted’ for a sufficient period of time, in a well sufficient period of time, in a well ventilated areaventilated area

How many people are How many people are affected? affected?

• ~3% of Canadians have been ~3% of Canadians have been diagnoseddiagnosed with with MCSMCS (Commonly also present: chronic fatigue syndrome (Commonly also present: chronic fatigue syndrome and fibromyalgia) and fibromyalgia) Statistics Canada, 2007Statistics Canada, 2007

• 5% of Canadians (1.2 million persons) have been 5% of Canadians (1.2 million persons) have been diagnosed with at least one of these disorders diagnosed with at least one of these disorders Statistics Statistics Canada, 2007Canada, 2007

• 3.6% of Canadian nurses live with ES3.6% of Canadian nurses live with ES 2005 National Survey of the Work and Health of Nurses2005 National Survey of the Work and Health of Nurses

• Up to 16% of Californians and 33% of North Up to 16% of Californians and 33% of North Carolinians report increased sensitivity and feel sick Carolinians report increased sensitivity and feel sick when exposed to low levels of common chemicals when exposed to low levels of common chemicals Kreutzer et al, Am J Epidemiology 1999;150:1-12; Meggs et al, Arch Kreutzer et al, Am J Epidemiology 1999;150:1-12; Meggs et al, Arch Environ Health 1996;51:271-82Environ Health 1996;51:271-82

Quebec StatisticsQuebec Statistics

A burden for society:A burden for society: Multiple Chemical SensitivityMultiple Chemical Sensitivity (MCS) (MCS)

Statistics Canada 82-003, Health Bulletins, 18(1) Feb. 2007Statistics Canada 82-003, Health Bulletins, 18(1) Feb. 2007

• Significant differences in functional capacity and use of Significant differences in functional capacity and use of health care between general population diagnosed and health care between general population diagnosed and not diagnosed not diagnosed multiple chemical sensitivity (MCS) multiple chemical sensitivity (MCS) Chronic multiple sensitivities (CMS)Chronic multiple sensitivities (CMS)

• 22% of persons diagnosed MCS/CMS needed help in 22% of persons diagnosed MCS/CMS needed help in cleaning house, preparing meals, shopping, cleaning house, preparing meals, shopping, appointments appointments

• 17% of persons diagnosed 17% of persons diagnosed MCS/CMS MCS/CMS had consulted had consulted family doctors 10 times and more in last 12 months; 43% family doctors 10 times and more in last 12 months; 43% had seen specialists; 33% had seen alternative had seen specialists; 33% had seen alternative practitioners practitioners

Canada Mortgage and Housing Canada Mortgage and Housing CorporationCorporation

• Researched viable accommodation for persons Researched viable accommodation for persons

affected with ES in 1980s-1990s affected with ES in 1980s-1990s Housing for the Housing for the Environmentally Hypersensitive: Environmentally Hypersensitive:

A survey and examples of clean air housing in Canada, 1990-208A survey and examples of clean air housing in Canada, 1990-208

• Surveyed health results from persons affected Surveyed health results from persons affected with ES after changes in housing to avoid with ES after changes in housing to avoid triggers triggers Survey of the medical impact on environmentally Survey of the medical impact on environmentally hypersensitive people and change in habitat, Stephen R. Barron, MD. hypersensitive people and change in habitat, Stephen R. Barron, MD. CCFP, CMHC Project Manager Peter Russell, P.eng. 1990-210CCFP, CMHC Project Manager Peter Russell, P.eng. 1990-210

• CMHC – Housing and the Environmentally Hypersensitive – Breathing Easy at CMHC – Housing and the Environmentally Hypersensitive – Breathing Easy at HomeHome

http://www.cmhc-schl.gc.ca/en/imquaf/hehosu/hoenhy/hoenhy_002.cfmhttp://www.cmhc-schl.gc.ca/en/imquaf/hehosu/hoenhy/hoenhy_002.cfm

• CMHC – Research in Housing for the Environmentally HypersensitiveCMHC – Research in Housing for the Environmentally Hypersensitive http://www.cmhc-schl.gc.ca/en/imquaf/hehosu/hoenhy/hoenhy_003.cfmhttp://www.cmhc-schl.gc.ca/en/imquaf/hehosu/hoenhy/hoenhy_003.cfm

• CMHC – Research House for the Environmentally HypersensitiveCMHC – Research House for the Environmentally Hypersensitive http://www.cmhc-schl.gc.ca/en/imquaf/hehosu/hoenhy/upload/Researchhttp://www.cmhc-schl.gc.ca/en/imquaf/hehosu/hoenhy/upload/Research House-for-the-Environmentally-Hypersensitive.pdfHouse-for-the-Environmentally-Hypersensitive.pdf

SCHL PUBLICATIONS SCHL PUBLICATIONS

• CMHC – Housing and the Environmentally Hypersensitive – Breathing CMHC – Housing and the Environmentally Hypersensitive – Breathing Easy at HomeEasy at Home

• CMHC – The Clean Air Guide: How to Identify and Correct Indoor Air CMHC – The Clean Air Guide: How to Identify and Correct Indoor Air Problems in Your HomeProblems in Your Home

• CMHC – Research in Housing for the Environmentally HypersensitiveCMHC – Research in Housing for the Environmentally Hypersensitive

• CMHC – Research House for the Environmentally HypersensitiveCMHC – Research House for the Environmentally Hypersensitive

• Healthy Housing Practical TipsHealthy Housing Practical Tips

• Building Materials for the Environmentally HypersensitiveBuilding Materials for the Environmentally Hypersensitive

To order call: To order call: 1 800 668-2642 1 800 668-2642 https://www03.cmhc-schl.gc.ca/b2c/b2c/init.do?language=enhttps://www03.cmhc-schl.gc.ca/b2c/b2c/init.do?language=en

Canada Mortgage and Housing Canada Mortgage and Housing Corporation Corporation

Environmental SensitivityEnvironmental SensitivityManagement and preventionManagement and prevention

The reduction and avoidance of toxic chemicals both inside

and outside in air, water and food constitute the best

practice for hypersensitive individuals and is a

prevention measure for the general population, which

will allow an health improvement for persons suffering

from ES and will prevent the general population to

develop similar sensitivities. National Environmental Justice Advisory Council (NEJAC) – Resolution #21to the EPA on MCS (2000)National Environmental Justice Advisory Council (NEJAC) – Resolution #21to the EPA on MCS (2000)

THE FINANCIAL BURDENTHE FINANCIAL BURDEN

• Air – air filters, removal of toxic Air – air filters, removal of toxic products, etc products, etc

• Water – water purificationWater – water purification

• Food - biologicFood - biologic

Ecological productsEcological productsIf you see:If you see:

• A bottle with a green liquid, orA bottle with a green liquid, or

• A green bottle with liquid, orA green bottle with liquid, or

• Products labelled ‘organic’, ‘green’, Products labelled ‘organic’, ‘green’, ‘eco’, etc.‘eco’, etc.

STOP AND CHECK...STOP AND CHECK...

‘‘GREEN’ ProductsGREEN’ Products

If logo absent:If logo absent:Read list of ingredientsRead list of ingredientsProducts labelled without coloring, Products labelled without coloring,

without odour, biodegradable.without odour, biodegradable.Recyclable or reusable packaging.Recyclable or reusable packaging.

Prevention – Alternative productsPrevention – Alternative products

•Baking soda (all-purpose cleaner)Baking soda (all-purpose cleaner)•Corn starch (cleans/deodorizes carpets)Corn starch (cleans/deodorizes carpets)•Lemon juice (grease remover)Lemon juice (grease remover)•Pure soap (cleans everything)Pure soap (cleans everything)•Table salt (disinfects and scours)Table salt (disinfects and scours)•vinegar (glass cleaner, removes molds)vinegar (glass cleaner, removes molds)•Soda ash (disinfectant, removes grease)Soda ash (disinfectant, removes grease)•Peroxyde (whitens, disinfects moulds)Peroxyde (whitens, disinfects moulds)

LET’S LOOK AHEAD…LET’S LOOK AHEAD…

May is Environmental Sensitivity month

www.EHAQ-ehaq.ca