Clinical Ecology: Environmental Medicine or Unsubstantiated Theory?
Authors: Ephraim Kahn
Journal: Annals of Internal Medicine (1989)

Editorials15 July 1989Clinical Ecology: Environmental Medicine or Unsubstantiated Theory?Ephraim Kahn, MD, MPH, Gideon Letz, MD, MPHEphraim Kahn, MD, MPH, Gideon Letz, MD, MPHAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-111-2-104 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptA concept known by several terms, including "environmental illness," "multiple chemical sensitivities," "environmental hypersensitivity disorder," "20th century disease," and "total allergy syndrome," has recently attracted public attention and generated considerable controversy. The concept was developed by physicians known as clinical ecologists who now call themselves practitioners of "environmental medicine." These physicians believe that certain persons are adversely affected by synthetic chemicals in the environment at doses far lower than can be explained by accepted pathophysiologic mechanisms. They believe that such low-level exposures can damage the immune system and make these persons hypersensitive to all or most synthetic chemicals. The symptoms...References1. . Clinical ecology. Ann Intern Med. 1989;111:168-78. LinkGoogle Scholar2. Terr A. "Multiple chemical sensitivities": immunologic critique of clinical ecology theories and practice. State Art Rev Occup Med. 1987;2:683-94. MedlineGoogle Scholar3. . Clinical ecology—a critical appraisal. West J Med. 1986;144:239-45. MedlineGoogle Scholar4. Report of the Advisory Panel on Environmental Hypersensitivity, 1986. Toronto, Ontario: Ministry of Health, Province of Ontario; 1986. Google Scholar5. Clinical Ecology.. J. Allergy Clin Immunol. 1986;78:269-71. CrossrefMedlineGoogle Scholar6. Brodsky C. 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Workers with multiple chemical sensitivities: a psychiatric approach to diagnosis and treatment. State Art Rev Occup Med. 1987;2:739-53. MedlineGoogle Scholar13. Brodsky C. Multiple chemical sensitivities and other "environmental illness": a psychiatrist's view. State Art Rev Occup Med. 1987;2:695-704. MedlineGoogle Scholar14. Marshall E. Woburn case may spark explosion of lawsuits [news]. Science. 1986;234:418-20. CrossrefMedlineGoogle Scholar15. Kahn E. Chemical sensitivity: a non-believer's view. Journal Pesticide Reform. 1987;7:33-6. Google Scholar16. NikiforukNikiforuk GM. Evidence for the "hypersensitivity syndrome." Can Med Assoc J. 1986;134:1343-4. Google Scholar17. Levin A. Quoted in: Legro W. Under Siege. Organic Gardening. 1988 (April) :66. Google Scholar18. Levin A. Science in court. Lancet. 1987;2:1529. CrossrefMedlineGoogle Scholar19. Miller D. Courtroom science and standards of proof. Lancet. 1987;2:1283-4. CrossrefMedlineGoogle Scholar This content is PDF only. 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Author, Article, and Disclosure InformationAuthors: Ephraim Kahn, MD, MPH; Gideon Letz, MD, MPH PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byLong Noncoding RNAs: New Regulators of Resistance to Systemic Therapies for Gastric CancerClinical Ecology—Transforming 21st-Century Medicine with Planetary Health in MindUnconventional Theories and Unproven Methods in AllergyUnconventional Theories and Unproven Methods in AllergyRecent advances in integrative allergy carePsychiatric Inferences from Data on Psychologic/Psychiatric Symptoms in Multiple Chemical Sensitivities SyndromeSuccessful Outcome in a Patient With Chemical Sensitivity: Treatment With Psychological Desensitization and Selective Serotonin Reuptake InhibitorDevelopment of Multiple Chemical Sensitivities in Laborers after Acute Gasoline Fume Exposure in an Underground Tunneling OperationSymptoms and Health Status in Individuals with Multiple Chemical Sensitivities Syndrome from Four Reported Sensitizing Exposures and a General Population Comparison GroupAssessing Beliefs about 'Environmental Illness/Multiple Chemical Sensitivity'Behavioral treatment of phobic avoidance in multiple chemical sensitivityThe Sixth SensePesticides on food.Heterocyclic amine-induced cancer and myocardial lesions in nonhuman primates.IDENTIFYING SKIN REACTIONS TO DRUGSPräventivmaßnahmen aus sozialmedizinischer Sicht: Der Wandel von Lebens- und Arbeitswelt und die UmweltängsteEnvironmental illness and biomedicine: Anomalies, exemplars, and the politics of the bodyMULTIPLE CHEMICAL SENSITIVITIES SYNDROMEPsychiatric Treatments in Multiple Chemical SensitivityDoes environmental tobacco smoke (ETS) cause adverse health effects in susceptible individuals? 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