Talk:Multiple chemical sensitivity/Archive 4

Archive 1

Archive 2

Archive 3

Archive 4

Archive 5

Infobox

User:Natureium, the infobox – or the "disinfobox", as some might call it – does not seem to display most of the codes. It displays alternate names in a monospace font (why?!), and then says "Pseudomedical diagnosis", "Risks Nocebo", and "MeSH D018777". That's it. The ICD codes are ignored. There's no useful information for the reader in the box, to the point that the infobox doesn't really even manage to be redundant. The implicit claim that MCS is a "pseudomedical diagnosis" – which I assume was someone's prime goal in switching the template from the usual one – appears to be unverifiable in reliable sources (zero hits in PubMed and Google Scholar). I can't even find a solid source that says this is an altmed subject, which is what that link leads to. For example, the highly skeptical Science-Based Medicine blog doesn't believe that; they say it's real suffering with an unproven cause, and that these suffering people at risk of becoming victims of the altmed industry – not that the diagnosis itself is specific to the altmed.[1]

I think we should remove this, and have no infobox on this article. WhatamIdoing (talk) 21:51, 20 December 2018 (UTC)

Yes that font is awful. SBM doesn't use the words altmed, and sort of says that it's a real condition, but what they actually say is that while people do experience symptoms that they blame on exposure to "chemicals", there has been no link found, and no scientific evidence whatsoever that exposure to chemicals is the cause of the symptoms people are experiencing. If you want a direct quote: "Chemical sensitivities have been ruled out owing to chemical challenges that cause symptoms only in the absence of proper blinding." It also says that "MCS is not recognized as a distinct clinical entity in any country (with the exception of Germany and Austria) given the lack of confirmed physical effects and the lack of clear diagnostic criteria." So while they are not saying the symptoms are invented, they aren't due to chemical exposure, which makes this a pseudoscientific condition. I am concerned that this article seems to be moving away from the scientific consensus on this condition by cherry-picking sources to support a specific point of view. Natureium (talk) 22:38, 20 December 2018 (UTC)

And they're wrong about Austria and Germany, for that matter, as the ultimate source for that is a letter about billing codes, rather than any actual recognition by medical or scientific people.

I think that the scientific position has shifted in the last decade (which is good for all concerned), and I think that we need to make some significant changes to the article. But it's not good enough for an editor to say "Well, the etiology originally proposed by some folks is X, and X isn't the pure cause, so I say that the whole thing is pseudoscientific." You actually have to have a reliable source for that claim – a rock-solid one, given that this is at least an uncommon understanding of MCS, even by researchers who reject the "chemicals" thing outright. Do you have sources to back up that claim? WhatamIdoing (talk) 00:35, 21 December 2018 (UTC)

Pending changes

I wonder is it worth pursuing pending changes given that semi-protection offered little resistance to the second sock farm? Is it possible to have both pending changes and semi-protection on the same article? Maybe semi-protect and add pending changes (if this is possible) to the talk page as well as much of the disruption occurs on the talk page here.--Literaturegeek | T@1k? 02:19, 15 December 2019 (UTC)

Might need extended-confirmed. Maybe ask at ANI? Guy (help!) 02:23, 15 December 2019 (UTC)

Proposal: nuke most of the "causes"

I propose that we restructure this article to be similar to the structure found at Electromagnetic hypersensitivity. In particular, most of the "causes" listed beg the question by assuming a cause/effect relationship when there is no evidence that the claimed effect exists. Some of the "psychological" section might be salvageable, but would need to be confined to claims made by WP:MEDRS-compliant sources. --Guy Macon (talk) 20:54, 14 December 2019 (UTC)

• Support as proponent. ---Guy Macon (talk) 20:54, 14 December 2019 (UTC)
• Support. This is tooth fairy science. Guy (help!) 20:56, 14 December 2019 (UTC)
• Support per above. TylerDurden8823 (talk) 03:19, 15 December 2019 (UTC)
• Make it so. jps (talk) 13:05, 15 December 2019 (UTC)

But does it actually exist?

*"At this time, it is a controversial issue as to whether it is a clinical diagnosis or not. Many in the medical community lean towards these symptoms being physical manifestations of psychiatric illness rather than a primary medical illness. While others in the medical community along with organizations agree that multiple chemical sensitivity is a negative physical reaction to certain chemicals. There is debate as to whether multiple chemical sensitivity should be classified and diagnosed as an illness. " --Johns Hopkins Medicine @Guy Macon:You may be interested in the criticisms the 2019 Italian Consensus makes of this research from John Hopkins.Leobenite (talk) 10:01, 14 December 2019 (UTC)Leobenite

• "The question is whether MCS is an illness. Health experts don’t agree on that. The American Medical Association doesn’t consider multiple chemical sensitivity to be an illness." --WebMD
• "[MCS] has been rejected as an established organic disease by the American Academy of Allergy and Immunology, the American Medical Association, the California Medical Association, the American College of Physicians, and the International Society of Regulatory Toxicology and Pharmacology. It may be the only ailment in existence in which the patient defines both the cause and the manifestations of his own condition. Despite this, it has achieved credibility in workmens compensation claims, tort liability, and regulatory actions." --Americal Family Physician

• "Multiple Chemical Sensitivity: Separating facts from fiction: Does multiple chemical sensitivity exist? The symptoms certainly do, but it’s less clear if they are due to 'chemicals'. A 'fake disease' doesn’t mean a patient’s symptoms aren’t real, or that they’re not suffering. Patients aren’t 'faking' their symptoms. A 'fake disease' means that the difficult work confirming the relationship between specific symptoms and an objective diagnosis is lacking. A real disease can be proven false or ruled out: There are objective ways to show someone does not actually have the disease. That’s not possible with fake diseases." --Science Based Medicine

• "Multiple chemical sensitivity (MCS) is an expression that was developed within a community of medical professionals who thought they had identified a new kind of medical illness that is an effect of modern living. They called it ecological or environmental illness. Some people are especially sensitive to our treated water, polluted air, synthetic clothing, cleaning products, paints, perfumes, and other items that many of us are likely to come in contact with in our day to day activities. The only way to identify those who are especially sensitive to things in our modern environment is by their complaints and behaviors. There is apparently no organic basic for their sensitivity, which makes it impossible to develop something like a blood or allergy test to identify who is especially sensitive." --Skeptics Dictionary

• "The expression "multiple chemical sensitivity" ("MCS") is used to describe people with numerous troubling symptoms attributed to environmental factors. Many such people are seeking special accommodations, applying for disability benefits, and filing lawsuits claiming that exposure to common foods and chemicals has made them ill. Their efforts are supported by a small cadre of physicians who use questionable diagnostic and treatment methods. Critics charge that these approaches are bogus and that MCS is not a valid diagnosis." --QuackWatch Also see:[2]

• "In the 1950s, allergist Dr. Theron G. Randolph introduced the idea of chemical sensitivity. He thought that humans were not adapting to modern man-made chemicals and experiencing physical symptoms. The concept had a number of names. Today, this collection of non-specific symptoms is known as MCS, multiple chemical sensitivity. Spinoffs of MCS are Gulf War syndrome, sick building syndrome, toxic carpet syndrome, and people who say they are allergic to almost everything (including water). Diagnoses of such syndromes are problematic. So far no basis for MCS has been found except psychological. " --Skeptical Inquirer

• "Environmental Sensitivity (or multiple chemical sensitivity – MCS) is not recognized as a legitimate illness. It was first proposed by Dr. Theron G. Randolph in the 1940s, who first thought that it was due to food, but later expanded the syndrome to include artificial chemicals in the environment. Like most dubious diagnoses, MCS lacks a discrete clinical picture or any pathophysiological plausibility. Those who have the diagnosis typically have fatigue, non-specific pains, depression, irritability, and confusion. These are all non-specific symptoms and do not point to a specific physiological dysfunction or cause. They are also common symptoms of psychologically based syndromes. In the last half century proponents of this diagnosis have failed to achieve any scientific credibility. They have not demonstrated that MCS exists as a discrete entity, that it can be reliably diagnosed, that there are any objective markers or underlying pathophysiology. In other words, they have demonstrated nothing to suggest that MCS actually exists. There have been some scientific studies of MCS, but the results of these studies are consistent with the hypothesis that MCS is psychological. For example, Staudenmeyer et al challenged patients with the diagnosis of MCS in a blinded fashion with various environmental challenges (the control being clean air challenges). He found no difference between clean air challenges and a variety of chemical challenges." --NeuroLogica Blog

--Guy Macon (talk) 08:35, 14 December 2019 (UTC)

Guy Macon, the results of provocation trials are strikingly similar to those in electromagnetic hypersensitivity: no robust association with the claimed stimulus, no ability to distinguish between genuine and fake exposure.

"We conclude that persons with MCS do react to chemical challenges; however, these responses occur when they can discern differences between active and sham substances, suggesting that the mechanism of action is not specific to the chemical itself and might be related to expectations and prior beliefs." - https://www.jacionline.org/article/S0091-6749(06)01696-4/fulltext

Note also that last time we had an issue with this article it turned out to be from a sock farm. Guy (help!) 17:06, 14 December 2019 (UTC)

We are probably not doing an adequate job here of explaining what "an illness" is. These people are suffering; these people identify 'chemicals' (whatever that means to them) as a source of suffering. That much is generally agreed. What's not agreed is whether this is one disease, several diseases, or an alternative manifestation of known diseases. So, to give another example, Christmas tree syndrome is something that people experience, but at a medical level, it is several separate medical conditions (one person with Christmas tree syndrome will turn out to be allergic to mold, another gets a rash from touching pine tree sap, the next is allergic to the dust that's accumulated in their old fake tree, etc.). So these people have a similar experience, but it's not "an illness". Similarly, MCS could be something that people experience without being "an illness".

Being "an illness" requires things like a reasonably uniform set of diagnostic criteria, so that you can separate people suffering because of this from people suffering for other reasons. Also, you need to be able to tell which symptoms are part of this disease and which are not, because what if you have more than one medical condition going on, but you're blaming all your symptoms on one thing?

I think we should take this as feedback that the article is not well-written, and that we can explain this idea better. Conventional medicine accepts that these people are suffering. It does not accept that all of them are suffering from the same condition, or that the suffering is caused by any of the (several) etiologies proposed by various proponents over the years. We should do better about explaining what it means for MCS to not be accepted as an illness, so that it accurately educates readers and doesn't seem to insult anyone who is suffering. WhatamIdoing (talk) 04:39, 16 December 2019 (UTC)

I am convinced so far that these people really are sick for a whole host of reasons, functional disorders, CFS, IBS, anxiety disorders, neurotoxicity, brain injuries, various mental illnesses etc (all of which can explain limbic and/or the pro-inflammatory immunological findings) but they then search out explanations and start scanning their environment and daily activities to identify a link or explanation for how they feel. They then blame MCS, which doesn’t exist. I highly doubt there is one diagnosis or illness that causes MCS complaints. I felt terribly ill coming off cigarettes and scanned my environment, blaming food for how I felt, kind of the same thing, it is a survival mechanism mixed with some health anxiety.--Literaturegeek | T@1k? 06:07, 16 December 2019 (UTC)

The people who believe that they have MCS probably don't all have the same thing. That doesn't mean that they all have another known/accepted illness.

A larger than reasonable proportion of the sources in this article are more than 20 years old. We need to be updating it. Along those lines, I've found a chapter in a conventional medical textbook (occupational medicine) that covers this subject. It also says this:

The specialty of clinical ecology that emerged in the 1960s adopted theories of causation that differ from those of traditional allergy, immunology, and toxicology, thereby laying the basis for medical and legal disputes regarding legitimate or acceptable forms of treatment, medical or workers' compensation insurance reimbursement, and disability benefits. As a result, some clinicians believe that etiologic theories, diagnosis, and the clinical management of MCS are inconsistent with sound medical science. In more recent years, however, important progress has been made in elucidating and defining the nature of this condition. The combined efforts of several disciplines, including toxicology, psychology, and physiology, have suggested a multifactorial explanatory model for this condition. ISBN 978-0071808156

This kind of source is what I think we should be relying on – one that's not afraid to call the old stories about etiology garbage, and doesn't recommend any treatment that isn't evidence-based, but which doesn't focus on whether "it" (whatever "they" are) "exists" (whatever that means to the reader). WhatamIdoing (talk) 06:43, 16 December 2019 (UTC)

I do not dispute there are multifactoral causes, including psychological/psychiatric, toxicology in terms of previous neurotoxicity and physiology/biology. That source (and no source you have shown me) does not say MCS is real in the sense that the ultra low level brief chemical exposure causes the symptoms and abnormal biology. That source is just saying these people are to varying degrees psychologically and physically abnormal or unwell people who have a belief in them having MCS. Show me a source that says the multiple super low exposure chemical smells cause the symptoms, then I will see your position more clearly.--Literaturegeek | T@1k? 06:53, 16 December 2019 (UTC)

Reputable conventional medical sources do not say that an exposure to low levels of chemicals is the primary event in the etiology of the condition ("cause"). What they say is that low levels of (smelly) chemicals trigger the symptoms (which is also "cause"). I think if we want to get anywhere in these discussions, that we'll need to rely on specific medical jargon instead of words with multiple relevant meanings. WhatamIdoing (talk) 16:02, 16 December 2019 (UTC)

Discredited source

It appears from this review [3] that the dismissive quotations from writings of Ronald Gots should not be cited as authoritative. The abstract of his tendentious 1995 editorial is quoted in its entirety, with three references to that footnote in this article. A mere citation would suffice, and should be contextualized with his conflict of interest as one whose principle livelihood appears to have been as an expert witness in legal defense of corporations accused in court of wrongdoing. Bn (talk) 13:48, 29 January 2019 (UTC)

As of today (2019-12-13), this article relies on a number of WP:FRINGE individuals such as William Rea, Martin L. Pall and dubious working groups ("Italian Workgroup on MCS", and a Canadian Task Force on Environmental Health) that have produced unscientific documents. MCS is not a recognized condition by mainstream medicine. This article is in need of a rewrite. ScienceFlyer (talk) 01:47, 14 December 2019 (UTC)

::@ScienceFlyer: The Italian consensus is probably the largest collaborative review of MCS literature to date. It was funded by the Italian health department—hardly fringe.

And re the Canadian Taskforce, how are the conclusions of a large-scale, three-year government inquiry, set up by the health department, fringe?@ScienceFlyer:

Using labels like "fringe" on here seem to be a way to maintain old narratives and ignore new research and what seems to be a new emerging consensus.

Also @ScienceFlyer: note the paras on recognition in the 2017 Rossi & Pitidis review. Is that review too fringe too?

MCS clearly has some degree of recognition or there wouldn't be this abundance of academic activity around it, nor would formal representatives of college of physicians be talking about it as a disease, nor would the CDC be talking about it in their policies.Leobenite (talk) 05:49, 14 December 2019 (UTC)Leobenite

@Leobenite: Thank you for your comments. Mainstream medicine does not recognize MCS as a valid diagnosis. Nevertheless, the Canadian Task Force included advocates for MCS. The document produced by the Task Force seems to presume that MCS is a valid diagnosis, without credible science to back it up. It is also not a systematic review of the evidence. Hence, the Canadian Task Force document can not be considered reliable.

The 2019 Italian document appears to have been produced at least in part by an MCS advocacy group called AMICA and is endorsed by a number of WP:FRINGE individuals, such as homeopaths. AMICA also contradicts the scientific consensus about the safety of dental amalgam fillings and non-ionizing EMFs used by cell phones and WiFi. I don't see evidence that this "consensus" was supported by mainstream medical organizations, including the Italian health department. But the document is not text searchable, so let me know if I missed anything.

As said above, the article currently is riddled with WP:FRINGE sources and should be rewritten. William Rea had a disciplinary record and Iris Bell is a homeopath. Both are practitioners of pseudoscientific medicine.

The Rossi & Pitidis document was used inappropriately in the lede, pointing to WHO ICD10 codes (J68.9, T78.4 ) which do not seem to mention MCS. The document does not draw firm conclusions about MCS. ScienceFlyer (talk) 08:05, 14 December 2019 (UTC)

:::@ScienceFlyer: I didn't use it inappropriately. In the footnote (which is now deleted), I quoted VERBATIM what Rossi & Pitidis said about the IC10. They did not say the IC10 mentions MCS, but that their view was that existing codes could cover MCS. Their opinion, which I personally don't agree with. But I put it in there because they are a well regarded recent academic review who commented on recognition.Leobenite (talk) 11:57, 14 December 2019 (UTC)Leobenite

The journal of Occupational and Environmental Medicine is a high quality publication and the Rossi and Pitidis paper is a thorough and reliable review. KrisKelvin99 (talk) 12:54, 14 December 2019 (UTC) KrisKelvin99

Struck through edits by blocked sock, see Wikipedia:Sockpuppet investigations/SamuelBurckhalter/Archive Doug Weller talk 12:59, 18 December 2019 (UTC)

Changes to the lead

I skipped back to where the lead was ~250 edits ago. Here's what we have now, versus then:

Multiple chemical sensitivity (MCS), also known as idiopathic environmental intolerances (IEI), is an unrecognized diagnosis characterized by chronic symptoms attributed to exposure to commonly used chemicals. Symptoms are typically vague and non-specific. They may include fatigue, headaches, nausea, and dizziness. Although these symptoms can be debilitating, MCS is not recognized as an organic, chemical-caused illness by the World Health Organization, American Medical Association, or any of several other professional medical organizations. Blinded clinical trials show that people with MCS react as often and as strongly to placebos as they do to chemical stimuli; the existence and severity of symptoms is related to perception that a chemical stimulus is present. Some attribute the symptoms to depression, somatoform disorders, or anxiety disorders. Commonly attributed substances include scented products, pesticides, plastics, synthetic fabrics, smoke, petroleum products, and paint fumes. References

Multiple chemical sensitivity (MCS), also known as idiopathic environmental intolerances (IEI), is a chronic condition characterized by non-specific symptoms that the affected person attributes to encountering small amounts of common substances, such as perfume. The etiology, diagnosis and treatment of MCS are controversial and still debated among researchers, but a 2018 systematic review concluded that the evidence suggests that organic abnormalities in sensory processing pathways and the limbic system combined with some specific, uncommon personality traits (such as heightened attentional bias) best explains this condition. MCS symptoms are typically vague and non-specific. They may include fatigue, headaches, nausea, and dizziness. Although the symptoms of MCS themselves are real, and can be disabling, MCS is not recognized as a separate, discrete disease by the World Health Organization, American Medical Association, or by several other professional medical organizations. Some blinded clinical trials have shown that the study subjects reacted as often and as strongly to placebos as they did to chemical stimuli and that the presence of symptoms was related to the perception that a chemical stimulus was present. Some experts attribute the symptoms to depression, somatoform disorders, or anxiety disorders. References

I'm not satisfied with all of the changes that have been made. I'm not sure that all of them have been made intentionally, however; it's easy for stuff to get lost. Which changes do you all want to preserve? WhatamIdoing (talk) 04:51, 16 December 2019 (UTC)

In addition to the issues WAID raised, I also want to suggest including these references: [4] and [5]. Admittedly, they are relatively older references but they really get to the heart of the matter-analyzing whether MCS/IEI is plausibly real or not (spoiler alert-they said no, at least not from an organic/toxic perspective but from a psychiatric/somatoform perspective it makes sense) by Bradford Hill causality criteria. Thoughts? TylerDurden8823 (talk) 06:58, 16 December 2019 (UTC)

No, they get to the heart of whether two of the multiple proposed etiologies are plausibly correct or not. There are lots of ways in which "it" can be "real" without either of these two etiologies being correct.

They are a bit older, but frankly, a quarter of the sources in the article, even after stripping so much content recently, are from the previous century. I don't think that we currently have much grounds for quibbling over a source being 16 years old when so much is cited to 27-year-old sources. But it would of course be preferable if we could find a more recent (but still equially good) source that cited these two reviews.

I'm not sure that it should go directly in the lead, or at least not in any detail. It might be plausible to include a general line about MCS not originating in a chemical exposure and having some psychological components, but I don't think that the lead is the place to get into how well the popular theories of etiology align with the Bradford Hill criteria. I'd love to see how you'd write that up in the main body of the article, though. WhatamIdoing (talk) 21:36, 16 December 2019 (UTC)

Yes, WAID, that's what I mean. That's one of the crucial matters at hand about the disease-whether its etiology is organic or not. Many people with IEI advocate for it to be recognized as one despite a lack of supporting evidence. As you say, there aren't many new sources (that are high-quality) that I can see. TylerDurden8823 (talk) 15:23, 18 December 2019 (UTC)

Is the dispute these days still over whether it's "organic" (dementia is an organic illness), or more specifically over whether it's "chemical-caused" condition? The line between psychiatry and neurology gets so thin and fuzzy these days that I begin to doubt that the distinction between brain-function-affecting "inorganic" (traditionally psychiatric conditions) and "organic" (traditionally neurological conditions) conditions matters as much as it did back in the 1970s, when some psychiatrists still thought that schizophrenia could be successfully treated with talk therapy alone. WhatamIdoing (talk) 18:12, 18 December 2019 (UTC)

Etiology: cause, origin; specifically, the cause of a disease or abnormal condition.

What we know the cause isn't: exposure to chemicals. Double blind tests have shown that symptoms are correlated with thinking you are being exposed to chemicals and not to actual exposure:

What we know the cause isn't: Anything that stays the same no matter what your thoughts are. This rules out all known 100% physical causes with zero mental component. Alas, there aren't very many of those.

The first thing that the cause might be: A 100% mental cause with absolutely no physical cause. To try to rule this one out, we look for something that is different physically between those who do or do not report MCS. Do we have WP:MEDRS-compliant sources that show such a difference?

The second thing that the cause might be: A mental cause combined with a physical cause. To try to rule this one out, we do the same as above, but alas, we cannot prove a negative. If we find something physical we know that it isn't 100% mental. If we don't, maybe we just haven't found it yet.

The third thing that the cause might be: No actual symptoms, just imaginary ones or possibly deception. To rule this out, we look for measurable symptoms. Do histamine levels change? Body temperature? Reaction time? Any biomarkers at all (but not things like adrenaline which are known to change with changed mental states)? Also, statistics may shed light on the question: Is MCS more common in countries where it results in a financial reward and less common in countries that don't? --Guy Macon (talk) 21:15, 18 December 2019 (UTC)

Well, when I said organic I meant caused by chemicals as people with IEI say. That much is definitely not well-accepted. I'm not saying there can't be an organic explanation for why they hold those erroneous beliefs. TylerDurden8823 (talk) 04:32, 19 December 2019 (UTC)

"Organic" is a lot bigger than "caused by chemicals". I think we should rephrase that to use less jargon.

Guy Macon, AIUI the current thinking (among the evidence-based researchers) is that the etiology is multifactorial (including some personality traits but excluding "chemical exposure"), but the trigger for symptoms is smelly "chemicals". That's a fancy way of saying that "chemicals" simultaneously both are and aren't "the cause".

There do appear to be some objective differences between MCS folks and others (e.g., in which parts of the brain light up upon encountering a scent).

BTW, the WHO recommended changing the name to idiopathic environmental intolerance some years ago, specifically because "chemical exposure" isn't the original cause, and it's not technically "sensitivity" (which means "true allergy" in their world). We've stuck with the more popular word, but I can see the logic behind the WHO's preferred title. WhatamIdoing (talk) 06:49, 19 December 2019 (UTC)

I thought it was clear what I was trying to say here. I'll rephrase (thought I feel I'm being nitpicked a bit). I mean to say that the article I cited and suggested above makes a compelling case that the cause of IEI is not the low-level chemical exposures that people who self-diagnose themselves with this condition blame. TylerDurden8823 (talk) 07:22, 19 December 2019 (UTC)

Immunological

...the following source...

Albright JF, Goldstein RA. Is there evidence of an immunologic basis for multiple chemical sensitivity? Toxicol Ind Health 1992; 8(4): 215-9.

...is used to support the following claim:

"While others concluded that allergic or immunotoxicological reactions could be contributing factors in at least a subset of MCS patients"

I looked at the abstract at

https://journals.sagepub.com/doi/pdf/10.1177/074823379200800420

and saw this:

"At the present time, MCS does not appear to be a typical allergic condition because few if any patients peported to suffer from the condition show clinical evidence... The most compelling evidence for the existance of such a syndrome appears to be anecdotal..."

I do not have access to the entire paper.

As an engineer, I tend to avoid making edits on medical topics for the same reasons someone with no understanding of electronics engineering should avoid trying to "fix" our Cockcroft–Walton generator or Hall effect articles, but to my untrained eye it looks like the source does not support the claim. --Guy Macon (talk) 13:46, 16 December 2019 (UTC)

The idea that these symptoms are primarily immunological in etiology is outdated and discredited. (See the quote above from the textbook on its origins.) WhatamIdoing (talk) 15:43, 16 December 2019 (UTC)

Be WP:BOLD Guy Macon! Your edits can always be reversed.--Literaturegeek | T@1k? 16:19, 16 December 2019 (UTC)

This looks like an improvement to me. Thanks for making that edit. WhatamIdoing (talk) 20:42, 16 December 2019 (UTC)

I agree. The only thing I wonder about is the last part saying "as we look for other causes". Is there really a lot of legitimate research being done on the topic? I haven't really come across all that much (at least not high-quality research). TylerDurden8823 (talk) 04:35, 19 December 2019 (UTC)

There seems to be some research, but the main clinical emphasis is on the other part of the sentence. Clinicians have mostly decided not to waste time and erode trust by arguing with patients about whether the original etiology has anything to do with "chemicals". (Oncologists take a similar line: when patients decide that their cancer was caused by being unkind, or as divine punishment for getting divorced, or whatever, there's no real benefit to trying to tell them otherwise.) It doesn't always work, because a fraction of MCS patients get worse overall when they try to avoid "chemicals". Having a medical authority figure tell them to avoid exposures makes some people even more fearful. WhatamIdoing (talk) 16:12, 19 December 2019 (UTC)

Definition

Can anyone find a more recent "official" definition than the consensus statement at PMID 10444033 (full text available here with permission from the copyright holder)? It's not unusual for a definition to remain the same for decades, and this is still used by several other sources, but if there is something more recent, it'd be better to rely on that. WhatamIdoing (talk) 21:48, 16 December 2019 (UTC)

One difference between the 1999 and 1987 definitions (Harrison quotes the older one) is that the older one requires a "documentable" event that caused the symptoms. This means that if you had some sort of medical event (car wreck? serious illness?) and then started having problems afterwards, then you could meet the criteria, but if you just slowly slid into experiencing symptoms over a period of years, then you can't. I haven't yet figured out why this changed. WhatamIdoing (talk) 16:17, 19 December 2019 (UTC)

Rename to IEI?

PMID 31640568 says "Severe CI [note – chemical intolerance] is often referred to as multiple chemical sensitivity (MCS) [1, 2, 4, 6, 23]. Some groups prefer the name idiopathic environmental intolerance (IEI) to avoid confusion in diagnosis and etiology associated with the terms CI and MCS [24–28], because these terms imply unsupported judgments on causation, do not refer to a clinically defined disease, and are not based on accepted theories of underlying mechanisms or validated clinical criteria for diagnosis [29]."

I wonder whether we should consider moving this page to Idiopathic environmental intolerance. The current name does imply that chemicals are central to the etiology, and it's not a "true" sensitivity (which means "allergy"). What do you all think? WhatamIdoing (talk) 00:14, 1 January 2020 (UTC)

WhatamIdoing, MCS seems to be the most common term though? Guy (help!) 11:34, 1 January 2020 (UTC)

That's my impression, but I think the source is correct to say that it isn't necessarily the most neutral term. WhatamIdoing (talk) 19:58, 1 January 2020 (UTC)

WhatamIdoing, if we have a clear consensus among medical review sources that IEI is the correct term then that makes sense. If it's just a couple, then I guess WP:NOTYET as it were. Dunno. Guy (help!) 09:30, 2 January 2020 (UTC)

To the group of new editors

I assume you all know each other from some off-wiki site dedicated to discussing this syndrome. Anyway, I noticed in your edits the claim that some medical associations eg in Denmark and Germany recognise this disorder. The question is what do they recognise it as? Do they really believe and accept that short exposure to micro doses of perfume, petrol fumes etc causes a syndrome of severe symptoms? Or do they say yes this is a real disorder caused by psychological factors? Or real symptoms wrongly attributed by the individual to smells in the environment?--Literaturegeek | T@1k? 08:36, 16 December 2018 (UTC)

I think this article's probably due for a refresh.

I've just started into the latest papers, but the overall tenor seems to have moved from "we've got no clue what makes these people sick" to "neurological problems plus personality quirks means that smelling things is distressing". This seems to explain a lot, from why SSRIs work (because they mitigate some kinds of neurological problems) to why unscented toxins produce no symptoms.

Are you up for helping with a re-write? WhatamIdoing (talk) 20:04, 16 December 2018 (UTC)

The Germany-and-Austria thing is nonsense. It says what the ICD code medical services are usually billed under. It does not say that it's "physical". That is merely the self-serving interpretation of an advocacy group. WhatamIdoing (talk) 20:05, 16 December 2018 (UTC)

Well yes, the article did need to be updated re. the personality traits and hypersensitive limbic and sensory systems - but that has been done now. I am not seeing a major problem with the article in it’s present format. I mean, sourcing could aim to use higher quality sources but is it really worth the effort to replace or lose non-controversial unchallenged content when there are other more important articles? I guess the treatment section could do with being updated. I might try doing some work there but it is a busy time of year.

Good job with removing the misrepresentation of the Germany-Austria thing.

I think the main thing to do is watch list this article and help avoid the single purpose accounts skewing and biasing the article.--Literaturegeek | T@1k? 20:51, 16 December 2018 (UTC)

I'm thinking that the article needs to be updated primarily on the grounds that about a third of the sources are from the previous century, and we'd usually like to have everything from the last five years, or perhaps stretch it as far back as ten years for a rare disease. The stuff from twenty-plus years ago really should be replaced. For example, my quick search (feel free to prove me wrong) indicates that a connection between MCS and the Gulf War hasn't been discussed in the medical literature for over a decade now, so all of that ought to be either removed or at least significantly minimized. WhatamIdoing (talk) 01:14, 17 December 2018 (UTC)

Well, one reason is because the Gulf War happened in 1991, it (Gulf War Syndrome) was researched to death. It is no longer and likely never again will be an area of active research. That was why I was not motivated to remove that primary source. But I do understand your reasoning and am not strongly motivated one way or the other about that reference.--Literaturegeek | T@1k? 02:43, 17 December 2018 (UTC)

I'm new to this article so I guess I'll post here. Right off the bat, in the lead I find the use of this journal: Regulatory Toxicology and Pharmacology. Is that really appropriate? Also, the lead says symptoms are "vague" which I don't find in the source (and as far as I can tell they don't sound any "vague-er" than a lot of diseases). And lastly, it says the WHO does not see it as a disease but I can't find that in the source either. They may or they may not...the little bit of information given does not convince me either way. Perhaps the WHO just by policy does not list controversial diseases for all I know. Gandydancer (talk) 04:08, 2 January 2020 (UTC)

Welcome, User:Gandydancer. I couldn't figure out which ref you were talking about. The lead's a mess in general, but the article is overdue for a thorough re-write, so I think there's probably not much point in trying to fix the lead right now, but it's good to plan for the next phase. WhatamIdoing (talk) 05:49, 4 January 2020 (UTC)

Page protection

@AndersBirzulis, Literaturegeek, MKarlsssson, Natureium, SamuelBurckhalter, ToveK65, and WhatamIdoing: I would like to alert involved parties to a conversation on my talk page regarding my temporary semi-protection of this page. Hopefully we can centralize further discussion on the article here on its own talk page. Best, Airplaneman ✈ 21:41, 16 December 2018 (UTC)

Airplaneman, note that @AndersBirzulis, MKarlsssson, SamuelBurckhalter, and ToveK65: are blocked as socks. Guy (help!) 01:45, 15 December 2019 (UTC)

Japanese source - verification failed

PMID 29386440 is in Japanese and the English abstract says very little that's helpful. If anyone is aware of an English translation could you put a link or alternatively add the relevant quotes where it is cited. If there's no verification then unfortunately the source will need to be removed/changed for another. Amousey (they/then pronouns) (talk) 12:43, 11 June 2020 (UTC)

WP:NONENG does not permit the removal of sources merely because some editors can't read them. Have you ever used machine translation to look at a source? WhatamIdoing (talk) 16:18, 17 June 2020 (UTC)

Recognition

User:WhatamIdoing I noticed your revert on recognition of MCS. Which organizations recognize it, and where could this fit on the page? Apologies if it's already covered, and I didn't see it. Amousey (they/then pronouns) (talk) 19:46, 5 June 2020 (UTC)

The standard for "professional organization" is that you create an organization (a matter of paperwork and a bit of money in the US) and that you declare that the members must have some relationship to a given profession. As a result, (quick web search) there are "professional organizations" such as https://iseai.org/ that seem to believe MCS is a chemical-caused thing.

BTW, the wording has to be precise there: you can "recognize" that your patient is sick without "recognizing" that your patient's sickness is caused by chemicals. You could even "recognize" that it's triggered by chemicals without recognizing that it was caused by chemicals. WhatamIdoing (talk) 20:24, 5 June 2020 (UTC)

Interesting. I was thinking specifically of those that clinical guidelines or diagnostic criteria, or established organizations providing info. I have seen there's an Italian Consensus Criteria for instance but don't know the background. I did a quick search and find these - will need to check reliability later though. There's a brief mention of the situation in Canada and Japanese proposed criteria on the page. I was expecting something on medically unexplained symptoms or somitization about it.

• Info here on organizations not accepting it AAFP
  

Symptoms from John Hopkins University look worth adding, and explains controversy and different views.

• Ontario / Canada may have some recognition. I will look into it another time.
• [Hojo 2019 https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0215144] Quick Environmental Exposure and Sensitivity Inventory - claimed to be used in 10 countries. Writing from Japanese perspective.
• Merckx manual
• WHO info on EHS - is that part of MCS or covered on a separate page?

If not much has changed since this report then there's some recognition from

• BSAEMN in the UK
• AAEM and AOCEM in the US
• 2018 review mentions some recognition from EPA and ADA in the US, plus Germany and Austria but that needs confirming.

Sounds like its worth a brief mention.

Interesting review turned up in a search too PMID: 30088144

Amousey (they/then pronouns) (talk) 01:44, 6 June 2020 (UTC)

A few quick replies:

• The AAFP source is from 1998. Too much has changed in the last 22 years for that to be useful.
  • Reliance on outdated sources is one of the big problems with the article at the moment. The Gots quote, for example, should probably be confined to the ==History== section.
• Electromagnetic hypersensitivity is a separate thing.
• The EPA and ADA are the other kind of "recognition". They're recognizing that people genuinely experience symptoms. The kind of "recognition" that the proponents want is a recognition that the ultimate etiology is 'chemicals' (and not, say, 'brain damage' or 'feelings' or 'sloth').
  • The focus on "recognition" is another problem in this article. Think about this as if it were a regular medical condition (i.e., a single clinical entity with reasonably consistent constellation of signs and symptoms), like back pain. Normally, we don't declare who "recognizes" any regular medical conditions. So why should this one get so much content about who "recognizes" it and who doesn't? Almost none of our readers have any training in nosology, so they don't even know what it means for a disease to be recognized. The American Medical Association ethics group, for example, says that the AMA doesn't actually have a role in "recognizing" diseases,[6] so why should we care that they didn't do for MCS what they don't do for any disease? (Also, much of this is out of date.)
• PMID 30088144 is in the new 'brain damage' line of thinking about MCS. It's in a good journal[7], and that POV (which is newer than most of this article) should certainly be represented better in this article.
• I think that medical school textbooks will be better sources than health websites. They may even be better than research papers here. WhatamIdoing (talk) 18:45, 10 June 2020 (UTC)

I think perhaps the way forward then is to reduce the text on recognition and not have a long list, just perhaps say "the majority including the AMA". I think a list like we have on the article affects the NPOV, as does the several mentions of Allergy - it's even in the illness name(s) used by all view points - Sensitivity / Intolerance. No need to debunk what isn't there. I think best to delete any allergy thing rather than confuse the issue. With there being so few resources that are detailed, I think they should be kept in regardless of age due to notabilty. There is a new Italian Consensus Criteria that needs to be added as a secondary source, but I think it's from 2019 so too early to know what impact it will have. There's an English version and it's clearly been developed with an aim to be suitable for international use. Amousey (they/then pronouns) (talk) 19:10, 10 June 2020 (UTC)

• We should not include the AMA. Read this to understand why.
• The "allergy thing" should be in the ==History== section. The guy who started this idea insisted that it was an allergy, just like people have pollen allergies. WhatamIdoing (talk) 19:29, 10 June 2020 (UTC)

• Italian consensus (English version) - pdf Amousey (they/then pronouns) (talk) 19:18, 10 June 2020 (UTC)

References

I can't find a source for the allergy thing, is it a reference to the "total allergy syndrome" name? Or "All allergy syndrome" mentioned in Drexler 2019? Harrison's book chapter is used extensively but I can't find it online to verify what it says - can you access it? It's also from 2004 so it would be better to use a new source or systematic review for those points where possible. I am in favor of moving old stuff to history but didn't see a quote from Gots in the text. The MCS workshop looks like a source for some history. Amousey (they/then pronouns) (talk) 11:40, 11 June 2020 (UTC)

The Harrison chapter is from 2014, not 2004. The Gots quotation is in the footnote.

I had access to Harrison when I added it; I don't know whether it's still easy to get to. I can go look later. If you want a copy, you might try your local interlibrary loan service. WhatamIdoing (talk) 18:46, 17 June 2020 (UTC)

Most widely used

The cited source says, "Currently, the Cullen criteria,6 with or without Lacour revision,7 and the year 1999 criteria of the consensus8 are the most accepted." Depending upon how you count it, that means that these two or three sets are the most common. However, this source does not actually say whether Cullen's 1987 is more widely used [by researchers] than the 1999 criteria. WhatamIdoing (talk) 20:48, 17 June 2020 (UTC)

I think I read this source and it did not clarify which Cullen one was more common, so I think it was basically saying there was a split between three possible criteria, with the two from Cullen being similar (Cullen's original is the one that stated a prior known excessive exposure incident was needed). It seems better to give the possibilities since it's clear some criteria are being disregarded almost entirely. Amousey (they/them pronouns) (talk) 23:01, 23 June 2020 (UTC)

Reputable sources please

Implicit in WP:MEDRS are high impact journals (not just any journal) and reviews that are highly cited. --Smokefoot (talk) 15:18, 23 June 2020 (UTC)

Is there anywhere besides Scopus worth using to check impact factor? If I am asking this in the wrong place then please let me know where to ask.

Also I want to clarify something: impact factor is partly / largely a measure of popularity in citing - and some topics are more popular than others. I have noticed that the top journal in one category may have a lower impact factor that a journal near the bottom in a different category. Impact factor sometimes isn't comparable. The Lancet is top of 500ish general medicine journals, but top out of 1000 in Cultural studies is the Journal of Peasant Studies which has a tenth of the impact factor, and even across medical categories there are great differences in impact. Biases are possible due to things like which publish in English or multiple languages too. So surely if there is a quality secondary source like a systematic review in a journal with a good impact factor for its category but a low impact factor in comparison with journals in a different category, MEDRS still considers this a good quality source? (I am asking this as a relatively inexperienced editor rather than having specific things in mind on this topic). Amousey (they/them pronouns) (talk) 00:00, 24 June 2020 (UTC)

Smokefoot, MEDRS does not require only "high-impact" journals. It is not even an "implicit" idea. The use of Wikipedia:Impact factors, especially as the sole determinant, has been discussed and repeatedly rejected. There is nothing wrong with citing a review article that was published a middle-tier journal.

If you are trying to evaluate a journal, then you may find that https://www.scopus.com/sources is useful. The main advantage that Scopus' approach has is that you can see how the journal ranks compared to other journals in the relevant field. This prevents apples-to-oranges claims, such as that the best journal in one field is somehow better or worse than the best journal in a field with different characteristics.

Scopus' rankings are also helpful, because if you are looking for a rule of thumb, then the rule supported by actual research is that journals in the bottom quintile tend to have problems with copyvios and plagiarism, which the researchers took as a marker for the journals having insufficient editorial oversight. WhatamIdoing (talk) 21:31, 25 June 2020 (UTC)

Recent changes

I saw the recent changes that got reverted and thought it worth starting a discussion. Discussing changes per section might be easiest. Seems like WP expects sections to be updated before any changes to the lead. I haven't made the time to read up on the details of the reverted edits and their sources. Amousey (they/them pronouns) (talk) 23:20, 23 June 2020 (UTC)

Here are two small changes that could be discussed:

• "MCS is not an allergy" – It isn't, and it has been claimed to be. The direct statement is probably more useful/educational than a technical statement about immune markers.
• 'Some experts attribute the symptoms to depression, somatoform disorders, or anxiety disorders. – This had been incorrectly tagged as needing a non-primary source, but the cited source is a review article. A more recent source would be appropriate.

WhatamIdoing (talk) 22:04, 25 June 2020 (UTC)

The German thing

Someone tried, in good faith, for approximately the zillionth time, to add a claim that the German government recognizes MCS as a single, discrete, non-psychiatric disease. The sentence in question was copied straight from a MCS website.

The main problem is that it's not exactly true. AFAICT basis for this claim is that a MCS patient wrote to the Austrian (remember, Austria is not part of Germany) health system to find out what medical billing code should be used for MCS patients whose doctors want to get paid. The reply has been scanned and posted all over the internet. The letter says that Austria uses the same set of billing codes as Germany (large countries create their own custom variations of the ICD, and smaller ones mostly copy their neighbors to save the expense of creating their own), and the Austrians will pay for MCS-related medical services billed under T78.4, which is a catch-all category for all unknown/unspecified apparent reactions to anything – or nothing.

So on the theory that the best defense is a good offense, I've expanded the ICD section to cite a recent journal that discusses the problem of which billing codes to use, and provided basic background information. I hope that will both educate people on the actual situation, and discourage them from repeating misleading claims. WhatamIdoing (talk) 17:23, 14 August 2020 (UTC)

Today's changes

Today's changes are welcome in my opinion as a person who has had MCS for 25 years. Exceptional job supporting every statement with a reference from current literature. The opening to the article now contains no statements contradicting my lived experience. The opening to the article also no longer contains any of the (my opinion) disinformation about MCS traceable to the 1990s chemical industry litigation defense effort led by ESRI / Ron Gots.

Fstevenchalmers (talk) 06:54, 15 June 2021 (UTC)

Disappointed of course to see the pendulum has swung back to the skeptical view of MCS essential to the chemical industry litigation defense interests. Sigh.

Fstevenchalmers (talk) 23:03, 17 September 2021 (UTC)

Symptoms

The article, first paragraph included, states symptoms as vague and nonspecific. However, There is starting to be statistically significant data on symptoms. Therefore, I move we update the Introduction and symptoms section to include modern scientific research. Please post your articles (with actual numerical data) on symptoms here, and we can discuss how to integrate the data into a more up to date description of symptoms. I'll go first:

https://doi.org/10.3390/ijms21061915 Electrohypersensitivity as a Newly Identified and Characterized Neurologic Pathological Disorder: How to Diagnose, Treat, and Prevent It

Silliestchris (talk) 23:43, 17 September 2021 (UTC)

That article by Dominique_Belpomme and Philippe Irigaray also focuses on another unrecognized condition, Electromagnetic hypersensitivity (EHS), published in a predatory special issue in MDPI, which has been listed as a predatory publisher. Dominique Belpomme is a fringe individual and promoter of EHS. The wiki article presently states, "Although these symptoms can be debilitating, MCS is not recognized". What, exactly, would you like to add that's not already in the article? ScienceFlyer (talk) 03:20, 18 September 2021 (UTC)

I have process concerns with this response, which in other contexts would be appropriate.

Concern that Silliestchris cited EHS data rather than MCS data.

Legit concern on your part ScienceFlyer about the credibility of 2nd tier journals.

However, there was an active effort 25 years ago by Gots/ESRI pressuring the mainstream journals to put any discussion of MCS as a physical ailment off limits. This successful PR effort paid for by special interests has the effect, to this day, of making it difficult to publish on MCS in a 1st tier journal. So saying the data isn't credible because it's in a second tier journal creates a catch-22 where this Wikipedia article's sources are constrained to be the ones who were (and quite possibly still are) discouraged from publishing on this topic. That is no excuse for writing color words in a Wikipedia article which cause a reader newly exposed to the topic to emotionally reach the conclusion that reported MCS is always psychological. That was the PR conclusion ESRI and Gots were paid to cause academia, government policy, and the courts to conclude. It's a conclusion inconsistent with the facts of my life over the last 25 years, and inconsistent with the facts as reported by researchers who believe patients like me in the lesser journals to which they have access.

So I believe that invoking "unrecognized" (which exhibits bias on your part) followed by dismissing the class of journals in which facts such as I experience can be reported, in the context of what ESRI did 25ish years ago, has the effect of entrenching ESRI's disinformation of that era into Wikipedia. This is my process concern.

Separately, and as background, MCS as I experience it, and EHS as it has been explained to me by those who experience it, simply cannot occur given the basic theory underlying not just the practice of medicine today, but also underlying all medical research today. I will grant you both of those statements. The conclusion the overwhelming majority of physicians reach when faced with a patient reporting something which simply cannot occur given the basic way of thinking they were taught in medical school and their residency is to disbelieve the patient. And the literature is full of such people who disbelieve their patients talking with each other in an information bubble which excludes the patients and their experiences. I will grant there's a lot of literature like that. Reality is that the theory is wrong; the theory needs a fix as big as Pasteur and the whole infectious disease model; by the way that new theory will also explain 5-10 other syndromes medicine really can't explain today; and it is impossible to take a leap that big within the medical research world today. So if you're one of the physicians trying to force this article to conform with what you were taught in med school, we have different facts and will never agree. So let's agree to take all the color words and bias out of the article and report only facts.

Fstevenchalmers (talk) 05:16, 18 September 2021 (UTC)

Dear "Science"Flyer, I find your lack of references alarming. If this were writing submitted to me by a student, the grade would be F. I find the following logical problems in your reply:

1) Referring to Belpomme as a fringe individual is opinion, not fact, so this is an irrelevant comment. However, Belpomme works for the European Cancer and Environment Research Institute, and the Association for Research and Treatments Against Cancer. Doesn't sound very fringey to me.

2) Can you please cite the article published by Belpomme in MDPI? Would love to check it out.

I am aware of Belpomme's work on EHS, which is even more controversial and poorly understood than MCS. However, in the paper I cited, Belpomme publishes a significant dataset on specific clinical symptoms experienced by people with MCS only. This is why I provided it as a springboard for the discussion.

In regard to your question, I would like to add the extensive list of specific symptoms and appropriate references. The specific symptoms found by several researchers, such as belpomme, who found symptoms include (in descending order of prevalence):headaches, fatigue, concentration/attention deficiency, dysesthesia, memory loss, dizziness, myalgia, insomnia, ocular deficiency, balance disorder, and tinnitus. This specificity is also at odds with symptoms being "vague and nonspecific", so I would like to correct this as well.

Silliestchris (talk) 04:31, 18 September 2021 (UTC)

Silliestchris To be clear, according to the Cambridge Dictionary, "A non-specific disease or condition does not result from any one particular cause". All the symptoms you list are non-specific. It's not necessary to list every non-specific symptom attributed to MCS because any symptom can be attributed to MCS. MCS can be whatever someone wants it to be. ScienceFlyer (talk) 07:51, 18 September 2021 (UTC)

ScienceFlyer If that were truly the case, then since the symptoms of a low grade virus are indistinguishable from the symptoms of a low grade poisoning, it would be inappropriate for the medical profession to have trained physicians to always diagnose the virus when the patient presents with those non specific symptoms. My contrary view is that it is permitted for MCS to exist, and to be diagnosed, despite the symptoms being non specific. Diagnosing MCS will remain a matter of physician training and judgment until such time as there is an objective measure of the nervous system malfunction, which cascades to observable symptoms in some aspect of the body which is semi repeatable for a given patient. Just as diagnosing epilepsy was "impossible" and considered psychosomatic for millennia before the invention of the EEG. Dismissing patients with real suffering and real disability because the symptoms are inconvenient to diagnose seems inconsistent with "Physician, do no harm." If I could learn to distinguish an MCS reaction from childhood illness and acting-out/laziness in my then 3 and 7 year old children in the aftermath of my sick house 25 years ago, then I assure you with proper training a physician can as well. And I'm just a retired computer designer whose degrees are in Electrical Engineering.

The fact that science and medicine were unable to create a sufficient case definition for MCS (although the late 1990s case definition was pretty good) does not mean MCS does not exist, it means medicine is incapable at this time of thinking about the class of problems which include MCS from a suitable point of view. Kind of like in my profession trying to describe how a radio works in time domain, when it's trivial to explain in frequency domain. Just as medicine lacked the basic concepts to explain infectious disease before Pasteur, medicine today lacks the basic concepts to explain MCS, EHS, and 5 to 10 other symdromes all of which involve flaky, individual, semi repeatable malfunctions of individual body processes, usually centered in some aspect of the nervous system. In computer design we ran into a set of these problems in the 1970s when I was in college; they confused really smart people for about 5 years as they struggled to find logic errors where there were none; after about 5 years they found the right point of view. MCS has been baffling mainstream medicine for 140 years, minus the derivatives of Theron Randolph's work 60ish years ago which was sent into exile. It's not a logic error.

Fstevenchalmers (talk) 12:27, 18 September 2021 (UTC)

I would add the first five articles from Dr. Anne Steinemann's bibliography to this list as well, but they are primarily about prevalence rather than effects.

https://www.drsteinemann.com/publications.html Fstevenchalmers (talk) 01:43, 18 September 2021 (UTC)

Not idiopathic environmental intolerances

The lede stated that this unrecognized diagnosis is also known as idiopathic environmental intolerances (IEI). This is incorrect. Since the subject has no diagnosis code, as it is not accepted in mainstream medicine, it has been proposed to use the idiopathic environmental intolerances (IEI) diagnosis code in lieu. Ifnord (talk) 20:39, 20 February 2021 (UTC)

It's still a verifiable other name.

MCS is not entirely "rejected" by mainstream medicine. It is accepted that these people are sick, sometimes to the point of being fully disabled. It is accepted that people experience symptoms when they can detect exposure.

It's really only the exact mechanism of pathogenesis that is rejected. Multiple different ones have been proposed over the decades. WhatamIdoing (talk) 05:50, 2 March 2021 (UTC)

While successfully accepted in the academic community at the time, remember that the name "Idiopathic Environmental Intolerance" was coined by the chemical industry litigation defense effort. The motivation was presumably disconnecting MCS from "chemical", and of course making it clear that the syndrome's cause is unknown rather than poisoning by chemicals such as pesticides or formaldehyde. I think the objection is to the disinformation origin of the name.

Fstevenchalmers (talk) 07:11, 15 June 2021 (UTC)

MCS is the official name used in medical literature and diagnosis for MCS. Some doctors refer to it alternatively as IEI and some refer to it alternatively as TILT . As neither IEI or TILT are officially used, in order to remain impartial, the article should include neither TILT nor IEI or include both TILT and IEI. If the decision is made to include both of these alternative and unnoficial names, scientific literature proposing and discussing the terminology should be cited for each, otherwise they are merely hearsay.

Silliestchris (talk) 21:48, 17 September 2021 (UTC)

I think Claudia Miller, the researcher who sacrificed her career over co writing the book "Chemical Exposures" 30ish years ago, was brilliant in creating the term TILT (Toxicant Induced Loss of Tolerance). The name is correctly neutral as to whether the toxin comes from nature or from the chemical industry, and makes no statement about what is happening in the person other than that tolerance has been lost. With the support of the Hoffman Foundation we are now seeing real science articles like https://link.springer.com/article/10.1186/s12302-021-00504-z focused solely on TILT which does not bash a particular source of toxin but rather is inclusive of a wide range of human experience. So I have no problem with the TILT label as opposed to MCS for what I have experienced for the last 25 years. As I mentioned above, my only objection to IEI is its origin in the chemical industry litigation defense disinformation effort, and the unethical way an obscure subsession on an obscure topic at a UN/academic conference was hijacked to introduce the term IEI.

Fstevenchalmers (talk) 23:15, 17 September 2021 (UTC)

Well, I don't exactly agree that TILT doesn't assign a cause to the illness. Rather, TILT ascribes the mechanism to be "toxicant induced" whereas IEI calls the mechanism "idiopathic". Now, in 2021, Each name has come to symbolize each side of the hotly divided discussion. Therefore we need to include both in the first paragraph, or none.

Fstevenchalmers, as the only other individual on the talk page to comment on the term IEI, would you be opposed it I changed the following:

"Multiple chemical sensitivity (MCS), also known as idiopathic environmental intolerances (IEI)"

to

"Multiple Chemical Sensitivity (MCS), also known as Toxicant Induced Loss of Tolerance (TILT), and Idiopathic Environmental Intolerances (IEI), "

?

Silliestchris (talk) 23:34, 17 September 2021 (UTC)

I support the change as you describe. (MCS aka TILT aka IEI, spelled out). Fstevenchalmers (talk) 00:04, 18 September 2021 (UTC)

I support including both alternative names. Connecting the dots is educational. Janraison (talk) 04:20, 18 September 2021 (UTC)

The TILT wikipedia page redirects here, to the MCS page:

Where it says:

"Toxicant-induced loss of tolerance From Wikipedia, the free encyclopedia Redirect page

Multiple chemical sensitivity From an alternative name: This is a redirect from a title that is another name or identity such as an alter ego, a pseudonym, a nickname, or a synonym of the target, or of a name associated with the target. This redirect leads to the title in accordance with the naming conventions for common names to aid searches and writing. It is not necessary to replace these redirected links with a piped link. If this redirect is an incorrect name for the target, then

• From an incorrect name: This is a redirect from an incorrect name, that serves readers as a good search term. The correct name is given by the target of the redirect.
  • Pages that use this link should be updated to link directly to the target without the use of a piped link that hides the correct details.

should be used instead."

Roxy the Dog, ScienceFlyer, as you have rejected my previous attempt to correct this mistake by mentioning TILT as an alternative name, how do you suggest we repair this inconsistency?Silliestchris (talk) 19:52, 21 September 2021 (UTC)

Section "Possible causes"- mistakes.

The first line is biased, incorrect, and has no citation:

"There is a general agreement among most MCS researchers that the cause is not specifically related to sensitivity to chemicals"

Actually looking at the research shows there is no such agreement. The MCS research community is, in fact, quite divided over whether the condition is caused by chemicals.

Rather than force you guys to look through dozens of citations, I refer you to a recent review on MCS in the Journal of Occupational and Environmental Medicine:

10.1097/JOM.0000000000001215

In this high impact article (45 citations since 2018), Rossi & Pitidis conclude:

"From the analysis of the results observed in the current review, it is difficult to assess the weight of the self-induced psychological component compared with the physiological one..." and "As highlighted in the above indicated studies, the analysis of the patient at anamnestic and etiological level is of great importance. In particular, it should be inquired about the differences in timing and mode of manifestation between endogenous psychiatric syndromes and those caused by chemicals in order not to err on the diagnosis, as symptoms can overlap. In this regard, more information gathering would be useful in order to perform longitudinal epidemiological studies."

So basically, there is no consensus or agreement. Could be physical, could be psychological, chemicals might be involved, we don't know. More research is needed.

I suggest we change the first line to

"There is no general agreement on the cause of MCS among researchers ,"

Silliestchris (talk) 03:57, 18 September 2021 (UTC)

SUPPORT. Well stated, @silliestchris, that is a better summary.

Janraison (talk) 04:42, 18 September 2021 (UTC)

(ScienceFlyer) can you please comment on the change we are discussing here?

Silliestchris (talk) 18:26, 21 September 2021 (UTC)

(ScienceFlyer) I still haven't heard from you, can you please comment on the discussion here, or should I just go ahead and make the edit?Silliestchris (talk) 00:38, 22 September 2021 (UTC)

New section: Status in Canada

Hello all, I think I can be very helpful by adding a short section on the official government status of MCS in Canada, which includes a 2014 decision by the Canadian Human Rights Commission . Silliestchris (talk) 23:37, 21 September 2021 (UTC)

References

Does this document exist? The links don't work. Alexbrn (talk) 03:42, 22 September 2021 (UTC)

Alexbrn I checked the link and it worked, what does it show when you click it? Silliestchris (talk) 04:58, 22 September 2021 (UTC)

They seem to work now. Must've been some problem somewhere. Anyway, this is now moot per the discussion in the section above. Alexbrn (talk) 05:37, 22 September 2021 (UTC)

Narrative Bias of Multiple Chemical Sensitivity Wikipedia Page

It has come to my attention that this page does not accurately reflect the total and rapidly advancing state of knowledge in Multiple Chemical Sensitivity (MCS).

MCS is a highly controversial illness, with researchers hotly divided. However, the views of only one side of the debate appear to control the narrative on Wikipedia's page. For example, when one searches Toxicant Induced Loss of Tolerance (TILT) in Wikipedia, you are automatically redirected to the MCS page. However, there is no mention of TILT anywhere on the MCS page. I discussed this on the talk page and everyone who participated in the discussion agreed that TILT should be added beside IEI. This was immediately undone by another user who had not participated in the discussion. This is just one example, overall the entire MCS page is full of unreferenced and improperly referenced opinion statements, some of which are completely false (eg, "unrecognized").

Even a single example of MCS being recognized by a governing body would invalidate use of the word unrecognized, particularly in the first sentence. A very strong example is the Canadian Human Rights Commission . These references prove that MCS is officially recognized at the federal level by a G8 country of over 30 million people.

This is only my introduction to the bias on this page. I will continue with a systematic review of the inaccuracies and opinion statements. I hope to repair the biased narrative without escalation to other Wikipedia checks and balances, as the current version of the MCS page is in flagrant violation of Wikipedia's Neutral Point of View policy.

Silliestchris (talk) 18:20, 21 September 2021 (UTC)

There is no reliable source showing that TILT is a widely recognized synonym for MCS. People with disabling symptoms and intolerances are frequently accommodated by governments. This does not mean that MCS is a medically recognized diagnosis. I would be fine with adding a well-sourced line about governments accommodating people who believe they have MCS. ScienceFlyer (talk) 00:08, 22 September 2021 (UTC)

The TILT people, in this explainer Comparing TILT to Multiple Chemical Sensitivity (MCS) or IEI , talk about the relationship between the terms TILT, MCS, and IEI. They also discuss the bias against patients which has come from the use of MCS and IEI as they reason they prefer TILT. Remember, this is Claudia Miller's work.

I do not believe there is a credible position which does not allow TILT to encompass, or be treated as a synonym for, MCS and IEI, based in facts. I do believe someone with editor bias to keep MCS fringe, for which position there is an extraordinary level of not just support but also need in certain circles, would advance this argument. So would someone who genuinely believed in the 1960s decision to exile Theron Randolph's research and all its descendants from mainstream medicine. But that's a belief, not a set of facts.

Fstevenchalmers (talk) 02:57, 23 September 2021 (UTC)

ScienceFlyer I think I see the misunderstanding. Although it may be true that MCS is not recognized medically (I will have to look into this more), legal recognition is a different matter. Now that I have shown that it is recognized by a legal body (The Canadian Human Rights Commission), perhaps we can add the modifier "medical" in front of the word unrecognized? Without this specificity, the naked word "unrecognized" implies that nobody anywhere recognizes it. Unrecognized? Unrecognized by whom? This is very confusing. Specificity is best for clarity and neutral point of view.Silliestchris (talk) 00:26, 22 September 2021 (UTC)

Alexbrn Please explain why you think Canadian stuff is irrelevant? Environmental illness redirects to this page. https://en.wikipedia.org/w/index.php?title=Environmental_illness&redirect=no. It would have been constructive to fix the references instead of simply deleting them. This is disruptive editing. I will add back the additions of knowledge to this page, now.Silliestchris (talk) 03:57, 22 September 2021 (UTC)

The term is Environmental sensitivity, not "illness". Looks like it might mean the same thing. Anyway what you added was undue and editorialized; I have trimmed it into a more due/NPOV state. Alexbrn (talk) 04:06, 22 September 2021 (UTC)

(Add) Looking at this further, the Canadian 2007 linked document, although not MEDRS, lists 36 aspects and overlapping conditions for what is included under "Environmental sensitivities", of which MCS is only one. So the terms are non synonymous and this is irrelevant/undue without some high-quality secondary sourcing to explain. Also, Silliestchris you are edit-warring. Please gain consensus for desired changes that are disputed per WP:ONUS. Alexbrn (talk) 04:20, 22 September 2021 (UTC)

Alexbrn You still have not explained why Canadian policy on MCS, a G8 country with a population of 30 million, is not relevant on this page. Undoing these contributions are not constructive (https://en.wikipedia.org/w/index.php?title=Multiple_chemical_sensitivity&oldid=1045730353). Please stop your disruptive edits. Silliestchris (talk) 04:20, 22 September 2021 (UTC)

I have, see above. It's not a "policy on MCS". Alexbrn (talk) 04:22, 22 September 2021 (UTC)

Alexbrn, it is true that chemical sensitivity is a specific subtype of environmental sensitivity, as defined here in Canada. Environmental illness/sensitivity are a broader term which encompasses any type of sensitivity to one's surroundings which may include heat, noise, chemicals, etc. You said yourself that MCS is included in the linked 2007 Canadian document, so if the CHRC policy applies to environmental sensitivities, then it applies to each type of environmental sensitivity of which MCS is one, as you specifically stated. Please comment.Silliestchris (talk) 04:56, 22 September 2021 (UTC)

WP:SYNTHESIS and original research are prohibited. By your argument you would be able to insert an identical section into 36 articles, including (e.g.) Asthma. We need to reflect good sources which are specific to this topic, or find good sources which directly relate the broad Canadian position to MCS. We can't just smudge it based on a Wikipedia editor's agenda. Alexbrn (talk) 05:00, 22 September 2021 (UTC)

Alexbrn, oh, I understand now. Ok, so now that we know environmental illness is not the same as MCS does it make sense that page would redirect here?

https://en.wikipedia.org/w/index.php?title=Environmental_illness&redirect=no

Also, the Wikipedia page on environmental sensitivity is definitely not what this Canadian document is describing, would you oppose creation of a disambiguation page where I talk about environmental sensitivity in the context of the CHRC and other Canadian agencies that use this term?

https://en.wikipedia.org/wiki/Environmental_sensitivitySilliestchris (talk) 05:15, 22 September 2021 (UTC)

Huh? You're the only person using the term "environmental illness". The Canadian term is "environmental sensitivities" (which usage seems Canada-specific and out-of-tune with the wider world, in any case). Alexbrn (talk) 05:33, 22 September 2021 (UTC)

Alexbrn ok, let's focus on environmental sensitivity for now:

The Wikipedia page on environmental sensitivity is definitely not what this Canadian document is describing, would you oppose creation of a disambiguation page where I talk about environmental sensitivity in the context of the CHRC and other Canadian agencies that use this term?

https://en.wikipedia.org/wiki/Environmental_sensitivitySilliestchris (talk) 05:36, 22 September 2021 (UTC)

I have added a top note at Environmental sensitivity. Please ensure you WP:INDENT your Talk page posts. Alexbrn (talk) 05:43, 22 September 2021 (UTC)

Alexbrn, you yourself have said that environmental sensitivity is not multiple chemical sensitivity, as it encompasses 36 different sub types. Wouldn't you need a high quality source stating that environmental sensitivity is MCS in order to do a blanket redirect like you did in your previous edit? Since environmental sensitivity is not the same thing as MCS, as you have previously stated, shouldn't it have its own page?Silliestchris (talk) 05:48, 22 September 2021 (UTC)

Quoting Alexbrn:

"Looking at this further, the Canadian 2007 linked document, although not MEDRS, lists 36 aspects and overlapping conditions for what is included under "Environmental sensitivities", of which MCS is only one. So the terms are non synonymous and this is irrelevant/undue without some high-quality secondary sourcing to explain."Silliestchris (talk) 05:51, 22 September 2021 (UTC)

What do you mean? I have not created any "blanket redirect" (whatever that means). Alexbrn (talk) 05:59, 22 September 2021 (UTC)

You said it yourself right above here, that environmental sensitivity is not multiple chemical sensitivity. Therefore, environmental sensitivity should not redirect to multiple chemical sensitivity. Here, I'll correct it for you. I see you didn't discuss that in the talk page of environmental sensitivity.Silliestchris (talk) 06:07, 22 September 2021 (UTC)

There is/was no "redirect". The terminology is messy and I created an explanatory note and link to help readers navigate the mess. There is no need to discuss such edits before making them, and your reversion for this reason actually is disruptive and unhelpful. Alexbrn (talk) 06:12, 22 September 2021 (UTC)

The whole reason you got involved is because you think my Canadian citations from the CHRC are irrelevant, mainly because environmental sensitivity does not mean multiple chemical sensitivity. So I am trying to find an appropriate home for these citations. Authors in research in the USA use the term environmental sensitivity, as well. See the following article as an example:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315542/

Silliestchris (talk) 06:24, 22 September 2021 (UTC)

The appropriate home is Disability in Canada. Or maybe Canadian Human Rights Act, although the assertion that "environmental sensitivity" is covered by this Act, appears to be false. Alexbrn (talk) 06:28, 22 September 2021 (UTC)

It would be suitable there, but what I am more concerned with is the lack of a page on environmental sensitivity, which is a term we just discovered is used in both the USA and Canada.Silliestchris (talk) 06:32, 22 September 2021 (UTC)

It seems ill-defined, and was addressed to some degree by the hat note you deleted. Your desire to create a new page is no reason to damage other pages. Alexbrn (talk) 06:48, 22 September 2021 (UTC)

You were very clear that environmental sensitivity does not mean multiple chemical sensitivity, therefore referring readers with that hat would be misleading... by your own logic. However, if you believe that referring readers from environmental sensitivity to multiple chemical sensitivity is appropriate, then references discussing environmental sensitivity in that context would be suitable on this page.Silliestchris (talk) 06:54, 22 September 2021 (UTC)

"therefore referring readers with that hat would be misleading" ← False. Linking to a page does not indicate that the linked concept is identical; the topics are however related, in a messy topic space. The note would help readers find what they might be looking for. You seem to be intent on ... something, but whatever it is, is not productive. Alexbrn (talk) 06:59, 22 September 2021 (UTC)

Concur with Silliestchris that the existing MCS page (and its history for more than a decade) have narrative bias.

After thinking about this, I think it's a difference of opinion between people like me affected by MCS who know it's real, and the common belief in medical circles which is that it's fringe. Unfortunately, the belief that it's fringe originated, at least in part, in the quite successful chemical industry litigation defense disinformation campaign of 25-30 years ago, which was able to affect the medical literature, propose a false black and white duality of physical vs psychological, and then create the illusion of consensus around psychological in the literature, then (through a separate actor) went to the medical boards in all 50 states to shut down even a single instance of diagnosing MCS as quackery, and finally put together a legal package which helped defendants include MCS-is-psychological expert witnesses and exclude as fringe MCS-is-real experts. Legal home run.

So we're going to need to face this "is this an issue of neutral tone" vs "is this an issue of MCS being seen as fringe by some constituencies" head on in this discussion.

As someone who has had MCS for 25 years I am at least an interested party here, so can't be the person who makes the decision whether this is the right decade to put neutral tone in the Multiple Chemical Sensitivity page.

Fstevenchalmers (talk) 13:07, 22 September 2021 (UTC)

In any case, you are starting at the wrong place. Wikipedia is not a shortcut. The Wikipedia page will take the same stance as the reliable sources do. As long as "medical circles", as you call it, agree that MCS is probably not organic, the page will say it. You have to start by convincing them first, then Wikipedia will follow. Since your reasoning have been too weak in the past to do that, there is not much chance of that to happen in the future either. --Hob Gadling (talk) 17:33, 22 September 2021 (UTC)

Oh I fully understand that Wikipedia is not the place to publish hypotheses or debate science. Wikipedia is an encyclopedia and reports only fact as established in the relevant literature. I have been biding my time for over a decade on this article. We now have about 5 years of papers, in peer reviewed journals, indicating that what is reported as MCS can have a physical basis. Wikipedia has, over the years I have bided my time, chosen to have very non neutral language Wikipedia:Neutral point of view in this article on Multiple Chemical Sensitivity. I believe this is because the consensus of editors has been that Multiple Chemical Sensitivity is fringe Wikipedia:Fringe theories . I am asserting here that it is time to, in the open, based on the new peer reviewed data, reopen the question of whether this article should be in neutral tone reporting only facts, or if it should continue to include color and judgment words, that is, continue the non neutral tone of at least a decade, on the assumption that MCS remains fringe. I take it from your response that you believe MCS remains fringe. I happen to believe it's time for this article to take neutral tone.

Separately, MCS and TILT are the same patient experience reported through two different viewpoints. TILT in Wikipedia refers to this page. TILT was named by Claudia Miller, who co wrote the book "Chemical Exposures". I believe the recent dispute over including TILT in the opening of this article indicates an editor bias to continue marginalizing MCS as fringe. I want that editorial decision made in the open, by consensus, and not by default.

Fstevenchalmers (talk) 01:39, 23 September 2021 (UTC)

I think you need Conservapedia, they appear to have the same ideas as you with regard to what neutral means. -Roxy the sceptical dog. wooF 05:12, 23 September 2021 (UTC)

Nonconcur. The family members or employer of a person suddenly experiencing TILT, upon reading this article, will get the emotional impression that their family member or employee has simply gone crazy. This is accomplished with color words throughout the article. This *is* the agenda of the special interests who funded unethical PR work by ESRI 25 years ago, and whose interests still exist. The result of this perception, although I'm not remotely saying the perception comes just from reading Wikipedia, frequently leads to both non-support by family and unemployment. The result is also officials, including the legal system, disbelieving that chemical injury has occurred or is occurring. So this article has far more consequences to far more people's lives than a normal fact based Wikipedia article. Oh, and I'm immune to personal attacks.

A neutral article Wikipedia:Neutral point of view would say that people report these experiences, and that there is disagreement between theories such as TILT which say a change happened in the body's ability to tolerate some substance as the result of exposure, and the theory that such reports are always psychosomatic. And then the article would stop.

Fstevenchalmers (talk) 06:32, 23 September 2021 (UTC)

"It" (MCS) is not "fringe", what's fringe are certain aspects of the topic, including ideas about the cause of symptoms. As the overview in pmid:32058864 (2020) puts it:

Firstly, there is a lack of convincing evidence for the role of any physiological dysfunction caused by exposures to the environmental factors that could explain the symptoms. Secondly, carefully blinded exposure studies have shown that afflicted persons cannot reliably distinguish real from sham exposures and that symptom reporting in these studies is critically depending on (veridical or illusionary) knowledge that exposure took place [19]. Thirdly, a large array of well controlled experimental studies has demonstrated that expectation induction, either by associative learning (i.e. Pavlovian conditioning) and/or informational manipulations can cause the symptoms, both in healthy subjects and in afflicted persons

So long as this article remains reality-based per good sources, all shall be well. Alexbrn (talk) 06:16, 23 September 2021 (UTC)

We cannot have the debate about causes of symptoms here. I absolutely agree that we need to stay reality based with good sources, and that it is the availability of good sources on the TILT/MCS recognition side which will pace any change in the tone of this article from "MCS is fringe" to "MCS is real but we just don't understand it". I believe the quoted section from the overview is (1) based on literature over 5 years old and (2) more one sided than the literature supports, and what would have been written on behalf of the special interests whose talking point is "MCS is always mental illness".

Citing those studies, in that form, tells the reader "MCS is always psychological." I know from personal experience as a fact that's simply not true, but my knowledge and experience is inadmissible in Wikipedia debate. Do you understand now my preference for a short Wikipedia:Neutral point of view article?

Note for full disclosure that I am the utterly-without-credentials author of a hypothesis about how MCS works which is such heresy as to be not just unpublishable but un discussable in relevant science circles. That gives me a view of the topic, and those studies, inadmissible in Wikipedia debate.

Fstevenchalmers (talk) 06:59, 23 September 2021 (UTC)

To repeat, MCS is not "fringe". It's a real problem irrespective of its nature, and has fringe aspects. You appear to be here to WP:RGW. If you're saying literature from 2020 is somehow too old, that would seem peculiar given the dearth of reliable recent sourcing on this topic. If the literature is "wrong" in your view, Wikipedia shall be similarly wrong in reflecting it. That is neutrality. In any case, this entire section has meandered and one editor has already been indefinitely blocked. If there is a proposal for change, could it please be stated precisely with some text and source. Alexbrn (talk) 07:31, 23 September 2021 (UTC)

There are, of course, proposals for change, and quite a number of them. There were also numerous sources. But nobody seems to bother reading through the studies ... -- Brackenheim (talk) 13:17, 23 September 2021 (UTC)

Thank you for acknowledgement that MCS is not "fringe". To be crisp and clear, I am here to do what I said on this talk page 2 years ago: replace this article with a short, fact based article in what I now know to call Wikipedia:Neutral point of view. It remains my perception that this page has contained disinformation traceable to the ESRI anti MCS recognition PR effort of the late 1990s for many years, including naming the head of ESRI as an expert in an older opening paragraph of this article. My motive is to correct a long standing editing error of neutrality in this article, not to have the article change to give only the evidence from "my side". I am patient. The new science literature of the last 5 years may not be sufficient to carry the day is this argument in this year. But I believe the editors rejecting TILT as a synonym for MCS, and summarily rejecting all new literature cited, in reversions over the last week are not acting objectively, and I do not understand why. Both the chemical and insurance industries have deep financial reasons for not wanting MCS recognized, and the medical establishment would lose generational face if a physical cause were found and proven beyond reasonable doubt (ie Pasteur experiment proving existence of infectious disease). And MCS as I experience it simply cannot occur if one assumes the basic theory underlying the practice of medicine today is correct, which means there is extraordinary cognitive dissonance when a physician hears a patient like me describe history/complaint. I would like to understand if these editor decisions are made out of conservatism, out of bias which comes from cognitive dissonance, or (and I hope not) out of undisclosed COI.

Fstevenchalmers (talk) 01:26, 24 September 2021 (UTC)

Wow, that's a lot of attacks on unnamed editors. For the record, and to answer just your last sentence, had you considered the possibility that we are just following policy? -Roxy the sceptical dog. wooF 02:58, 24 September 2021 (UTC)

I apologize. Those words demean the work of the editors who create the Wikipedia I use almost daily in my life. That was never my intent.

For the record, for over 5 years now in various MCS support and advocacy forums, I've been a broken record saying again and again that Wikipedia is based on ground rules that truth is what's in the peer reviewed science literature, and if we want the Wikipedia MCS article changed we need to advocate for research, and the publication of that research; that that will take years; and that the Wikipedia editors are doing what they're supposed to with the science literature they have. Yes, I think you are just following policy.

I disagree with the decision in the last week to revert the synonym TILT out of the first sentence. The reasoning given for that action raised questions for me. I am too inexperienced as an editor to know how to cause debate on this point, on this page.

I disagree with the decision in the last week reject out of hand certain new science literature on MCS. I am not an academic, which means I might not understand something basic about sources.

I have raised an issue around neutral point of view, that the tone of overall writing in this article leaves a reader new to the topic with the perception that MCS is always psychological. I am too inexperienced as an editor to know how to cause debate on this point, on this page. I am certainly not going to start proposing detail edits to remove color words.

Is there a way anywhere in Wikipedia's process to flag a page as being on a topic of such importance to a special interest that special attention needs to be paid to ensure that page does not end up amplifying a PR message or disinformation?

Fstevenchalmers (talk) 23:39, 24 September 2021 (UTC)

There are indeed many unnamed editors, who post here. But each of these unnamed editors has contributed more to the content than all logged-in users together ... -- Brackenheim (talk) 21:17, 25 September 2021 (UTC)

Rapidly evolving state of knowledge in environmental medicine

I am wondering what y'all think of this new review article published in reviews on environmental health? (journal impact factor 3.5). It's a degruyter journal, so fairly trustworthy.

https://www.degruyter.com/document/doi/10.1515/reveh-2021-0043/html Sciencebuilder (talk) 19:03, 25 September 2021 (UTC)

Coauthor Riina I. Bray is pretty well-known as WP:FRINGE, so I'd urge caution in relying on it. ScienceFlyer (talk) 19:15, 25 September 2021 (UTC)

Basically, they conclude (after a systematic review) the following: "There are interacting and overlapping pathophysiological features of responses to environmental exposures that are associated with neurodegeneration and MCS. These include genotypes for detoxification, oxidative stress, systemic inflammation, disruption of the BBB, chronic pain, central sensitization, decreased cognition and upregulation of TRPV1 and TRPA1 receptors". I am wondering how this conclusion by the authors may affect statements in the current Wikipedia article?

Sciencebuilder (talk) 19:18, 25 September 2021 (UTC)

@ScienceFlyer:, really? I didn't know that. Where can one find info/consensus on who is a fringe author? Wouldn't a reputable journal have a vetting process for quacks? Sciencebuilder (talk) 19:26, 25 September 2021 (UTC)

Here she is making false claims about 5G wireless technology and electromagnetic hypersensitivity. 5G is no different healthwise than other wireless. ScienceFlyer (talk) 20:28, 25 September 2021 (UTC)

@ScienceFlyer: I have a question for you, which is probably way out of process for Wikipedia. Preface: Despite my interests in the topic, I see the article above as a bit too interpretation-y and opinion-y to be the basis of major rework of this page. And I appreciate you being willing to let your guard down and share your opinion that millimeter wave (30ish GHz band) will be no different healthwise than the 1-3GHz mobile phones have used for the last 30 years. BTW, I agree on that point, and further, think that the millimeter wave might even have less health effects than 1-3GHz has. But I find it interesting that you are willing to cite an opinion piece rather than peer reviewed literature (of which there is none with real facts about what millimeter wave will do when deployed in the general public) to support that opinion. My out of process question, which will help me grow as a neophyte Wikipedia editor but you are free to tell me is utterly wrong to ask: is it appropriate to have a lower threshold of "quality" for peer reviewed literature which supports the status quo than for peer reviewed literature indicating a need to change the status quo?

Fstevenchalmers (talk) 00:49, 26 September 2021 (UTC)

@ScienceFlyer:, that's a really interesting news article which appears to cover something unrelated (5g protests). Not really sure how this is related to MCS. I respect your opinion that she is a fringe individual, but I thought we were only supposed to used peer reviewed journals? Do you have a source supporting her as a fringe individual that meets Wikipedia's guidelines? Sciencebuilder (talk) 21:42, 25 September 2021 (UTC)