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Multiple Chemical Sensitivity - Is it a Disability under ADA?
by
Grace T. Hanson, Mei-Ling Hsieh, Kambiz Khoddam, Monica Lee, Gary Nellesen,
Sonya Sevier, Steve Shackelford, and Timothy Takashima, Mount San Antonio College
Winter 2011 “Accommodating Students with Disabilities in the Classroom;” course facilitated
by Grace T. Hanson, February 2011 (http://elearn.mtsac.edu/ghanson/dspsaccess).
I asked my Winter 2011 class to respond to the following: “A good student, whom you
have known to have taken several courses in your area, approaches you the second day of class
and says that she has chemical sensitivity disorder. She states that you must tell the class they
can wear only unscented products. As the instructor, what can and must you consider regarding
this request? The following information will help you respond to this question.
What is Multiple Chemical Sensitivity Disorder?
Multiple Chemical Sensitivity (MCS) is a condition in which a person develops markedly
negative reactions to everyday chemical exposure. Sometimes referred to as “chemical
sensitivity,” MCS is an extreme sensitivity, or allergic reaction, to any of various chemical
compounds present in the normal environment. This condition is said to develop from an
exposure or overexposure to a specific chemical or a variety of chemicals in the environment.
WebMD explains that this condition is a result of being exposed to a “wide range of chemicals
after a major environmental event, such as a chemical spill, or from long-term contact with lowlevels of chemicals, such as in an office with poor ventilation.” The effect of this chemical
exposure may be intolerance to even very low levels of exposure to certain chemicals that
generally cannot be detected by others in the same immediate area.
According to the Disability Opportunity Internetworking and Technology (DO-IT)
program at the University of Washington, “Multiple Chemical Sensitivity (MCS) is a disorder
triggered by exposure to chemicals in the environment. Like allergies, symptoms tend to come
and go with various exposures, although some reactions are delayed. Symptoms typically occur
in more than one organ system in the body, such as the nervous system and the lungs. MCS
typically impairs many bodily functions, including the nervous system and digestion. It also
affects the overall health and well being of those with the disorder. Each individual affected by
MCS has a unique set of health problems. Some symptoms of MCS that could impact academic
performance include headaches, asthma or breathing problems, memory loss, fatigue, and
depression. Students with MCS may experience difficulties with academic requirements such as
attendance, fieldwork, test taking, completing assignments, and carrying full course loads”
(http://www.washington.edu/doit/Faculty/Strategies/Disability/Other/) .
Causes and Symptoms of MCS
Wikipedia states that “symptoms may be vague and non-specific, such as nausea, fatigue,
and headaches. This has led some to believe that MCS symptoms are due to odor
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hypersensitivity or are mainly psychological. Regardless of etiology, some people with severe
symptoms are disabled as a result” (http://en.wikipedia.org/wiki/Multiple_chemical_sensitivity ).
The symptoms as well as the chemical irritants vary from person to person; yet, however
affected individuals tend to react the same way to similar triggers. Exposure to the chemical
irritant can be via air, food and water, or through the skin. It is clear that multiple senses, as well
as organs and bodily systems, may be affected.
Symptoms
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Exposures
acute abdominal pain
wheezing, asthma, breathlessness,
headaches, migraines,
vertigo and dizziness
rashes,nausea
extreme or chronic fatigue &
weakness, lethargy
concentration & memory loss
muscle & joint pains
numbness, tingling, twitching
sore eyes, ears, nose & throat
Multiple Senses
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alcohol & medications
caffeine & food additives
raw fuels & engine exhaust
new carpet & furnishings
paint & renovation materials
perfume & scented products
pesticides & herbicides
solvents & cleaning agents
molds
smoke
poor indoor air quality
Organs & Systems
hypersensitive to smells
photosensitive, blurred vision
intolerant of loud noises
bothered by abnormal tastes
hypersensitive to touch &
temperature extremes
impaired "senses" of balance,
coordination, & concentration
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Central nervous system
Eye, ear, nose, & throat
Gastrointestinal
Musculoskeletal
Peripheral nervous system
Respiratory
Skin
Cardiovascular
Neurological
Immune
Endocrine
(Adapted from: http://www.mcsrr.org/factsheets/mcsdisorders.html, and
http://ohioline.osu.edu/cd-fact/pdf/0192.pdf, retrieved March 6, 2011).
In the classroom environment, such things as felt tip pens, white board markers, other
marking pens (including highlighters), chlorine from a nearby swimming pool, perfume and
other scented products including aerosol deodorants, after shave lotion, hair spray, perfume in
some cosmetics, and nail polish can all be chemical irritants to those with MCS. In areas adjacent
to classrooms, other irritants might include asphalt pavement, public restroom deodorizers, and
cigar or cigarette smoke.
Why is MCS Controversial?
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MCS is not currently recognized by the American Medical Association, American
Academy of Allergy and Immunology, California Medical Association, American College of
Physicians, and International Society of Regulatory Toxicology and Pharmacology
(http://ohioline.osu.edu/cd-fact/pdf/0192.pdf). There is disagreement within the medical
community as to just about every aspect of MCS, including its name. The condition commonly
referred to as MCS is also called: Environmental Irritant Syndrome, Acquired Intolerance to
Solvents, Immune System Dysregulation, Idiopathic Environmental Intolerances, Multiple
Chemical Reactivity, Toxic Response Syndrome, 20th Century Syndrome, Chemical AIDS, Total
Allergy Syndrome, Environmental Hypersensitivity, Environmentally Induced Illness,
Ecological Illness, Total Allergy Syndrome, Food and Chemical Sensitivity, Sick Building
Syndrome, Toxic Carpet Syndrome, Cerebral Allergy, and Allergic Toxemia
(http://www.winterbauerdiamond.com/inprint/Doc040629.PDF, retrieved March 6, 2011).
Areas of divergence include a comprehensive definition and course of treatment.
Differences of opinion can be attributed to symptoms varying greatly from one patient to the
next; some treatments fail to work at all. Additionally, symptoms that have been labeled as those
of MCS are common to other illnesses as well. Finally, studies in MCS show about 2/3 of those
with Chronic Fatigue Syndrome (CFS) and Fibromyalgia also have MCS (and vice versa), as do
half of those with allergies. Like CFS, MCS is more common in women and can start at any age,
but usually begins in late puberty to mid-life.
(http://www.mcsrr.org/factsheets/mcsdisorders.html, retrieved March 6, 2011).
In a paper entitled “Multiple Chemical Sensitivity: Toxicological Questions and
Mechanisms,” published in 2009, professor Martin L. Pall argues that multiple chemical
sensitivity (MCS) “is a stunningly common disease, even more common than diabetes...In the
U.S., approximately 3.5% of the population is affected by severe MCS, with much larger
numbers, at least 12% of the population, being moderately affected. MCS is, therefore, a very
large international disease epidemic with major implications in terms of public health”
(http://www.mcs-international.org/news_prof_pall_mcs.html ).
Although MCS is very controversial, both the U. S. Department of Housing and Urban
Development and the Social Security Administration have recognized MCS as a disability. Many
state agencies help individuals with MCS by providing assistance with homemakers, counselors,
and many other crucial. Individuals with MCS have won Workers' Compensation cases. A
human rights lawsuit in Pennsylvania established the right of an individual with MCS to a safe
living space in subsidized housing. Both the Maryland State Legislature and New Jersey State
Department of Health have officially commissioned comprehensive studies of MCS
(http://www.lectlaw.com/filesh/csl01.htm.
According to J. E. Heimlich (2008) of Ohio State University, some of the indicators that
MCS diagnosis include: The symptoms are reproducible with repeated exposure; the condition is
chronic, both high and low levels of exposure may result in the same symptoms; the symptoms
improve or resolve completely when the triggers are removed; responses often occur to unrelated
substances; and the symptoms attack more than one organ or area of the body
(http://ohioline.osu.edu/cd-fact/pdf/0192.pdf). To provide a credible diagnosis of MCS, these
indicators should be mentioned in a verification of disability document written by a qualified
medical professional.
Is MCS a Disability Under the ADA?
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Prior to the amendments to the Americans with Disabilities Act coming into effect
(ADAAA), MCS was slow to become recognized as a disability. A law office web site cited a
Detroit case where an employee with MCS won a monetary award and the employer adopted a
workplace policy where employees were to refrain from wearing scented products and were no
longer allowed to wear colognes, perfumes, scented deodorants, and the like. The court ruled that
an allergy to scents can be a disability under ADAAA. More specifically, when an employee has
severe symptoms as a result of being exposed to odors or scents, that can be ruled a disability.
The interactive process should be conducted privately and individually between employer (or
student) and employee (or student). The Jobs Access Network (JAN) provided these question
that could be asked in an employment situation. Replace the word “employee” with “student,”
and “job” with “school,” and the same questions can be asked in an office of higher education
disability services (http://askjan.org/media/mcs.html, retrieved March 6, 2011).
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What limitations is the employee experiencing?
How do these limitations affect the employee and the employee’s job performance?
What specific job tasks are problematic as a result of these limitations?
What accommodations are available to reduce or eliminate these problems? Are all
possible resources being used to determine possible accommodations?
5. Has the employee been consulted regarding possible accommodations?
6. Once accommodations are in place, would it be useful to meet with the employee to
evaluate the effectiveness of the accommodations, and to determine whether additional
accommodations are needed?
7. Do supervisory personnel and employees need training?
(http://askjan.org/media/mcs.html, retrieved March 6, 2011).
After asking the general questions, it is a good idea to customize the conversation to the
specific disability. In the case of MCS, ask the student if they know what is causing their
reaction. Ask the student what accommodations worked in the other classes. Most likely, he/she
knows, and it may be a simple exercise in polite conversation to resolve the problem. Even
though there might not be a uniform belief regarding the nature of chemical sensitivity, because
there has been precedence in Workers’ Compensation claims, tort liability, and regulatory action,
disability services should acknowledge MCS as any other disability.
Some Classroom Accommodations and Strategies
1. Make sure that the room is well ventilated.
2. If the ventilation system does not work correctly or cannot do the job, see if a better,
more ventilated room is available.
3. If the offending chemical is cigarette smoke, ask for help from public safety in enforcing
state law related to smoking in proximity of a room or to enforce non-smoking campus
policies.
4. If the offending chemical is unknown, provide an alternate section, if available, as the
offending chemical may be brought in by another student (perfume, after shave, or
deodorant).
5. If the offending chemical is part of the curriculum, see if there is an alternate assignment,
or a different class section.
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6. Provide on line classes as alternatives, if available.
7. Provide technology, such as assistive listening devices or teleconferencing, and have the
student “tune in” from another room.
8. At this point, it is unclear as to what definitive action could be taken when the rights of
individuals to access learning in a classroom conflict with the rights of others to wear
scents. However, it is reasonable to inform the class of the situation, protecting the
affected student’s confidentiality. An incidence of MCS can be used as a teachable
moment.
9. Provide a classroom that has working windows.
10. Although in some classroom buildings, the windows do not open, allow the student to sit
near the door to provide the opportunity to quickly exit if exposure occurs.
11. Consider flexible attendance due to the unpredictable nature of the disorder.
12. Request alternative test accommodation through the campus disability office.
13. Given the chemical, plastics, and petroleum-based culture that we all live in, and short of
total isolation, it is a practical impossibility to insulate a student from all possible
offending chemicals, perfumes, and fragrances.
Conclusion
The public has been misled into thinking that perfumes and scented everyday products
are perfectly safe. Perfumes and scented products are made of hundreds of chemicals known for
their neurotoxicity. Unfortunately, the majority of consumers are uneducated about the health
risks; the real dangers of chemicals used in synthetic fragrances, in the same way that average
non-smokers were unaware of the risks of second-hand smoke
(http://www.americanchronicle.com/articles/view/149122).
It is likely that we all have a certain level of sensitivity to certain chemicals. The actual
test as to whether or not MCS should be considered a disability protected under the ADA relies
on the severity of one’s symptoms. Do the symptoms cause a major life barrier?
Accommodation is needed for a student who has appropriate documentation of the condition and
who can show that the symptoms cause a major life barrier. Additionally, students appreciate any
efforts an instructor takes on his/her behalf. Given the possible psychosomatic aspects of this
disorder, there may be a beneficial “Hawthorne Effect” if the student perceives that something is
being done to make their classroom experience more manageable.
Additional Resources
http://www.chemicalinjury.net/
http://www.beyondpesticides.org/infoservices/pesticidesandyou/Fall08/ChemicalSensitivity.pdf
http://www.chemicalsensitivityfoundation.org/
www.multiplechemicalsensitivity.org
www.mcs-global.org
www.mcs-america.org
www.niehs.nih.gov/external/faq/mcss.htm
www.mcsrr.org
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