The Medical Perspective on Environmental Sensitivities

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The Medical Perspective on Environmental Sensitivities

By: Margaret E. Sears (M.Eng., Ph.D.)

http://www.chrc-

ccdp.ca/research_program_recherche/esensitivities_hypersensibilitee/t

oc_tdm-en.asp?highlight=1

The opinions expressed in this report are those of the author and do

not necessarily reflect the views of the Canadian Human Rights

Commission.

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Table of Contents

Abstract

Executive Summary

Introduction

What are " environmental sensitivities " ?

Diagnostic criteria

Prevalence

Summary

Recognition and medical education

Recognition

International recognition of environmental sensitivities

Recognition of environmental sensitivities by the Canadian federal

government and national bodies

Recognition of environmental sensitivities by Canadian provincial

bodies

Summary

Awareness of environmental sensitivities by health care practitioners

Physicians' organizations

Medical schools and continuing medical education

Summary

Initiating factors, triggers and symptoms of environmental

sensitivities, and their impacts in the workplace

Agents initiating the condition of environmental sensitivities and

triggering reactions

Symptoms

Impacts of environmental sensitivities in the workplace

Summary

Origins of environmental sensitivities

The controversies

Physical or psychological origins

Allergy/role of the immune system

Possible explanations

Chemical exposures

Neural sensitization

Receptor sensitization

Inflammatory cycle

Overload

Summary

Diagnosis and treatment of sensitivities

Summary

Building codes, regulations and guidelines

Building codes

International initiatives

Canadian federal initiatives

Provincial initiatives

Municipal measures and roles

Summary

Indoor environmental quality

Air quality

Microbes - moulds and bacteria

Ventilation

Pest control

Electromagnetic radiation and fields

Lighting

Electromagnetic radiation arising from the use of electricity

Summary

Accommodating and preventing environmental sensitivities

Environmental sensitivities and the workplace

Organization of the work space

Energy costs vs. ventilation

Buildings' surroundings

Air quality inside vehicles

Accommodation resources

Publications related to the workplace

Publications related to " green " buildings

Best practices - Accommodations for children in daycares and schools

Costs and benefits of accommodations

Summary

Conclusions

Appendix A: Acronyms and abbreviations

Appendix B: Collaborators, people and organizations consulted

Appendix C: Resources

Appendix D: Thomson recommendations (1985) and progress to 2006

References

Tables

Table 1: Names used for aspects of environmental sensitivities and

commonly overlapping conditions

Table 2: International recognition of environmental sensitivities

Table 3: Recognition of environmental sensitivities by the Canadian

federal government and national bodies

Table 4: Provincial Ministry of Health recognition of environmental

sensitivities

Table 5: Recognition of environmental sensitivities and possibly-

related conditions on Workers' Compensation Boards websites

Table 6: Typical agents that trigger reactions in susceptible

individuals (and may contribute to initiation of environmental

sensitivities)

Table 7: Environmental sensitivity symptoms/reactions

Table 8: International initiatives addressing environmental

sensitivities in building

Table 9: Canadian national initiatives addressing environmental

sensitivities in building