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. 2021 Oct 27;18(21):11294.
doi: 10.3390/ijerph182111294.

Italian Expert Consensus on Clinical and Therapeutic Management of Multiple Chemical Sensitivity (MCS)

Giovanni Damiani  1   2   3 , Marco Alessandrini  4 , Daniela Caccamo  5 , Andrea Cormano  6 , Gianpaolo Guzzi  7 , Andrea Mazzatenta  8 , Alessandro Micarelli  9   10 , Alberto Migliore  11 , Alba Piroli  12 , Margherita Bianca, Ottaviano Tapparo  13 , Paolo Daniele Maria Pigatto  1   2
Affiliations

Italian Expert Consensus on Clinical and Therapeutic Management of Multiple Chemical Sensitivity (MCS)

Giovanni Damiani et al. Int J Environ Res Public Health. .

Abstract

Multiple chemical sensitivity (MCS) is a multisystem, recurrent, environmental disorder that flares in response to different exposures (i.e., pesticides, solvents, toxic metals and molds) under the threshold limit value (TLV) calculated for age and gender in the general population. MCS is a syndrome characterized by cutaneous, allergic, gastrointestinal, rheumatological, endocrinological, cardiological and neurological signs and symptoms. We performed a systematic review of the literature to summarize the current clinical and therapeutic evidence and then oriented an eDelphi consensus. Four main research domains were identified (diagnosis, treatment, hospitalization and emergency) and discussed by 10 experts and an MCS patient. Thus, the first Italian MCS consensus had the double aim: (a) to improve MCS knowledge among healthcare workers and patients by standardizing the clinical and therapeutic management to MCS patients; and (b) to improve and shed light on MCS misconceptions not supported by evidence-based medicine (EBM).

Keywords: chemical intolerance; environmental exposure; multiple chemical sensitivity (MCS); neurogenic inflammation; threshold limit value.

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Conflict of interest statement

The funders had no role in the design of the study; in the collection, analyses or interpretation of data; in the writing of the manuscript or in the decision to publish the results. G.D. received honoraria from A.M.I.C.A., Galderma, Novartis, Almiral, Sanofi and a grant from Rocchetta.

Figures

Figure 1
Figure 1
Research domains identified during the pre-Delphi. MCS: multiple chemical sensitivity.
Figure 2
Figure 2
Third round agreement summary for the diagnosis domain.
Figure 3
Figure 3
Third round agreement summary for the therapy domain.
Figure 4
Figure 4
Third round agreement summary for the hospitalization domain.
Figure 5
Figure 5
Agreements summary for the emergency domain.
See this image and copyright information in PMC

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