Talk:Multiple chemical sensitivity

Possibly Relevant

I have no idea whether this is worth putting in the article, but it looks like there may be some relationship between this and mast cell disorders like Mast Cell Activation Syndrome. https://enveurope.springeropen.com/articles/10.1186/s12302-021-00570-3

Possibly also relevant, not that it's worth citing: https://www.hsph.harvard.edu/hoffman-program/resources/chemicals-in-your-life/what-is-mcstilt/ 173.66.202.193 (talk) 03:12, 30 July 2023 (UTC)

The list of differential diagnoses is long. That's one of the challenges with having (or trying to diagnose a patient who has) non-specific symptoms. WhatamIdoing (talk) 03:45, 30 July 2023 (UTC)

New in depth peer reviewed survey paper / not sure journal is credible enough

Just ran across a heavily sourced August 2023 review paper on MCS, from a peer reviewed journal, but pay-to-published on Elsevier. I thought the content was thorough and timely. The authors in their conclusions do, citing the role of TRPV1 and TRPA1 receptors, come down strongly on a physical origin.

This journal is not seen as credible under Wikipedia standards, correct? I'd love to give it a citation in the article, but only if appropriate

https://www.sciencedirect.com/science/article/pii/S0149763423001963 Fstevenchalmers (talk) 09:16, 26 February 2024 (UTC)

What gives the impression that Neuroscience and Biobehavioral Reviews isn't credible? Reconrabbit 16:08, 26 February 2024 (UTC)

Neuroscience & Biobehavioral Reviews is one of the top journals in their field.[1] Whatever one thinks of Elsevier's profitability, it is still considered reputable.

The main challenge with this paper will be determining what is WP:DUE. Is this more of a "one source thinks this" situation, or more of a "most researchers think this"? We can't look into a WP:CRYSTALBALL to figure out what will be accepted in the future.

This reminds me of a debate about Polycystic ovary syndrome about 20 years ago, in which one researcher proposed that women who didn't have a particular indicator (something about insulin resistance, I think) didn't really have PCOS, even if they had the traditional symptoms. This line of research could have a similar effect: if you think you have MCS, but you don't have this biological marker – well, you don't actually have MCS after all. This transition happens a lot in some fields (e.g., various subtypes of cancer get lumped and re-divided all the time), and sometimes it's quite easy to handle in an article (you add some variant on "In 2012, the Medical Authority changed the diagnostic criteria to require a minimum of four French hens and three calling birds"), but I'm not sure that it will be so easy in this case. WhatamIdoing (talk) 23:00, 26 February 2024 (UTC)

If someone wanted to do something useful to help people understand this paper, then an article on a cough challenge study might be useful (just a generic "what is it?" article, not mentioning MCS). Look at Bronchial challenge test for a basic model. Both capsaicin and citric acid have commonly been used in these studies, though I didn't see anything about citric acid in this particular paper. WhatamIdoing (talk) 23:17, 26 February 2024 (UTC)

I have added information from this paper as well as other sources. This is absolutely a top journal in its field and is a review article so it absolutely isn't a case of just one source thinks this. Morgan Leigh | Talk 05:07, 13 May 2024 (UTC)

@Morgan Leigh I reverted your edits due to adding WP:FRINGE material. The journal features opinions by various authors, including long-time MCS advocates John Molot and Margaret Sears. When content by advocates for fringe topics is published in a journal, it does not whitewash it into a reliable medical source. I would suggest considering the paywalled material in the same journal by Karen Binkley. Binkley has also co-authored a response to Molot et al which I haven't read yet because it is paywalled. ScienceFlyer (talk) 00:49, 14 May 2024 (UTC)

Sources from the last five years are best; if it's older than 10 years, we really should avoid citing it.

I don't think we can reject the The Journal of Allergy and Clinical Immunology – it's impact factor (~9) and Scopus ratings indicate that it's an influential journal – even though they did publish a letter to the editor from John Molot (though I don't see Sears anywhere in the search results for that journal, ever?), but we don't normally want to be citing the correspondence section, either.

If the Binkley paper looks useful, then perhaps someone at Wikipedia:WikiProject Resource Exchange/Resource Request could find it. WhatamIdoing (talk) 02:18, 14 May 2024 (UTC)

I have reverted your revert because reverting a lot of changes because you don't support one source used when many other sources were also included is not a reasonable approach. Rather one should deal with each source at a time.

I agree with WhatamIdoing that Journal of Allergy and Clinical Immunology is a reputable journal and I also agree a more recent source would be preferable. Also you seem to be saying that it is not ok to cite a review article from one author from this journal but it is ok to cite a letter to the editor from another author in the same journal. This does not seem to be a cogent approach.

I suggest that when what you call fringe material is published in reputable journals it just might not be as fringe as you are charachterising it to be. Morgan Leigh | Talk 04:30, 15 May 2024 (UTC)

@Zefr Simply reverting a page that has already been unreverted and about which discussion is ongoing without discussing it at all on the talk page is poor practice and I ask that you post here to seek consensus for your view. Unless you are suggesting every one of the several sources that were added are all fringe your reversion seems unwarranted. Reverting on the basis that the reference formatting is not great makes it super difficult to presume good intent on your part as such things are not a valid reason to revert. The normal thing to do would be to fix them. I totally agree that the refs in this page need a lot of work as there are all different styles used. Seeing you feel the refs are so bad that they were worth including as a reason for reversion I invite you to fix them.Morgan Leigh | Talk 05:34, 15 May 2024 (UTC)

Despite insufficient discussion here and no consensus existing, you re-established your prior version which reads like a synthesis of interpretations particularly from the Molot publication, which itself is highly speculative and based on early-stage studies. Your version does not impress as a mainstream view.

Regarding the style and reference formatting issues, I left a message on your talk page. Zefr (talk) 15:09, 15 May 2024 (UTC)

A synthesis of information from reliable academic journals is exactly what every single wikipedia page does. I can't see how this is a serious critique.

I did revert for the very good reason that the reasons given by the person who reverted the work I had done on the article were not consistent with wp policy. i.e. the journal they claimed was not reliable was agreed by two other editors to be reliable and as ScienceFlyer did not identify any other sources that they thought were fringe.

Your claim that I didn't work towards consensus is erroneous. e.g.;

I agreed with editor WhatamIdoing that The Journal of Allergy and Clinical Immunology that ScienceFlyer criticised was a reliable source and as ScienceFlyer did not identify any other sources that they thought were fringe I call that a consensus.

I also agreed with WhatamIdoing that Neuroscience & Biobehavioral Reviews is one of the top journals in its field so I call that a consensus. Your personal opinions about the Molot paper are completely irrelevant. It is published in a top journal so it can be cited.

I agreed with WhatamIdoing that the Sears reference was outdated and the idea of diseases being recognised by countries is a bit silly and so removed that material. I call that a consensus.

Your note on my talk page is just a complaint about referencing format, in itself not a reason for reversion as the references do actually work. It seems to me you could have more profitably spent the time you spent complaining on my talk page on fixing the referencing format if you were so concerned about it.

All in all it looks to me like I spent considerable time good faith editing this page, and admitting it still needs a lot of work, and you just drive by reverted it. So I am not seeing any valid reasons for your reversion here. Unless you can explain exactly what you think is fringe I don't think the reversion should stand. Morgan Leigh | Talk 23:53, 15 May 2024 (UTC)

I am not especially well versed in the way medical topics are written about and the sourcing requirements, but as someone watching this conversation I am willing to go through and correct the unformatted citations to use Citation templates, provided that work isn't reverted in this ongoing discussion. Reconrabbit 23:58, 15 May 2024 (UTC)

Thank you for your kind offer. Perhaps it might be wise to wait until Zefr replies and we work out what we will do about the reversion. While it is possible to revert and keep some content it is a bit fiddly and I would hate for your work to be lost. Morgan Leigh | Talk 00:41, 16 May 2024 (UTC)

Understood, I'll give it some time. Reconrabbit 01:05, 16 May 2024 (UTC)

For reference, this is the complete Molot review from the Wikipedia Library. It is a comprehensive analysis of MCS issues, but the potential mechanisms discussed are unestablished beyond preliminary research to address direct cause-and-effect relationships between chemical stimulants and in vivo receptor hypersensitivities that would explain MCS.

Morgan's prior version mentioned speculation about TRP receptor stimulation, capsaicin challenges, and brain imaging studies which provide only conjecture about how chemical stimulants affect people with this syndrome. The revision added was not an improvement over the prior and existing version.

The Molot review reveals the slow progress of good research on MCS: it is difficult to study precisely, with nothing notable in recent literature as acceptable sources for the article per WP:MEDASSESS. Zefr (talk) 17:00, 16 May 2024 (UTC)

Firstly, your comments are not in accord with your reason given for reverting i.e. that the material was fringe. Please specify how it is that research published in journals that a consensus of authors here have agreed are reliable sources is fringe.

Your claim that my edit "was not an improvement over the prior and existing version." is not substantiated by the rest of your reply which is comprised of your unsourced opinions about the state of research into MCS while my additions to the article were supported by reliable sources or were direct quotes from research published in top journals.

It is difficult to see how can you sustain your claim that there is "nothing notable in recent literature as acceptable sources" regarding MCS while at the same time arguing to remove material published in an in depth review of the most recent research that is published in sources that a consensus of editors agree are reliable. Morgan Leigh | Talk 22:39, 17 May 2024 (UTC)

Zefr has had a week to reply to justify their position with sources but has failed to do so. However WhatamIdoing has done some good work in the article in the mean time so instead of reverting I suggest we go forward and add the info that we have consensus on. So if @Reconrabbit you want to go ahead and fix the referencing that would be a great start. I will get onto citing some stuff from journals once you have done that. Morgan Leigh | Talk 00:51, 24 May 2024 (UTC)

I have started working on it. I am using a tool that segregates all citations from the text and reinserts them so apologies if there are errors in the process. Reconrabbit 01:35, 24 May 2024 (UTC)

Should be standardized now. Please let me know if there is anything strange that resulted from my changes - I am not intimately familiar with the content of the article, only this particular discussion. Reconrabbit 01:57, 24 May 2024 (UTC)

Thanks for doing that work @Reconrabbit. It is an important and oft overlooked thing. Morgan Leigh | Talk 22:02, 25 May 2024 (UTC)

That German myth will apparently never die

@Morgan Leigh:

I noticed that your preferred version included this: "MCS is recognized as an organic, chemical-caused illness by several countries, notably in the United States, Germany and Denmark, and Australia."

Leaving aside the whole question of what it means for a disease to be "recognized by a country", Sears is not only outdated but merely repeats a since debunked claim. Words like "Germany says it's an organic, chemical-caused illness" don't appear in the source.

The real story, which is explained a bit in the section that differentiates between "discrete disease entity" and "how the doctor gets paid", is this:

Years ago, someone wrote to the Austrian health bureaucracy to ask what they thought about MCS. The response, which was in German, that the Austrian health agency uses the same billing system as Germany, and that German healthcare providers bill for MCS-related services under ICD-10 code T78.4 (idiosyncratic reactions, which itself is part of T78, Adverse reactions, not otherwise specified).

A scanned copy of this letter was posted in internet forums with the false claim that Germany (i.e., the country that did not write this letter) officially recognizes MCS (i.e., what the letter did not say)! The letter didn't say that MCS is a discrete disease or that MCS is caused by chemicals; it said that if the doctor wants to get paid for treating a symptomatic person, then the doctor's office have to bill under something that's not MCS because they don't recognize MCS as a separate disease. Since 99% of the people seeing this couldn't read a word of German, they trusted it – and forwarded it, and repeated it, and believed it. But it's not true.

We've tried to explain this rather obliquely in Multiple chemical sensitivity#International Statistical Classification of Diseases but perhaps we're being too polite. If you think it would help to have something that sounds like "Despite long-standing myths circulating on the internet, Germany doesn't actually recognize MCS as an organic, chemical-caused illness", then we could probably source that.

For the other countries:

• Sears says it's recognized in the US because "Prevalence has been measured, based upon doctor diagnoses, and self-reporting". Not one word about "organic, chemical-caused illness", nor a single syllable about governmental recognition.
• Sears says it's recognized in Denmark because an anti-pollution organization congratulated themselves on reducing indoor air pollution.
• The Australian website carefully specifies that MCS is "attributted to...chemicals", which is the opposite of recognizing it as an organic, chemical-caused illness. The cited source is National Industrial Chemicals Notification and Assessment Scheme, which was replaced by the Australian Industrial Chemicals Introduction Scheme a few years ago. The new website says nothing about MCS.

Bottom line: None of these countries actually recognize MCS as an organic, chemical-caused illness. WhatamIdoing (talk) 02:49, 14 May 2024 (UTC)

I agree with you about that source being questionable, both due to it's age and what it was being used to cite. But seeing it was already there instead of removing it I changed the text to say what it seemed to me to be saying. You seem to have more details from other sources than I was able to get from that source so I have just gone ahead and deleted that passage as I agree that saying a disease is not/is recognised is dumb anyway.Morgan Leigh | Talk 04:03, 15 May 2024 (UTC)

Chemical used loosely

@Morgan Leigh, you've removed this statement:

"The word chemical in the name is used loosely and includes natural substances"

saying that "erroneous material not supported by source". The cited source says, in part, "The term “chemical” is used to refer broadly to many natural and man-made substances, some of which have several chemical constituents".

Please let me know exactly which word(s) you think are not supported by that source. WhatamIdoing (talk) 22:53, 25 May 2024 (UTC)

Firstly, I was unable to find a 2016 source of that name. A search of the publisher's site reveals 0 results see [2]

Presuming that maybe the year was a typo I thought it must be referring to this work [3] which does not contain anything about MCS.

If there is indeed a 2016 work as cited I would be most obliged if you could point me to it.

Secondly there is a difference between "The word chemical in the name is used loosely and includes natural substances" and "The term “chemical” is used to refer broadly to many natural and man-made substances, some of which have several chemical constituents". The former is erroneous in that all natural substances are chemical substances. The second is making a point that chemical substances and chemical mixtures or compounds are not the same thing. Which, while a valid point, doesn't seem to be a substantive addition to the article. For example such a distinction is not made on other pages that use the word 'chemical' e.g. Chemical Burn.

However if you can provide a link to this source for verification I would support something that makes the source's point unambiguous like "The word chemical in the name refers to single chemicals, chemical mixtures and chemical compounds". Morgan Leigh | Talk 00:13, 26 May 2024 (UTC)

You can find the source in Wikipedia:The Wikipedia Library under De Gruyter. In the future, I suggest that if you can't find the source, you should ask for help instead of asserting that material is not in the cited source, even though you've never read that source and don't actually know what's in it.

I think there are two points to be made here, and that both of them are fully supported by the cited source:

• The word chemical (in MCS) does not have the meaning that a chemist ascribes to that word. It is not "a molecule"; it is "some stuff".
• The problems are not limited to "synthetic" chemicals.

These points are related, and they have to do with two common misunderstandings. The first is the lay person, who probably never took a chemistry class. MCS is widely misunderstood as applying strictly to "synthetic" or "man-made" chemicals, or even as being a type of Chemophobia. When they read "attributed to chemicals", then they think synthetic chemicals, and then think that natural substances are safe. This leads to them thinking that "natural" scented products are safe gifts. However, many actual MCS patients struggle with pine trees – the 100% natural, organic chemicals in pine trees.

On the other end, we have chemical specialists who are told "The chemicals in pine trees make me sick", and they think "Okay, pine trees, that's mostly terpinols, so let's test specifically for α-terpineol", and then they "prove" that the patient isn't affected by pine trees. They overlook the fact that the problem is the whole thing, and not just a single isolated chemical.

The goal, in other words, is to educate well-meaning friends that "chemical" includes "natural" and to educate chemists (because the source does) that "chemical" doesn't mean "single purified molecule". WhatamIdoing (talk) 01:48, 26 May 2024 (UTC)

Morgan Leigh, you said:

A search of the publisher's site reveals 0 results see [2]

... it must be referring to this work [3] which does not contain anything about MCS.

Please see:

• https://en.wikipedia.org/w/index.php?title=Multiple_chemical_sensitivity&diff=prev&oldid=1225792249

Thanks. --Dustfreeworld (talk) 19:26, 26 May 2024 (UTC)