Spitzer R.L., Williams J.B.W., Gibbon M., First M.B. User's Guide for the Structured Clinical Interview for DSM-III-R. Washington, DC: American Psychiatric Press, Inc.; 1990.

Terr A.I. Environmental Illness: A Clinical Review of 50 Cases. Arch Int Med. 1986;146:145-149.

Trenerry M.R., Crosson B., DeBoe J., Leber W.R. Stroop Neuropsychological Screening Test Manual. Odessa FL: Psychological Assessment Resources, Inc; 1989.

Trites, R.L. Neuropsychological Test Manual. Montreal, Que: Technolab, 1981.

Valciukas, J.A., Control of Confounding Demographic Factors in the Analysis of Neurotoxicological Data. In Environmental Health Document 3. Neurobehavioral Methods in Occupational and Environmental Health. Copenhagen: World Health Organization, 1985.

Wechsler D. Wechsler Adult Intelligence Scale-Revised. New York: The Psychological Corporation; 1981.

Wechsler D. Wechsler Memory Scale-Revised Manual. San Antonio: The Psychological Corporation; 1987.

Weissman M.M., Bothwell S. Assessment of Social Adjustment by Patient Self-Report. Arch Gen Psychia 1976;33:1111-1115.

This project was supported by a grant from the Hazardous Substance Management Research Center, A National Science Foundation Industry/University Cooperative Center and A New Jersey Commission on Science and Technology Advanced Technology Center. We wish to acknowledge the contributions of Kathie Kelly-McNeil and Carol Natarelli, who have both been instrumental in providing the evaluation and care of our patients. We also appreciate the consultation of Bernard Goldstein, M.D. and Michael Gochfeld, M.D., Ph.D. in formulating this project Finally, we appreciate the support services of Joyce Kosmoski and Patricia Hutty in preparing this and other documents for this project.

Front Matter (R1-R4)

Introduction (1-4)

Research Protocol for Clinical Evaluation (5-8)

Exposures and Mechanisms (9-10)

Epidemiology (11-12)

Key Concepts: Chemical Sensitization (13-34)

Multiple Chemical Sensitivity - What is It? (35-40)

Case Definitions for Multiple Chemical Sensitivity (41-46)

Allergy and Multiple Chemical Sensitivities (MCS) Distinguished (47-64)

Design of Animal Models to Probe the Mechanisms of Multiple Chemical Sensitivity (65-76)

Antigen Specific and Antigen Non-Specific Immunization (77-88)

Neuropsychiatric and Biopsychosocial Mechanisms in Multiple Chemical Sensitivity: An Olfactory-Limbic System Model (89-108)

Neurobehavioral and Psychosocial Aspects of Multiple Chemical Sensitivity (109-116)

Diagnostic Markers of Multiple Chemical Sensitivity (117-138)

Possible Mechanisms for Multiple Chemical Sensitivity: The Limbic System and Others (139-150)

Developing Clinical Research Protocols for Studying Chemical Sensitivities (151-154)

Immunological Mechanisms of Disease and the Multiple Chemical Sensitivity Syndrome (155-168)

Considerations for the Diagnosis of Chemical Sensitivity (169-192)

Occupational Asthma (193-196)

List of Contributors (197-198)

List of Participants (199-202)