Study investigates coping strategies of those affected by multiple chemical sensitivity

​Swedish researchers have published results from a study looking at the coping strategies employed by chemically intolerant individuals and the social support they receive.

Chemical intolerance (CI), commonly referred to as multiple chemical sensitivity (MCS), leaves sufferers unable to tolerate manmade chemicals present in the environment, particularly synthetic fragrances found in perfumes, colognes, deodourants and laundry products. Upon exposure to even tiny amounts, those affected develop a host of symptoms ranging from breathing difficulties to rashes, depression and neurological disorders.

Despite the large numbers of people affected (estimated at 5-15% in developed nations) and the suffering and disability caused by CI, it is currently only recognised as a genuine medical condition by a handful of governments and medical care is sorely lacking. As a result those affected are all too often left to cope with their condition and its life-altering limitations with little or no support.

With this in mind researchers from the Department of Public Health and Clinical Medicine at Umeå University, Sweden, developed questionnaires which were completed by a total of 182 CI sufferers to determine how they approaches they used to cope with their illness, the social support they received, as well as their views on whether it was their personal responsibility to improve their health or that of society.

Specifically, 59 individuals with mild, 92 with moderate and 31 with severe CI participated by rating usage and effectiveness of six problem- and six emotion-focused coping strategies, emotional, instrumental and informative support provided by various sources and society's and their own responsibility for improvement.

The most commonly used and effective coping strategies were avoiding odourous/pungent environments and asking other people to limit their use of odourous/pungent substances. These are seen as problem-focused strategies. Additionally, acceptance of the situation and reprioritising were common emotion-based strategies reported to be helpful by the CI sufferers.

The picture that emerges from this study then is that to have the best chance of recovering a better level of health and to be happy with one's life when afflicted by CI, sufferers need to utilise both problem-focused and emotion-focused coping strategies. There is a need to be proactive to avoid those things that trigger symptoms but it is also essential to develop a sense of acceptance and reasses priorities in one's life.

Study results indicated that greater severity of CI corresponded with greater use of problem-focused strategies, which would be expected. For those with severe CI, even the tiniest amount of a substance to which one is sensitive can trigger unpleasant and even life-threatening symptoms. The amount of a substance required to trigger symptoms is often below the level that a sufferer can detect through their sense of smell.

Besides information on coping strategies associated with CI the study found that support offered to sufferers was predominantly emotional, rather than practical or informative, and that this was most often provided by partners or other family members. This reflects both the lack of information and medical care available for CI as well as a lack of understanding of the condition both from doctors and often the person's friends.

Finally, the researchers report that the feeling that society should take responsibility for improving CI sufferers' quality of life was greater among those more severely affected. Not surprising given that these individuals are often confined to their homes by their illness and may even need to move to a new home or area with cleaner air. Even those not confined to their homes often cannot enter public buildings, ironically including hospitals, because chemicals used in cleaning materials and other products aggravate their illness. 

The researchers conclude that these results can be used to help doctors and other healthcare providers recommend appropriate coping strategies to individual CI sufferers and also suggest the healthcare system needs to offer better social support to those affected. They stop short of addressing the issue of societies responsibility to CI sufferers, however. 

Source: Nordin M Andersson L and Nordin S (2010) Coping strategies, social support and responsibility in chemical intolerance Journal of Clinical Nursing 19(15-16):2162-73