| Preface to the Second Edition |
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xiii | (4) |
| Preface to the First Edition |
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xvii | (2) |
| Acknowledgments |
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xix | (2) |
| Introduction |
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xxi | |
| Part I. Defining Chemical Sensitivity |
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1 | (84) |
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1. Chemical Exposures and Sensitive Populations |
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3 | (24) |
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Groups Sensitive to Low-level Chemical Exposure |
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3 | (7) |
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5 | (5) |
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Changes in Chemical Production and Use, and the Emergence of Chemical Sensitivity |
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10 | (16) |
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Magnitude and Nature of the Problem |
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26 | (1) |
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2. Key Terms and Concepts |
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27 | (32) |
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27 | (7) |
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34 | (20) |
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54 | (5) |
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3. Origins of Multiple Chemical Sensitivity and Effects on Health |
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59 | (26) |
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59 | (15) |
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62 | (2) |
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Indoor Air Pollutants, Domestic and Workplace |
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64 | (6) |
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Foods, Food Additives, and Contaminants |
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70 | (1) |
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Water Contaminants and Additives |
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71 | (1) |
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Drugs and Consumer Products |
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72 | (2) |
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74 | (11) |
| Part II. Mechanisms, Diagnosis, and Treatment |
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85 | (60) |
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4. Mechanisms of Multiple Chemical Sensitivities |
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87 | (38) |
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Possible Physiological Mechanisms |
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87 | (26) |
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Mechanisms Involving the Limbic System |
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91 | (7) |
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98 | (9) |
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107 | (3) |
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110 | (3) |
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Possible Psychogenic Mechanisms |
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113 | (11) |
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124 | (1) |
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5. Diagnosis and Treatment |
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125 | (20) |
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125 | (3) |
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128 | (14) |
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Provocation-Neutralization |
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129 | (6) |
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135 | (3) |
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138 | (2) |
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Psychological Interventions |
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140 | (2) |
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Areas of Agreement and Disagreement between Allergists and Clinical Ecologists |
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142 | (5) |
| Part III. Responding to the Problem |
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145 | (24) |
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6. Needs, Concerns, and Recommendations |
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147 | (22) |
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147 | (6) |
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Patient and Community Concerns |
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153 | (6) |
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153 | (1) |
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154 | (1) |
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Alternative Employment and Housing |
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155 | (1) |
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156 | (1) |
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156 | (2) |
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Social and Legal Services |
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158 | (1) |
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The Regulation of Chemical Exposures and Other Preventive Initiatives |
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158 | (1) |
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The Role of Medical Practitioners and Their Societies |
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159 | (4) |
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163 | (6) |
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163 | (2) |
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165 | (1) |
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165 | (1) |
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Alternative Employment and Housing |
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165 | (1) |
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166 | (1) |
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166 | (1) |
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Social and Legal Services |
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167 | (1) |
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167 | (1) |
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Resolution of Conflicts among Medical Practitioners and Their Societies |
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167 | (2) |
| Part IV. Update since the First Edition |
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169 | (172) |
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171 | (36) |
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171 | (1) |
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171 | (2) |
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North American Workshops and Increased Governmental Interest in MCS |
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173 | (8) |
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Developments in the United States |
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173 | (7) |
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180 | (1) |
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Government Recognition and Accommodation |
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181 | (15) |
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181 | (6) |
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U.S. State Agencies and Courts |
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187 | (3) |
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190 | (1) |
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190 | (3) |
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193 | (3) |
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196 | (6) |
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Comparison of European and North American Experiences with Low-level Chemical Sensitivity |
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202 | (2) |
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204 | (3) |
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8. Key Research Findings since the First Edition |
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207 | (64) |
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207 | (4) |
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Clinical Data: Inherent Limitations and Unwarranted Extrapolations |
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207 | (2) |
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209 | (1) |
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Empirical Approaches to Understanding Chemical Sensitivity |
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210 | (1) |
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Characterizing the Patient Population |
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211 | (12) |
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211 | (7) |
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Exposure Challenge Studies |
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218 | (5) |
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223 | (5) |
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Overlaps with Other Illnesses |
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228 | (4) |
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232 | (1) |
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Origins of Chemical Sensitivity |
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233 | (21) |
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235 | (2) |
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237 | (1) |
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238 | (8) |
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246 | (3) |
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249 | (2) |
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251 | (3) |
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254 | (17) |
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Olfactory-Limbic Sensitization |
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257 | (4) |
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Other Hypotheses Involving the Olfactory System |
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261 | (1) |
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Cholinergic and Other Receptor Supersensitivity |
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262 | (1) |
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263 | (1) |
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264 | (1) |
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265 | (4) |
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269 | (2) |
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9. Reviews, Commentaries, and Polemics |
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271 | (18) |
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Published Work in Scientific Journals |
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272 | (9) |
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Other Writing and Publications |
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281 | (1) |
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282 | (4) |
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286 | (3) |
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Stages of a Paradigm Shift |
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287 | (2) |
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10. Research and Medical Needs |
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289 | (52) |
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Current Reflections on MCS |
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289 | (21) |
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Experimental Considerations and Approaches to MCS |
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296 | (14) |
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310 | (13) |
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316 | (7) |
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Medical and Patient Needs |
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323 | (18) |
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327 | (1) |
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328 | (4) |
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332 | (1) |
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333 | (1) |
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333 | (2) |
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Help from Governmental Agencies and Other Organizations |
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335 | (3) |
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338 | (3) |
| Epilogue |
|
341 | (4) |
| Appendix A: Health Effects Associated with Chemicals or Foods |
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345 | (14) |
| Appendix B: Laboratory Diagnostic Tests Used in MCS Studies |
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359 | (12) |
| Appendix C: Environmental Exposure and Sensitivity Inventory |
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371 | (14) |
| Bibliography |
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385 | (44) |
| Index |
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429 | |
