AHMF: Conf 2001: KH Kilburn

Objective Evidence of Brain Impairment in the Chemical Syndrome

Kaye H. Kilburn, M.D

Ralph Edgington Professor of Medicine,
Director of Environmental Sciences Lab,
University of Southern California,
Keck School of Medicine,
2025 Zonal Ave., CSC 201,
Los Angeles,
CA 90033
USA
Telephone: (323) 442-1830
Fax: (323) 442-1833

Three arguments will be presented.
First - The multiple labels applied to human responses to chemical exposure describe one syndrome. "Splitting" has no advantage and confuses the issue.
Second - This response is mediated by the human brain, which is the main target of the offending chemicals.
Third - Measurements of key brain functions compared to predicted values provide the missing link, objective demonstration of effects of chemicals.

Chronic fatigue syndrome vies with multiple chemical sensitivity as the most popular title for the status of being adversely affected by environmental exposure to chemicals. Asthma, indoor air illness, fibromyalgia, neuroendocrine, hyperactivity, attention deficit disorder and reactive depression emphasize other facets of this increasingly frequent illness. Each medical speciality adopts pet language like the blind men and the elephant. Let's all open our eyes at once to see similarities in light of human diversity "though each was partly in the right; and all were in the wrong".

Responses are in four categories after epiphenomena are excluded. These are physiological brain functions like balance, reaction time and vision; psychological performance for problem solving, recall memory, interpretation, concept juggling, emotional, feelings or mood states: tension-anxiety, anger, depression, confusion, fatigue and loss of vigor and complaints and symptoms such as irritation, sleep disturbance, headache, nausea, a list of 35 or more.

Testing for performance addresses the many functions of the brain but only measurable ones are useful. Experience shows there are 8 physiological tests and 11 psychological ones that yield reliable numbers because measurements distribute symmetrically around the mean value for groups. These have been applied in more than 20 groups of people exposed to chemicals, 5 unexposed groups and nearly 500 exposed individuals. Effects of exposure to formaldehyde and to an organophosphate insecticide chlorpyrifos (Dursban) and provide illustrative examples.