The Medical Perspective on Environmental Sensitivities
By: Margaret E. Sears (M.Eng., Ph.D.)

The opinions expressed in this report are those of the author and do not necessarily reflect the views of the Canadian Human Rights Commission.

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Table of Contents

Abstract
Executive Summary
Introduction
What are “environmental sensitivities”?

Diagnostic criteria
Prevalence
Summary

Recognition and medical education 

Recognition 

International recognition of environmental sensitivities 
Recognition of environmental sensitivities by the Canadian federal government and national bodies 
Recognition of environmental sensitivities by Canadian provincial bodies
Summary

Awareness of environmental sensitivities by health care practitioners

Physicians’ organizations
Medical schools and continuing medical education
Summary

Initiating factors, triggers and symptoms of environmental sensitivities, and their impacts in the workplace

Agents initiating the condition of environmental sensitivities and triggering reactions
Symptoms
Impacts of environmental sensitivities in the workplace
Summary

Origins of environmental sensitivities

The controversies

Physical or psychological origins
Allergy/role of the immune system

Possible explanations

Chemical exposures
Neural sensitization
Receptor sensitization
Inflammatory cycle
Overload
Summary

Diagnosis and treatment of sensitivities

Summary

Building codes, regulations and guidelines

Building codes

International initiatives
Canadian federal initiatives
Provincial initiatives
Municipal measures and roles
Summary

Indoor environmental quality

Air quality
Microbes - moulds and bacteria
Ventilation
Pest control

Electromagnetic radiation and fields

Lighting
Electromagnetic radiation arising from the use of electricity
Summary

Accommodating and preventing environmental sensitivities

Environmental sensitivities and the workplace

Organization of the work space
Energy costs vs. ventilation
Buildings’ surroundings
Air quality inside vehicles

Accommodation resources

Publications related to the workplace
Publications related to “green” buildings
Best practices - Accommodations for children in daycares and schools 

Costs and benefits of accommodations

Summary

Conclusions

Appendix A:  Acronyms and abbreviations
Appendix B:  Collaborators, people and organizations consulted
Appendix C:  Resources
Appendix D:  Thomson recommendations (1985) and progress to 2006
References

Tables

Table 1: Names used for aspects of environmental sensitivities and commonly overlapping conditions
Table 2: International recognition of environmental sensitivities
Table 3: Recognition of environmental sensitivities by the Canadian federal government and national bodies
Table 4: Provincial Ministry of Health recognition of environmental sensitivities
Table 5:  Recognition of environmental sensitivities and possibly-related conditions on Workers’ Compensation Boards websites
Table 6: Typical agents that trigger reactions in susceptible individuals (and may contribute to initiation of environmental sensitivities)
Table 7:  Environmental sensitivity symptoms/reactions
Table 8: International initiatives addressing environmental sensitivities in building
Table 9: Canadian national initiatives addressing environmental sensitivities in building