Levels of the chemical Crude MCHM, ironically used to reduce coal emissions in the air, have fallen low enough for most people in the Charleston, West Virginia, area to resume drinking tap water after thousands of gallons of the toxic chemical leaked into the Elk River, which provides water to some 300,000 residents across nine counties.
Still, officials have announced that pregnant women should not drink the water, while other experts say the same caution should be extended to small children as well, because the exact level of hazardous concentrations of MCHM can only be estimated, not established with certainty.
As of January 18, 411 patients sought treatment for possible chemically induced illnesses. People in the area must be agonizing over what this will mean for their long-term health. They have good reason to do so. Amid public assurances of safety, reports abound that the tap water still smells like licorice. How can the community be certain that the risks have truly been eliminated? Sadly, few physicians know how to recognize and treat symptoms that can develop after such an exposure.
But even if you don't live in or around Charleston, that doesn't mean you are off the chemical hook. All of us are exposed to toxic substances to some degree, and some people are affected more severely than others. Since World War II, a broad range of synthetic organic chemicals have been steadily introduced into our environment, and their widespread use has been on the rise.
Even beyond devastating disasters like the one that occurred in West Virginia or the Gulf Oil spill, we are exposed to these substances every day in construction materials, pesticides and cleaning products, yet their impact on our mental and physical health has been largely overlooked and little understood. Importantly, unlike germs and antigens, the human body did not co-evolve with these man-made substances and our bodies are not equipped with the metabolic machinery necessary to detoxify and eliminate them from our systems. Even low level exposures to certain chemicals like MCHM, whether ingested in water or absorbed through the skin in the shower, can have unexpected long-term consequences in individuals with unrecognized intolerances to particular substances.
Exposure to one toxicant can lead to sensitivities to other substances. Following an initial exposure, a cascade of intolerances to chemically unrelated substances can follow. This is a newly recognized medical condition I've termed TILT, or Toxicant Induced Loss of Tolerance, which can result from low-level repeated exposures, or a single high-level exposure. For this reason, based on decades of research, including federally funded and international studies, I developed a questionnaire to help doctors and patients determine if exposure to synthetic organic chemicals like MCHM, or any other toxicant, is creating new intolerances.
Up to one in five Americans has some form of chemical or environmental intolerance, causing them to suffer from a variety of illnesses, some of them quite serious. Yet shockingly few know what is making them sick. Now, the Quick Environmental Exposure and Sensitivity Inventory, or QEESI, is available at no charge, online to help individuals determine the origin of their symptoms.
The QEESI, the most widely used screening instrument for chemical intolerance among physicians and health practitioners, is now available to anyone with an internet connection. This validated and published questionnaire is used internationally to help diagnose the previously unrecognized disease process called Toxicant Induced Loss of Tolerance or TILT.
The QEESI, aka the TILT Test, asks a person to respond to questions about their health, and the results can be retained for review with their personal doctor and to document the severity of their symptoms and intolerances before and after an exposure. It also helps identify the most susceptible individuals and families. The QEESI can help residents in the affected zones and their doctors to identify symptoms of TILT which tend to show up in a delayed manner and make people intolerant of everyday exposures -- including chemicals, foods, drugs, alcohol and caffeine -- that were not a problem for them before.
These intolerances spread, and subsequently trigger symptoms of their own. The fact that TILT is a two-step process (initial exposure followed by new intolerances) makes the QEESI a critical tool for making cause-and-effect attributions in particular individuals and populations.
What is the QEESI, aka, TILT test?
I developed this questionnaire as a screening tool for chemical intolerances. It measures sensitivities on four scales: Symptom Severity, Chemical Intolerances, Other Intolerances and Life Impact. Each scale contains 10 items, scored from 0 = "not a problem" to 10 = "severe or disabling problem." Another 10-item tool called the "Masking Index" gauges ongoing exposures and overlapping symptoms that hide responses, blocking one's awareness of their intolerances, and the intensity of their responses to exposures.
Physicians often overlook conditions linked to chemical intolerance. Of particular relevance to West Virginians, The TILT Test is particularly useful for people whose symptoms began or intensified after a certain event, such as the current MCHM disaster. In a study of 421 people, it offered sensitivity of 92 percent and specificity of 95 percent in discerning between those with multiple chemical intolerances and the general population.
The QEESI has been used successfully to identify secondary chemical intolerances in people exposed to toxicants, including Gulf War Veterans, World Trade Center recovery and demolition workers, and thousands of ordinary Americans exposed to myriad substances found indoors and outside.
It is essential to diagnose TILT in susceptible individuals who experience long-lasting and diverse symptoms, including memory and concentration problems, fatigue, headaches, weakness and mood changes such as extreme irritability and depression. These patients often report gastrointestinal, respiratory and skin problems, and some even develop depression, addiction or violent behavior.
TILT has all the earmarks of a new theory of disease. The "germ theory" emerged just after the Civil War, followed by the "immune theory" in the 1930s, which explained how people develop allergies or autoimmunity via exposure to biological antigens like dust mites, pollen, or poison ivy.
TILT can be thought of as the 21st-century theory of disease. Instead of germs or biological proteins, it implicates synthetic chemicals or chemical mixtures.
I urge people in West Virginia, and everyone else for that matter, to visit qeesi.org and take the TILT Test for themselves to determine if they are suffering from TILT, and which substances may be causing their problems.
Unfortunately for many people, avoiding new exposures to even low-level concentrations of MCHM will not be enough to ward off illness. They must remain vigilant of new intolerances that might emerge, the treatment for which entails avoidance or elimination of the offending toxicants.