Canadian Human Rights Commission

Source:  Canadian Human Rights Commission    Tag:  postinfectious encephalomyelitis

Report: Medical Perspective on Environmental Sensitivities (86 pages)

Accommodation for Environmental Sensitivities: Legal Perspective (44 pages)

Executive Summary can also be found at:

Excerpts:

Pg. 3 “What are “environmental sensitivities”?

The term “environmental sensitivities” describes a variety of reactions to chemicals, electromagnetic radiation and other environmental factors at exposure levels commonly tolerated by many people. These phenomena are not yet fully understood. In contrast, some toxic environmental agents such as such as metals (e.g. lead, mercury), rock dusts (e.g. asbestos, silica), chemicals (e.g. hydrogen sulphide, dioxin) and biological agents (e.g. snake or scorpion venom) are better understood as to their ill effects on people.

“Environmental sensitivities” does not describe a single, simple condition with a universal cause. Environmentally sensitive individuals link their symptoms to aspects of their environment such as being in a particular place or being exposed to one or more factors such as chemicals, biological materials or electromagnetic phenomena.
                                        
Table 1: Names used for aspects of environmental sensitivities and commonly overlapping conditions*

Aspects of Environmental Sensitivities
Total allergy syndrome
Toxicant-Induced Loss of Tolerance (TILT)
Multiple chemical sensitivity(ies) (MCS)
Multiple chemical hypersensitivity(ies)
Chemical intolerance(s)
Gulf War illness/syndrome
Idiopathic environmental intolerance
Environmental illness
Chemical injury/allergy
Toxic injury
Tight building syndrome
Sick building syndrome
Twentieth century disease
Chemically induced illness
Chemophobia
Electromagnetic (hyper)sensitivities/intolerance
Radiowave sickness
Commonly Overlapping Conditions
Fibromyalgia
Myalgic encephalomyelitis (ME) Chronic fatigue syndrome
Post-viral fatigue syndrome
Post-infectious neuromyasthenia
Chronic pain
Migraine
Arthritis
Allergies
Rhinitis
Asthma
Food intolerance syndrome
Celiac disease
Irritable bowel syndrome
Major depression
Anxiety or panic disorder
Hypothyroidism

pg. 17 Table 6: Typical agents that trigger reactions in susceptible individuals (and may contribute to initiation of environmental sensitivities)
Electromagnetic radiation
Light
Radiowaves and Microwaves
Very low frequency
electromagnetic fields
Ground currents
Lighting
Video display screens
Fluorescent light bulbs, “dirty electricity,” wiring problems, energy-efficient devices, computers, televisions, telecommunications equipment
Power lines
Power supply services that allow current to flow through the ground, pipes or structures

pg. 19 Table 7: Environmental sensitivity symptoms/reactions Body system
Body system
Symptoms
Nervous system
  Heightened sense of smell
  Difficulty concentrating
  Difficulty remembering
  Apparent variability in mental processes
  Feeling dull or groggy
  Feeling “spacey”
  Headaches
  Restlessness, hyperactivity, agitation,
I insomnia
  Depression
  Lack of coordination or balance
  Anxiety
  Seizures
  Tinnitus
Upper respiratory system
  Stuffy nose, itchy nose (the “allergic salute”)
  Blocked ears
  Sinus stuffiness, pain, infections
Lower respiratory system
  Cough
  Wheezing, shortness of breath, heavy chest
  Asthma
  Frequent bronchitis or pneumonia
Eyes
  Red, watery eyes
  Dark circles under eyes
  Pain in eyes
  Blurred, disturbed vision
Gastrointestinal system
  Heartburn
  Nausea
  Bloating
  Constipation
  Diarrhea
  Abdominal pain
Endocrine system
Fatigue, lethargy
  Blood sugar fluctuations
Musculoskeletal system
Joint and muscle pain in the extremities and/or back
  Muscle twitching or spasms
  Muscle weakness
Cardiovascular system
  Rapid or irregular heartbeat
  Cold extremities
  High or low blood pressure
Skin (dermatological system)
Flushing (whole body, or isolated, such as ears, nose or cheeks)
  Hives
  Eczema
  Other rashes
itching
Genitourinary system
Frequency and urgency to urinate
Painful bladder spasms



pg. 22/86  
“Improving indoor environmental quality will potentially benefit many more people than the individual identified with sensitivities . Workers are more productive and general symptoms of sick building syndrome may improve when ventilation is improved or a pollution source is removed from offices. Children are healthier and learn better when indoor environmental quality is improved in schools......"The health and ability to work for those with environmental sensitivities rests with the choices and actions of others, such as building managers, co-workers and clients”.

pg. 23/86
“This review indicates that physical factors contribute to environmental sensitivities. There remain many unanswered questions regarding sensitivities and the interplay between biochemical, neurological and psychological processes. It is important for society to come to a common understanding, in order to offer the most efficient, effective care to people with environmental sensitivities”.

pg. 31-33/86
The high prevalence of neurological symptoms in people with environmental sensitivities led to interest in “kindling” within the nervous system. Kindling is a phenomenon whereby repeated low level exposures to chemicals, or electromagnetic currents or fields eventually cause symptoms at levels previously tolerated. In this process, neurochemical, behavioural, endocrine and/or immunological responses are amplified.
This is a basic part of the brain, governing autonomic functions that maintain biological homeostasis. It is involved with the sense of smell, sleep, emotions and behaviour, as well as learning and short-term memory. The limbic system can become sensitized to stressors, and once sensitized will react even to very weak stimuli, eliciting symptoms as seen in environmental sensitivities.

pg. 30 Table 8: International initiatives addressing environmental sensitivities in building
Country
Initiatives
International
• ASHRAE examined air quality standards for industrial settings in the USA and Germany, and concluded that standards are not set to protect environmentally sensitive individuals. Many are set to address irritation over the short term.
Prominent scientists signed the Benevento Resolution (Feb.06) affirming that there is considerable and strengthening scientific evidence that low-intensity, low-frequency and radio-frequency electromagnetic fields are responsible for biological effects and health effects . Scientists called for more research, and a more precautionary approach to standards, recommended exposures, and technologies in the market place.






pg. 46,47/86

C. Electromagnetic radiation and fields

“Electromagnetic radiation ” covers a broad range of frequencies (over 20 orders of magnitude), from low frequencies in electricity supplies, radiowaves and microwaves, infrared and visible light, to x-rays and cosmic rays. Our limited understanding of the biological effects of the vast majority of frequencies gives reason for concern. Although there is still debate in this regard, tinnitus, brain tumours and acoustic neuroma are associated with cell phones and mobile phones.

Communications and radar antennae expose those who live or work near these installations to their emissions. The radiation travels through buildings, and can also be conducted along electrical wires or metal plumbing. Wireless communications create levels within buildings that are orders of magnitude higher than natural background levels.

The World Health Organization (WHO) acknowledges the condition of electromagnetic sensitivity , and published a 2006 research agenda for radio-frequency fields. The WHO recommends that people reporting sensitivities receive a comprehensive health evaluation. It states: “Some studies suggest that certain physiological responses of EHS individuals tend to be outside the normal range. In particular, hyperactivity in the central nervous system and imbalance in the autonomic nervous system need to be followed up in clinical investigations and the results for the individuals taken as input for possible treatment.” Reduction of electromagnetic radiation may ameliorate symptoms in people with chronic fatigue”.

Pg. 48/86

Telecommunications

“The Royal Society of Canada reviewed the issue of health effects of radio-frequency transmissions for Health Canada in 1999, with updates in 2001 and 2004. The latest report summarizes and is consistent with positions taken by many other authorities in Britain, Europe and the USA (e.g. California). Regulations for telecommunications are based upon avoiding heating of tissue as a result of exposure to electromagnetic radiation. However, other biological phenomena are both plausible and observed at much lower exposure levels. The Royal Society concluded that even if the evidence is not clear that adverse health effects from lower exposures to radiofrequencies exist, there is a need for further research. There is growing evidence of cancers (particularly acoustic neuroma) associated with the use of mobile telephones. Given the seriousness of the adverse effects and the availability of alternative technologies, a precautionary approach is warranted.

In 2006, based upon a comprehensive review of the scientific literature, the International Firefighters took the position that transmission facilities should not be located at fire stations.256 The growing plethora of wireless communication devices such as Internet, WiFi, cell phones, satellite radio, microwave transmissions, TV broadcasts, etc. are exposing the populace to more and stronger electromagnetic frequencies. Shielding may block electromagnetic radiation (but not magnetic fields). Buildings, geography, weather and immediate surroundings affect exposure from telecommunications by reflecting or focusing radiation, thereby creating elevated local levels. Measurements in Canadian cities are many times higher than the regulated levels. Canadian regulations do not require labelling of emissions from communications devices. Use of alternative technologies (wire or fibre data transmission) is the most straightforward, feasible and effective measure to accommodate workers with electromagnetic sensitivities.”

Radiofrequencies on power lines

“Some emerging research regarding electromagnetic sensitivities focuses on the radio-frequency “noise” on power lines. This arises from problems in the wiring and from “chopping” of the 60-cycle signal in modern power-efficient and sophisticated electronics. Remediation of wiring and addition of low-cost tuned circuits to electrical equipment are two steps to address this problem. As a “band-aid,” Graham-Stetzer filters can be plugged into outlets to remove these high frequencies from the power lines. Using these filters to create an electromagnetically “cleaner” environment, improvements are reported for several health outcomes, including multiple sclerosis, behavioural problems and asthma in children in schools, and diabetes”.

Pg. 49/86

Summary

“One of the most effective and economical strategies for achieving healthy indoor spaces and good air quality is to minimize potential pollutants during construction and renovation. ... Least-toxic construction, maintenance and pest control, and infrastructure that minimizes exposure to electromagnetic phenomena all require attention to detail and might entail minimal additional costs”.


Pg. 52/86

“Assessment of electromagnetic phenomena in the workplace involves a variety of measurements and potential remediation, from correction of wiring in the building to use of alternative technologies”.

Pg. 53/86

c) Best practices - Accommodations for children in daycares and schools

“Some of the more detailed and stringent guidelines to improve indoor air quality and to minimize microbes and VOCs in indoor air have been the result of providing healthy environments for children. Citizens for a Safe Learning Environment (CASLE) exhaustively examined considerations for optimum indoor environments in institutions. Recently, the Canadian Partnership for Children's Health and Environment released Playing it Safe: Service Provider Strategies to Reduce Environmental Risks to Preconception, Prenatal and Child Health.” The Partnership also provides a checklist that covers many factors impacting environmental sensitivities, which follows from its “Child Health and the Environment - A Primer.” Health Canada has developed Tools for Schools” information to optimize environmental quality, although they are not as stringent as the citizens’ initiative. As of September 2006, New York State required Green Cleaning” in schools, hoping to improve asthma and behavioural problems”.

pg. 55/86

“This report was prepared to inform employers, service providers and individual Canadians about the medical aspects of environmental sensitivities. It covers the range of symptoms and conditions associated with environmental sensitivities; recognition and awareness by international, national, provincial and municipal bodies; medical research, diagnosis and treatment; issues regarding building codes and practices that affect accommodation of people with sensitivities; accommodation guidelines; and their impact in the workplace.

People’s responses to factors in their environment vary enormously. Some people have debilitating responses to chemicals or electromagnetic radiation. They usually experience neurological difficulties and often have symptoms such as fatigue, burning eyes, headaches, trouble thinking and concentrating, nasal congestion, pain in various parts of the body, respiratory distress and gastrointestinal ailmentsSymptoms are reproducible with repeated exposures, and resolve with avoidance of environmental factors that trigger symptoms. This condition may be initiated by one or a combination of environmental factors such as mould, pesticides, solvents, chemicals or electromagnetic phenomena.

Approximately 3% of Canadians have been diagnosed with environmental sensitivities and up to one-third of the population may experience discomfort due to factors in their environment. Early recognition, environmental control, avoidance of symptom-triggering agents, removal of residual toxins from the body, and recovery of normal biological processes are key to regaining and maintaining health for people with sensitivities. However, susceptibility to sensitivities will be lifelong.

Recognition of environmental sensitivities is developing internationally and in many Canadian government departments. Environmental sensitivities and related conditions are eligible for compensation by some Workers’ Compensation Boards, although there is marked inconsistency across Canada. Public policy, law and regulation are advancing to protect people from triggers of sensitivities, such as tobacco smoke, pesticides, scents and other chemicals in public places.... Furthermore, the medical community is advocating for broader policies and laws and increasingly acknowledging environmental sensitivities in medical education.”

pg.56/86

“Green” guidelines incorporate a wide range of important environmental measures, but do not ensure that indoor environmental quality will be sufficient for people with sensitivities. More stringent guidelines have been developed for schools.

Improving the environmental quality of the workplace promotes workers’ health and productivity and can prevent the development of sensitivities in others . Building or renovating with a view to accommodating people with sensitivities is not costly over the longer term; nor are education and leadership for behaviour change in the workplace.”
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Accommodation for Environmental Sensitivities: Legal Perspective

Excerpts:

Pg. 3

Executive Summary and Recommendations

The Canadian Human Rights Commission commissioned this research project to examine past legal assessments of accommodation for environmental sensitivities, including how third parties may be involved and the relevance of buildings codes and standards. Environmental sensitivities are a complex and often poorly understood group of chronic conditions. Individuals with environmental sensitivities experience adverse reactions to environmental agents that are prevalent throughout the built environment and include electromagnetic fields and the chemicals found in building materials, furniture, cleaning and copying products, fragrances and pesticides”

Accommodations that individuals with environmental sensitivities may require generally involve minimizing the use of triggering substances, filtering triggers from the environment or avoiding the trigger-filled environment. Each type of accommodation may meet the test of undue hardship in Canada, but will depend upon the circumstances of the accommodating entity. The entity may be able to require the individual’s non-attendance, where attendance would be detrimental to his or her health, and the entity may be required to use enforcement mechanisms to ensure that third parties co-operate with accommodation measures”.
                                                                       
Pg.8

“While this paper uses the term “environmental sensitivities,” numerous other terms refer to the same or similar conditions, including “multiple chemical sensitivity (MCS),” “chemical injury,” “sick building syndrome,” “environmental illness,” “environmental hypersensitivity,” “electromagnetic field (EMF) sensitivity,” “Gulf War syndrome,” “environmental sensitivity disorder,” “20th century disease” and “environmental allergies.” Because of the variation in triggers and symptoms, it is preferable to refer to sensitivities in the plural, rather than the singular.”

Pg. 9

II. Environmental Sensitivities, Disability and Medical Evidence

a. Definitions of Disability

“International approaches to definitions of disability in human rights protection vary in their reliance on medical diagnoses and symptoms. At one end of this spectrum are the Canadian and Australian approaches, in which a very broad definition of disability is adopted. As a result of this, complainants are required to provide minimal medical evidence to establish that they qualify as persons with a disability, and individuals with environmental sensitivities do not need to prove the veracity of their condition. In fact, the courts have specifically held that the inability of the medical community to diagnose a condition or identify its cause does not affect whether an individual has a disability, so long as its triggers can be identified. Instead, the analysis is meant to focus on the individual’s accommodation needs and the behaviour of the employer or service provider”.



Pg. 33

VI. Conclusion

“Successful accommodations require innovative strategies to minimize or eliminate exposure to triggers through their elimination or removal from the environment or through avoidance of the environment . Individuals normally excluded from the accommodation process, such as colleagues, other service recipients and neighbours, must actively participate in many accommodations of people with environmental sensitivities if the accommodation is to be successful. Employers and service providers must be willing to develop and utilize enforcement mechanisms to compel compliance where it is not provided voluntarily”.