Physician support

Formal and informal MCS support networks exist across the country. The following resources are intended to be starting points that will lead you to additional resources and help you to locate MCS-aware physicians, support groups or individuals with MCS in your area who can offer local information and referrals. These are just a few of the many organizations and groups serving people with MCS. Most of them are run by volunteers who have the illness. It is recommended that you contact at least several groups for information. Each offers a different perspective. Comparisons can be helpful. 

An invitation to join a pharmaceutical company, which is not given lightly, represents an opportunity to join a complex, cooperative enterprise. Within it, synthetic and medicinal chemists are not optional but indispensable, and their role has been likened to a mother s The chemist gives birth to the drug [italics added], but the [physician] supports its first steps (attributed to Foumeau by A Maurois)." Indeed, the labor of birthing drugs can earn not only a chemist s salary but a clinician s respect. 

The plant should have access to a full- or pan-lime occupational health physician supported by an occupational health nurse. They. should be responsible for the conduct and recording of pre- and periodic medical surveillance and be available for any emergency overexposures and poi.soning, Equipment and antidotes should be readily available in the event trf an accidental poisoning (c,g., aiisvays, oxygen, mask with manual inflator, and atropine and oxime). 

Technique The patient s knees and hips are flexed and the physician supports the patient s thighs on her thigh. Pressure is applied cephalad as the knees are rotated toward the side of dysfunction (Fig. 39-4). 

Full-day (24 hours) physician coverage is not essential, providing that experienced respiratory nurses, or in North America, RTs, are on site for 24 hours. If an experienced physician, supported by a knowledgeable team, is available during the day, most of the untoward medical events can be predicted. 

In most situations, adequate, usuaHy forced, ventilation is necessary to prevent excessive exposure. Persons who drink alcohol excessively or have Hver, kidney, or heart diseases should be excluded from any exposure to carbon tetrachloride. AH individuals regularly exposed to carbon tetrachloride should receive periodic examinations by a physician acquainted with the occupational hazard involved. These examinations should include special attention to the kidneys and the Hver. There is no known specific antidote for carbon tetrachloride poisoning. Treatment is symptomatic and supportive. Alcohol, oHs, fats, and epinephrine should not be given to any person who has been exposed to carbon tetrachloride. FoHowing exposure, the individual should be kept under observation long enough to permit the physician to determine whether Hver or kidney injury has occurred. Artificial dialysis may be necessary in cases of severe renal faHure. 

Many traditional allergists and other physicians discount the existence of an MCS diagnosis. They claim that there is not yet sufficient evidence that MCS exists. Research efforts regarding the mechanisms that cause MCS have been inadequate and unfortunately are often financed and supported by the industries which benefit from chemical proliferation. Generally medical doctors have not been trained to... 

Medical surveillance programs range from support contracts with local hospitals or physicians to full-scale on-site occupational health organizations that include physicians, nurses, and technicians who are employed by prime contractors. The option selected depends on the size of the project, the nature of the hazards involved, the capabilities of local facilities, and the resources available. 

Where sufficient toxicologic information is available, we have derived minimal risk levels (MRLs) for inhalation and oral routes of entry at each duration of exposure (acute, intermediate, and chronic). These MRLs are not meant to support regulatory action but to acquaint health professionals with exposure levels at which adverse health effects are not expected to occur in humans. They should help physicians and public health officials determine the safety of a community living near a chemical emission, given the concentration of a contaminant in air or the estimated daily dose in water. MRLs are based largely on toxicological studies in animals and on reports of human occupational exposure. 

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