Clinical ecology

Clinical ecology was the name given by proponents in the 1960s to a claim that exposure to low levels of certain chemical agents harm susceptible people, causing multiple chemical sensitivity and other disorders. Clinical ecologists are people that support and promote this offshoot of conventional medicine.^[1] They may have a background in the field of allergy, and the theoretical approach is derived in part from classic concepts of allergic responses, first articulated by Theron Randolph, leading them to find cause-and-effect relationships or low-dose effects that are not generally accepted by toxicologists.^[1] Components of the mainstream medical community have rejected these claims.^[2]

Training and qualifications

"Clinical Ecologist" is not claimed to be anything more than an orientation in the practice of holistic medicine. Current practitioners with this orientation do not use the term "Clinical Ecologist," although those opposed to this complementary medicine approach to illness often still do. Unlike terms such as physician or nurse, the term clinical ecologist is not legally regulated in any jurisdiction, which means that any person may legally claim to be a clinical ecologist. If wanted, they may obtain an extralegal certification or membership from the unregulated private organization American Academy of Environmental Medicine upon payment of a fee.^[1][3]

Many clinical ecologists are licensed healthcare professionals.

History

Randolph published a number of books to promote clinical ecology and environmental medicine, including:

• Randolph, Theron G. (1962). Human ecology and susceptibility to the chemical environment. Springfield, Ill: Thomas. ISBN 0-398-01548-1. 
• Moss, Ralph W.; Randolph, Theron G. (1980). An alternative approach to allergies: the new field of clinical ecology unravels the environmental causes of mental and physical ills. New York: Lippincott & Crowell. ISBN 069001998x. 
• Randolph, Theron G. (1987). Environmental medicine: beginnings and bibliographies of clinical ecology. Fort Collins, CO: Clinical Ecology Publications. ISBN 0-943771-00-5. 

In 1965, Randolph founded the Society for Clinical Ecology as an organization to promote his ideas about symptoms reported by his patients.

During the 1980s the movement was rejected by some medical organizations and judges,^[1] and health insurance companies often refused to pay their bills. The society's name was changed from the Society for Clinical Ecology, according to its opponents, in order to flee from its bad reputation.^[2]

Criticism

Randolph's theories about chemical effects have been criticized as nonsensical by toxicologists, and his rejection of the signal importance of IgE antibodies in true allergy conflicts with modern allergists. Of course, Randolph did not claim that environmental sensitivities were "true allergies" mediated by IgE and this fine point is irrelevant to people suffering from non-allergic sensitivities. The turf war waged by allergists and defense expert witnesses has long since been understood as irrelevant to the true, recognized category of illnesses observed and accepted by two workshops of the National Academy of Sciences.

Clinical ecology is not a recognized medical specialty.^[4] Practitioners have been criticized for tricking mentally ill and suggestible women into thinking that they were chemically sensitive.^[2] Critics of clinical ecology charge that multiple chemical sensitivity has never been clearly defined, no scientifically plausible mechanism has been proposed for it, no diagnostic tests have been substantiated, and not a single case has been scientifically proven. Well-conducted studies establishing the theories and practices of clinical ecology were not found in reviews of evidence supporting its practices by the American Medical Association in 1992,^[5] the American College of Physicians in 1989,^[6] the Canadian Psychiatric Association, the International Society of Regulatory Toxicology and Pharmacology in 1993,^[7] the American Academy of Allergy, Asthma and Immunology,^[8] and more recently by the American College of Occupational and Environmental Medicine in 1999.^[9]

Clinical ecology is an offshoot of Environmental Medicine and a sub-specialty within the biological anthropology field. Specifically ecological anthropology. Ecological anthropology studies how humans interact with our environment and vice versus.

References

1. ^ ^{a b c d} Federal Judicial Center, Reference Manual on Scientific Evidence, second edition, pages 30, 416-17, 432 (2000).
2. ^ ^{a b c} Murphy M (2000). "The 'elsewhere within here' and environmental illness; or, how to build yourself a body in a safe space". Configurations 8 (1): 87–120. 
3. ^ Membership requirements of the American Academy of Environmental Medicine. Accessed 27 October 2009.
4. ^ ACOEM position statement. Multiple chemical sensitivities: idiopathic environmental intolerance. College of Occupational and Environmental Medicine. J Occup Environ Med. 1999 Nov;41(11):940-2.
5. ^ AMA Council on Scientific Affairs. Clinical ecology. JAMA 268:3465-3467, 1992.
6. ^ Terr AI. Clinical ecology in the workplace. Journal of Occupational Medicine 31:257-261, 1989.
7. ^ Board of the International Society of Regulatory Toxicology and Pharmacology. Report of the ISRTP Board. Regulatory Toxicology and Pharmacology 18:79, 1993.
8. ^ Anderson JA and others. Position statement on clinical ecology. Journal of Allergy and Clinical Immunology 78:269-270, 1986
9. ^ Position Statement on Multiple Chemical Sensitivities: Idiopathic Environmental Intolerance. American College of Occupational and Environmental Medicine, April 26, 1999