The evaluation of symptoms attributed to specific environmental factors is an important object of clinical environmental medicine (Wiesmueller et al., 2002; Herr et al., 2004). Symptoms can indicate that a person does not tolerate a certain annoyance or is strained by an exposure. In cases of a continued exposure, diseases may arise. A patient has then to decide how to handle his or her perceived symptoms and upcoming consequences of a possible treatment. The decision whether people ignore the symptoms, simply worry about them, treat them by themselves or whether they seek professional medical advice depends on possible causes that a patient identifies for his complaints (Robbins and Kirmayer, 1991). Thus, when it comes to possible diseases, individual awareness concerning the relevance of triggers, is of great importance in the evaluation of causes.

Among patients suffering from environmental-related diseases, the construct of environmental worry (EW) seems to be a possible surrogate to assess these individual awareness processes (Moffatt et al., 2000). The analyses in this paper were focused primarily on the evaluation of EW with the use of a standardized questionnaire, i.e., the Environmental Worry Scale (EWS) according to Hodapp et al. (1996). In scientific theory, worry is described as a process of mental problem solving which may lead to a benefit in the motivation of the individual and in defining potential problems. According to Borkovec et al. (1983) worry is a ‘‘relatively uncontrollable chain’’ of negative thoughts and images. Obviously, there are individual differences in experiencing worry and the question arises ‘‘How much worry is too much?’’, as proposed by Taillefer et al. (2003). Until now, no reference values for an acceptable level of worry have been established.

So, the presented work intends to demonstrate the relevance of the assessment of EW in the context of reported health complaints considering as example patients with self-reported multiple chemical sensitivity (MCS). From a clinical point of view, MCS is characterized by reported sensitivity concerning a great number of different chemical substances in concentrations still tolerated by healthy individuals. The sensitivity is expressed through several different symptoms in multiple organ systems (MCS-Consensus, 1999). Over the years, different hypotheses have been developed on the etiology of MCS, i.e., toxicological, enzymatic, olfactory as well as immunological assumptions (Eis et al., 2005; Hornberg et al., 2003, 2004; Wolfe et al., 2002; Simon et al., 1993; Bell et al., 1992). So far, the etiological role of worry about environmental factors has not been considered in MCS-related research. However, it can be assumed that for patients suffering from MCS the environment is ideal for projecting anxiety and worry. The assessment of worry with the use of the EWS may help to put a patient’s worries into concrete terms and to individualize risk communication. According to Stoeber (1998), defining worries plays a vital role in depicting problems and finding solutions; a process that has an impact on the healing process.

Categories: Kebijakan Lingkungan
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