Exclusive Interview for Medicine.Org. with Dr. William J. Rea, MD, FACS, FAAEM, Founder and Director of the Environmental Health Center-Dallas Speaks on Chemical Sensitivity
[Note: This interview was conducted November 28, 2006 by Steve Ross, MA, editor of the Chemical Sensitivity section, and co-editor of the Mental Health section, of Medicine.Org. Steve has known Dr. Rea since the year 2000, when he and his wife, Julie, visited the Environmental Health Center-Dallas, Dr. Rea's clinic, to treat Julie's severe chemical sensitivity. She was very sick at the time. Not feeling ill himself, Steve casually decided to be tested, just to see what would happen. When tests showed that he was on the brink of auto-immune illness, he became a patient too. Julie knows that Dr. Rea's guidelines, protocols (including the rotation diet), and antigens, especially the ground-breaking Autogenous Lymphocytic Factor (ALF) and the B-Cell Stimulator, saved her life. And by following Dr. Rea's orders, Steve reversed his auto-immune marker from positive to negative, saving him from sliding into a seriously debilitating illness. We believe Dr. Rea's clinic is the premier treatment facility in this country for the diagnosis and treatment of chemical sensitivity.]
Medicine.Org: Dr. Rea, thank you so much for your time today. This interview is for Medicine.Org, a non-profit site maintained and updated by site editors, healthcare consumers, and health professionals. The mission of Medicine.Org is to create a quality information and news resource – a healthcare connection -- for patients, family members and medical professionals. The site does not accept commercial advertisements or endorse any products or services.
I believe your practice was not initially in the environmental area. What was your field and how did you become a specialist in environmental medicine?
WJR: Well, my field was general surgery and cardiovascular surgery, but, of course, during that time I studied a lot of lung diseases which were due to molds and mycotoxins. I also studied blood vessel inflammation and worked on the artificial lung and artificial heart, and realized that the plastics really did damage the individual. And so it was a gradual evolving of ideas with that background.
Medicine.Org: Were there other environmental specialists at that time?
WJR: Yes, Doctor Randolf was the fellow who started that field and he was very active at that time. And of course I found him, read his book, and knew that he knew what he was talking about.
Medicine.Org: Was he a mentor of yours?
Medicine.Org: What was the state of the art at that time?
WJR: Well, there were probably a hundred guys doing this to some lesser extent in their offices, while Dr. Randolf was doing it in a hospital at this time. The big thing was that there was really no technical data. For example, we have T&B cells now and blood levels for different toxics, and minerals, and so on, and we didn’t have that at that time.
Medicine.Org: If you do experimental research at your clinic, what contributions to the field of Environmental Medicine have come from your efforts?
WJR: We do experimental research and I think the big thing that has come is the fact that we’ve helped create less toxic housing. * We’ve written books on this so that people can build houses they are comfortable in or remodel houses that they have to be less toxic. The other thing that’s happened is that we have developed Autogenous Lymphocytic Factor (ALF) and another one, the Mycotoxin Lymphocytic Factor (MIM) that modulate the immune system, and these have been pretty good for a lot of our people. And of course we’ve developed a very large clinic for implant toxicity because a lot of people have reaction to their implants, such as heart valves, hip replacements, tooth or jaw replacements – there are 220 different implants now.
Medicine.Org: How do you address that?
WJR: Well, we make vaccines for them and some of them, if we can get them removed, we do that, but not all of them can be.
Medicine.Org: On your website you have an illustration called the Principles of Chemical Sensitivity. However, there appears to be no universally accepted medical definition of chemical sensitivity. Why is this and how would you define chemical sensitivity?
WJR: I would define Chemical Sensitivity as the adverse reaction to the ambient dose of toxic and non-toxic chemicals, and it can be manifested in any system in the body. The definition problem stems from the work of Cullen from Yale.1 We’re not sure whether he worked for the chemical companies or whether he just was ignorant. [In any case] …he didn’t come to any of us. He created something called “Multiple Chemical Sensitivity” and this was defined as an entity that has only clinical symptoms and no signs and no laboratory data. Of course he was very wrong about that. And that has fueled the controversy for the last twenty years. And that’s been part of the problem. But I think everybody working in the field agrees on the definition that I gave.
Medicine.Org: That’s particularly interesting because most of the people we know with chemical sensitivity refer to their problem as “Multiple Chemical Sensitivity.”
WJR: Yes, I know, and that’s always been a problem because they don’t realize the legal implications. The legal implications are that it is psychosomatic because you have no physical findings and no laboratory data. Every chemically sensitive patient we see has physical signs and laboratory data.
Medicine.Org: What are the main terms you use to describe environmental illness?
WJR: Well, Environmental Illness is just a very big waste basket that encompasses all of medicine, basically, and all environment. Environmental Illness is any entity that is triggered by something in the environment. I mean, infections are environmental illness, if you want to look at it that way. Or bio-infections, bacterial infections, protozoa, amoeba, or anything that’s related to the environment, pesticide-induced and so on. It’s such a broad term that we don’t use it. And some people with a brain involvement have neurotoxicity, which is in the code books. We try to stick with the medical code books because most of it fits in there, you see. Lot of people have vasculitis, inflamed blood vessels, so that’s in the code books.
Medicine.Org: Can you identify the most common signs and symptoms of multiple chemical sensitivity…let me drop this word “multiple” from now on…patients with chemical sensitivity?
WJR: No, because that’s individual, related to whatever (organ) system is involved. But generally, people with chemical sensitivity have odor sensitivity, like to perfumes, gasoline, car exhaust, and so on, but there is also a large group that doesn't.
Medicine.Org: How do allergies differ from chemical or other environmental sensitivities?
WJR: Well, number one, normal allergies are now defined as anything that triggers the IgE mechanism, that’s gammaglobulin E mechanism. That’s a very narrow type of substances, usually involving runny noses and sinus and sometimes asthma and occasionally skin diseases. Whereas the sensitivities like chemical sensitivities, food sensitivities, may not be that mechanism. There are multiple mechanisms involved.
Medicine.Org: What is the relationship between chemical sensitivity and auto-immune disorders like Lupus, Multiple Sclerosis, and Crohn’s Disease?
WJR: A lot of the auto-immune disorders are triggered by chemicals. If you remove the chemicals or are lucky enough to figure out the triggering agent, a lot of those diseases will regress. But if they become too autonomous, then there’s nothing you can do about them. In other words, they can be self-generating after a while, if they’ve gone on too long.
Medicine.Org: Do you consider chemical sensitivity a true illness?
WJR: Of course it is.
Medicine.Org: Do you consider it an auto-immune disorder?
WJR: No. **
Medicine.Org: Can you briefly talk about the course, prognosis, and treatment of Chemical Sensitivity?
WJR: It’s too broad a field. I can’t really do that because it depends on which end-organ is involved. For example, if you’ve got asthma due to chemicals, and you’ve got chemical sensitivity, a lot of times, yes, that can be cleared. But sometimes people have so much lung damage that it progresses and you have lung failure and you eventually die from it, you see. And that’s true of every organ.
Medicine.Org: So it’s very specific.
Medicine.Org: If people can’t go to a clinic like the Environmental Health Center-Dallas, is there self-treatment they can do?
WJR: Well, only to a point. I mean, you know, everybody can protect themselves by drinking glass-bottled spring water, no plastics, eating organic food, and trying to get as good air as they can. Everybody can do that and it does help people.
Medicine.Org: Are there other illnesses you have found to have a major environmental component?
WJR: Oh yes. In my opinion, almost every disease has a major environmental component and probably a genetic component as well. These are usually time bombs waiting for the environmental triggers. But every disease has some environmental influence. Sometimes it may not be very much, but other times it may be very significant.
Medicine.Org: Pesticides, herbicides, insecticides, and fungicides are used everywhere. On the one hand some experts say they are dangerous, while on the other hand we see some landscapers, gardeners, even pest exterminators applying these chemicals with little or no protection. What would you say about the health impact from pesticide exposure?
WJR: Pesticides are dangerous, very toxic. I’d say it is the number one generator of disease in this world today. The only people who really say its not dangerous now are the people who work for the chemical companies or the pesticide companies or people like that.
Medicine.Org: Pesticides are used almost everywhere, in restaurants, schools, in public buildings as well as on food crops. Might there be any connection between pesticide use and the large amount of advertising dollars put into sexual enhancement products like Viagra and Cialis?
WJR: Yes there really is. What’s being found is that the sperm count is going down in the male and loss of libido is skyrocketing, and this can be directly traced in some cases to the pesticides, but also to other toxic chemicals.
Medicine.Org: Regarding relapse, we have heard stories of substantial recovery from chemical sensitivity as well as terrible stories about relapse. Is relapse an issue and if so, what would you advise about relapse prevention?
WJR: Relapse is always an issue because of the fact that you can always get another exposure. I call it the “Second Hit Phenomenon.” That always seems to be worse than the primary hit. But let’s say you’ve really done very well and gotten your body built up and you get a second hit, the thing to do so you don’t relapse very much is to get intravenous nutrients: Vitamin C, Glutathione, Taurine, multi-minerals and B vitamins. Get those for a couple of weeks and usually it will reverse if you get it early. The key, besides avoidance – which is a given – is to get it early.
Medicine.Org: Are there any unusual cases or cautionary tales about that you could discuss with us that might be helpful to others?
WJR: Let’s see. We have a ton of unusual cases. Well, we had one airline flight attendant who was working at the ticket counter right before boarding a flight. Several flights were cancelled so she ended up working there for about 4 hours. They were stripping paint or something in the stairwell behind her. She got exposed to this and almost had a stroke and got severe pancreatitis, inflammation of the pancreas. And it was just a fluke, really, and we have many cases like that. Odd things. Being in the wrong place at the wrong time.
Medicine.Org: Patients with chemical sensitivity and other environmental illnesses are under enormous stress. Doctors may not take their complaints seriously and may refer them to a psychiatrist instead of providing services. They seldom get support from family or friends, their partners usually leave them after a while, they need special housing and often end up living in their cars. Under these conditions, it’s no surprise if such a patient presents as if they have mental problems.
WJR: I would, wouldn’t you?
Medicine.Org: I think so. What are your thoughts about the relationship between environmental illness and mental health?
WJR: If you get brain toxicity – I mean, look, the brain is another organ. You can have heart, lung, or intestinal irregularities, or bladder or kidney abnormalities, but if it hits the brain you can look like you’re crazy. And you’re not! It’s very tragic. Of course the best thing is that you keep that belief up until you find somebody that can help you.
Medicine.Org: Right, because you’ll get a lot of pressure to believe that you are crazy!
WJR: That’s right. Exactly.
Medicine.Org: You have written a book on designing and building a healthy home or office. Could you briefly outline some of the most important principles?
WJR: I really feel strongly about this because we’ve done so many environments. As you know our latest one is with the Marriott Hotel here in Dallas where we’ve built some rooms. So we’ve had a lot of experience. We’ve probably helped remodel or build new about 20,000 buildings now. And what we’ve learned is that, number one, get the concept before you build it. Get it well thought out and written down, you know. Then number two, whoever your builder is, educate him. And you’ve got to be sure you’ve got a conscientious one you can trust. And then the third thing is to make rounds twice a day, morning and night, and supervise him just so nothing goes wrong. If it does, you can deal with it right away before there’s a lot of cost involved. Those are our three biggest principles.
Medicine.Org: We followed those principles in building our house here in Tucson, out in the desert.
WJR: How’s it working out?
Medicine.Org: Really well.
Medicine.Org: The only problem we had was with the heating system. We wanted to let it outgas for about a month before moving in, but had to move in about two weeks sooner than expected.
WJR: You had to move in prematurely.
Medicine.Org: That’s right. As a result she got sensitized to something in the system and although the system is thoroughly outgassed by now, she still feels some reaction to it. It’s the only fly in the ointment. In that respect, we were very lucky.
My last question is about relocation. Due to ill health, many people decide to relocate. What are the most important things to consider when relocating for health reasons?
WJR: The first thing is to evaluate it in all four seasons before you jump, because one season may be fantastic and the next one may be just the pits. Secondly, find out where the wind currents are coming from because they could come from a pollution emitter and dump in your area. Also, take a good look at the local terrain and be sure you’re not in a valley where pollutants or molds will settle.
[Interviewer's Note: At this point my tape recorder failed. However, I have filled in the answer to this question with information from Dr. Rea’s book, Optimum Environments for Optimum Health and Creativity.]
WJR (from the book): The third thing to consider when relocating is the emission levels of the area. The major sources of chemical pollution in the air include transportation, fuel combustion in stationary sources, forest fires, and solid waste disposal. The worst contamination is from large urban areas and rural areas with year-round aerial insecticide spraying. Another important consideration are the area’s weather patterns, which can have a direct bearing on air quality. 2
[Interviewer's Note: At the end of the interview I asked Dr. Rea if he had anything more to say that might be of help to our readers. It surprised and moved me that he immediately returned to the problems people with chemical sensitivity have finding help for this still badly misunderstood and misdiagnosed illness. Although I lost his answer because the tape player malfunctioned, the gist of his original answer was to keep up hope, despite all the difficulties. I called him back two days later to ask again and re-record his answer. Of course we were no longer “in the flow,” but his response was similar: keep up hope.]
WJR: The problem can usually be solved if you continue to work on it.
* Dr. Rea's answer that the development of construction techniques for less toxic housing was his most important contribution to the field, took us by surprise. We expected him to say something like his experimental laboratory vaccines. But on second thought, the healthy housing issue seems paramount. For example, many times the exposure leading to chemical sensitivity is from chronic exposure at home or at work. Under those circumstances, if a person goes for treatment, gets better, and then returns to the toxic environment (even if they have vaccines to help), recovery will be difficult.
1. Mark R. Cullen, editor, WORKERS WITH MULTIPLE CHEMICAL SENSITIVITIES (Philadelphia, PA: Hanley and Belfus [201 South 13th St., Philadelphia, PA 19107; phone (215) 546-4995], 1987). This is Volume 2, No. 4 of the ongoing series called OCCUPATIONAL MEDICINE, STATE OF THE ART REVIEWS.
** Although Dr. Rea did not elaborate on his answer, we thought we would explore further why chemical sensitivity is not considered an auto-immune disease. After all, chemicals can trigger both of them. The reason becomes clear when comparing the medical definition of an auto-immune disorder with Dr. Rea’s definition of chemical sensitivity. Auto-immune disorders are characterized by antibodies that attack one’s own body tissues (for the source of this information, click here). If we understand Dr. Rea correctly, patients with chemical sensitivity – at least those who do not also have an auto-immune disorder – do not have these antibodies in their blood. They therefore cannot, by definition, be diagnosed with an auto-immune condition. But there is another important difference between these two illnesses. Although auto-immune disorders and chemical sensitivity both may be triggered by chemicals (and reversed, if the offending agent is recognized and removed early enough), in untreated chemical sensitivity there is a “spreading phenomenon” that causes adverse reactions to more and more substances. Patients with auto-immune disorders do not experience the spreading phenomenon and can therefore tolerate the “ambient dose” of chemicals, even though exposure to a particular chemical may have triggered their condition.
2. Rea, William J., M.D., Optimum Environments For Optimum Health & Creativity; Designing and Building a Healthy Home or Office, Crown Press, 2002, pp. 40-47.
About Dr. Rea:
William J. Rea, M.D., is a thoracic and cardiovascular surgeon with a strong passion for the environmental aspects of health and disease. Founder of the Environmental Health Center-Dallas (EHC-D), Dr. Rea is currently director of this highly specialized Dallas based medical facility. The center also has a clinic in Chicago, Illinois.
In 1988, Dr. Rea was named to the world's first professorial chair of environmental medicine at the Robens Institute of Toxicology at the University of Surrey in Guildford, England. He was also awarded the Jonathan Forman Gold Medal Award in 1987 and the Herbert J. Rinkel Award in 1993, both by the American Academy of Environmental Medicine, as well as named Outstanding Alumnus by Otterbein College in 1991.He was also named to the Mountain Valley Water Hall of Fame for work in the field of study of clean water and, in 1995, he received the F.A.M.E. Award for pioneering work in environmental and preventive medicine. In 1997 he was named International Man of the Year and in 2002 Dr. Rea received the O. Spurgeon English Humanitarian Award from Temple University.
Author of the medical textbooks, Chemical Sensitivity, Vol. 1-4, a home building book Optimum Environments for Optimum Health and Creativity, and co-author of Your Home, Your Health and Well-Being, Dr. Rea has published more than 100 peer-reviewed research papers related to the topic of thoracic and cardiovascular surgery and environmental medicine.
Born in Jefferson, Ohio, Dr. Rea graduated from Otterbein College in Westerville, Ohio, and Ohio State University College of Medicine in Columbus, Ohio. He then completed a rotating internship at Parkland Memorial Hospital in Dallas, Texas. He held a general surgery residency from 1963-67 and a cardiovascular surgery fellowship and residency from 1967-69 with The University of Texas-Southwestern Medical School system, which includes Parkland Memorial Hospital, Baylor Medical Center, Veterans Hospital and Children's Medical Center.
From 1984-85, Dr. Rea held the position of adjunct professor of environmental sciences and mathematics at the University of Texas, while from 1972-82, he acted as clinical associate professor of thoracic surgery at The University of Texas Southwestern Medical School. He has also served as chief of thoracic surgery at Veterans Hospital and as adjunct professor of psychology and guest lecturer at North Texas State University.