Clinical ecology in the workplace.

The field of clinical ecology is based on a putative diagnosis of "environmental illness," applied to persons who have multiple symptoms and are believed to be sensitive to numerous items in the environment. Increasingly this diagnosis is being used by workers for an occupational disability claim. Medical records of 90 workers claiming work-related "environmental illness" were reviewed. The majority were women. They worked in a variety of occupations with no unifying feature of the type of work or the claimed causative exposure. Symptoms were multiple and unaccompanied by objective clinical findings. Careful review of medical records showed that most had their symptoms before the claimed occupational exposure. Examining physicians who were not clinical ecologists invariably arrived at other diagnoses, usually psychiatric. This retrospective review lends no support to the clinical ecology concept of "environmental illness."