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In their book on multiple chemical sensitivity (MCS), Drs Nicholas Ashford and Claudia Miller say, "In recent years, we have observed a tendency to name MCS-like conditions after the suspected initiating event, for example, darkroom disease and Gulf War syndrome.... This may cloak a larger view that there is an underlying, unifying mechanism, for example, that some people lose tolerance following certain chemical exposures, and that thereafter their symptoms are triggered (and their illness is perpetuated) by common, low-level exposures."

Exposures that appear to initiate MCS are most often pesticides (especially organophosphates) and solvents. However, once the illness has a foothold, triggers are often substances like perfumes, tobacco smoke or cleaning agents. Because of this, patients often mistake triggers for the initiator.

They cite recent US research, involving random telephone surveys, which found that around 5% of people reported symptoms of MCS. In other surveys, 15-34% said they were unusually sensitive to certain chemicals. Although there are now many theories about the mechanisms involved in MCS, much more research is needed. According to Ashford and Miller: "Funding agencies will need to make a much greater financial commitment if progress is to be made.... [By] not understanding the causes of chemical sensitivity, we take an immense gamble - but knowledge will not come cheaply. Understanding chemical sensitivity is pivotal to establishing sound environmental policy. If there is a subset of the population that is (or can become) especially sensitive to low-level chemical exposures, a strategy for protecting them must be found" (N. Ashford and C. Miller, Chemical exposures - low levels and high stakes, 2nd edition, Van Nostrand Reinhold, 1998).

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