To the Editor.
—Dr Terr's study "Environmental Illness"1 reported in the January 1986 issue of the Archives, represents a significant advance for a common problem in occupational medicine. The concept that low-level exposure to chemicals results in widely diverse illnesses2,3 has resulted in an explosion of workers' compensation suits involving such "environmental illnesses" in the state of California. As an Agreed and Independent Medical Examiner, I have evaluated many such cases. It is of interest that all but four of Dr Terr's cases were litigated.Dr Terr's study represents a true scientific approach in evaluating this concept. It helps to put it in its proper perspective. As he indicates, this does not mean that chemicals do not cause disease. In certain circumstances in certain individuals, we must demand some objectivity before confirming an organic illness.Another method used to incriminate an organic illness due to chemicals is the use
Markovitz A. Environmental Illness. Arch Intern Med. 1986;146(6):1244. doi:10.1001/archinte.1986.00360180264064