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April 7, 1993

Clinical Ecology

JAMA. 1993;269(13):1634-1635. doi:10.1001/jama.1993.03500130048018

To the Editor.  —The recent Council Report1 on clinical ecology repeats a mistake that has been made in position papers published by other medical societies. The report confuses criticism of a mode of medical practice (clinical ecology) with analysis of several clinical conditions. Does the Council on Scientific Affairs really mean to imply that chronic fatigue syndrome (CFS), sick building syndrome (SBS), and multiple chemical sensitivity syndrome (MCSS) are inventions of clinical ecology? Each of these syndromes is the target of serious research by a broad spectrum of medical and environmental scientists.Well-conducted surveys have suggested that more than 20% of office workers suffer from nonspecific, building-related complaints.2 The World Health Organization made one of the first attempts to group these symptoms into one general definition of SBS.3 Extensive research on the health effects of indoor air pollution has failed to identify a specific causative agent for