Healthcare Access for Adults with Multiple Chemical Sensitivity in Canada: A Cross-sectional Survey

Multiple chemical sensitivity (MCS) is a chronic condition characterized by adverse multisystem reactions including to low-level chemical exposures. The use of fragranced and disinfectant products within healthcare institutions was frequently reported by individuals with MCS as a challenge to accessing healthcare. This study was conducted during the COVID-19 pandemic, when the use of infection control measures may have intensified the pre-existing barriers. This study examines how adults with MCS in Canada experience access to healthcare (such as access to diagnosis, physicians, and satisfaction with in-person and virtual care). A national cross-sectional survey was conducted between January and February 2021 among adults living with MCS for at least one year prior to the pandemic. Quantitative and open-ended questions captured experiences related to diagnosis, access to physicians, and satisfaction with virtual and in-person healthcare. Of the 119 participants who completed the survey, most reported having a formal diagnosis of MCS (78%). Among those who could not obtain an MCS diagnosis, common barriers included obtaining any other diagnosis but MCS (62%), and the belief among medical professionals that MCS does not exist (58%). In virtual care, dissatisfaction was primarily driven by a lack of understanding of the condition (43%). Dissatisfaction with in-person care was similarly attributed to a lack of understanding of the condition (21%) and exposure to cleaning and disinfection products (21%). Pandemic-related public health responses intensified pre-existing barriers to care for people with MCS by increasing chemical exposures and constraining access to knowledgeable providers. These findings highlight the need for healthcare systems and emergency preparedness frameworks that integrate chemical safety, disability inclusion, and provider education to ensure equitable access, including during public health crises.