The diagnosis of chemical poisoning is suspected from a history of exposures resulting in typical clinical syndromes and confirmed by the

appropriated medical tests. There are a series of criteria to be fulfilled to make a confident clinical diagnosis of poisoning by chemicals. The following criteria have to be fulfilled: 1. The subject was fit and well prior to chemical exposures. 2. There is evidence of exposure to the putative chemicals and toxins. 3. The subject initially developed local symptoms which became worse with repeated exposures. 4. With repeated exposures a typical clinical picture emerges characterised by chronic fatigue syndrome, immune disruption (allergies, autoimmunity, susceptibility to infections), accelerated ageing (so the sufferer gets diseases before their time), neuro-degeneration, diabetes and cancer. 5. Similar patterns of disease are seen in other people working under similar conditions. 6. Similar fact evidence from other subjects who have been poisoned such as the Gulf War veterans, sheep dip poisoned farmers, aerotoxic pilots. 7. There is laboratory evidence of poisoning and effects of that poisoning. 8. There are no other possible explanations for this pattern of symptoms. 9. There is a response to treatment with clinical improvements as a result of detoxification, nutritional and immune support.

The Clinical Picture of Chemical Poisoning

It is important to realise that the diagnosis of chemical poisoning relies on recognition of a clinical picture. Let me draw an analogy. If I saw a photograph of the Queen, standing on the balcony at Buckingham palace, surrounded by members of the Royal Family, with the flag flying above, the band playing below and thousands of people cheering, I would be happy to diagnose that it was indeed the Queen I was looking at. To be certain I would have to ask for DNA testing, but this has never been requested and never been done because the clinical picture is so obvious. We have a similar situation with people who have been chemically poisoned. The clinical picture to those trained and used to seeing it is obvious. The problem arises because these people who are poisoned have only presented in the last few years. This is not a long standing recognisable syndrome, it is a new illness. Doctors are traditionally very slow to recognised new diseases and most not only fail to even look at the clinical picture, many do not accept it exists at all because it does not fit into their paradigm of disease! It really does create a new picture! So for example it has taken the Americans 17 years to recognise the clinical picture of Gulf War Syndrome and ascribe this to pesticide poisoning. Fortunately the 9/11 firemen who were poisoned by the fumes inhaled as they fought the flames and picked over the debris of the destroyed twin towers had their illness quickly recognised and a detoxification centre set up in New York allowed effective and immediate treatment.