Exposures which can induce multiple chemical sensitivity (MCS) involve symptomatic, usually repeated, exposures to pesticides, solvents, combustion products, remodeling, sick buildings, carbonless copy paper (occupational heavy use) and other irritants and petrochemicals. Accompanying toxic injury often involves the immune, endocrine and nervous systems as well as impairments in detoxication, energy and neurotransmitter metabolism, protein, mineral, and other nutrient de ciencies and gastrointestinal changes such as candida, parasites, reduced chymotrypsin (marker enzyme for reduced pancreatic enzyme function), gluten intolerance, and reduced Secretory IgA. Chronic cortisol elevation leading to adrenal insuf ciency if not corrected is common. Such elevation can lead to protein and mineral de ciencies with increased osteoporosis and reduced steroid precursors for normal estrogen and testosterone production. Detoxi cation changes often involve reduction in one or more Phase II pathways which causes excess free radical production. Impaired digestive enzymes can reduce breakdown of foods, with larger more antigenic molecules being absorbed and consequent food intolerances. Many of these conditions are treatable. There is extensive overlap of MCS with Chronic Fatigue Syndrome and Fibromyalgia which may be one condition in many cases. Current occupational exposure limits are not health based and thus may not prevent MCS and are totally inadequate to accommodate sensitive persons. Warning symptoms indicating increased risk for MCS onset include repeated headache, eye and respiratory irritation and fatigue. Eliminating exposures which cause repeated symptoms is a critical strategy for preventing sensitization and MCS. It also signi cantly reduces the degree of disability in persons with MCS, the single most important factor from the literature. Affected persons with disability can utilize the Americans With Disability Act to request reasonable accommodations for work, home (condo, apartment), and school.