Responses to controlled diesel vapor exposure among chemically sensitive Gulf War veterans.
OBJECTIVE
A significant proportion of Gulf War veterans (GWVs) report chemical sensitivity, fatigue, and unexplained symptoms resulting in ongoing disability. GWVs frequently recall an association between diesel and petrochemical fume exposure and symptoms during service. The purpose of the present study among GWVs was to evaluate the immediate health effects of acute exposure to chemicals (diesel vapors with acetaldehyde) with and without stress.


METHODS
In a single, controlled exposure to 5 parts per million (ppm) diesel vapors, symptoms, odor ratings, neurobehavioral performance, and psychophysiologic responses of 12 ill GWVs (GWV-I) were compared with 19 age- and gender-matched healthy GWVs (GWV-H).


RESULTS
Relative to baseline and to GWV-H, GWV-I reported significantly increased symptoms such as disorientation and dizziness and displayed significantly reduced end-tidal CO(2) just after the onset of exposure. As exposure increased over time, GWV-I relative to GWV-H reported significantly increased symptoms of respiratory discomfort and general malaise. GWV-I were also physiologically hyporeactive in response to behavioral tasks administered during but not before exposure.


CONCLUSIONS
Current symptoms among GWV-I may be exacerbated by ongoing environmental chemical exposures reminiscent of the Gulf War. Both psychologic and physiologic mechanisms contribute to current symptomatic responses of GWV-I.
Department of Environmental and Community Medicine of UMDNJ-RWJ Medical School, Piscataway, NJ 08854, USA. nfiedler@eohsi.rutgers.edu
Nancy
N
Fiedler
Nicholas
N
Giardino
Benjamin
B
Natelson
John E
JE
Ottenweller
Clifford
C
Weisel
Paul
P
Lioy
Paul
P
Lehrer
Pamela
P
Ohman-Strickland
Kathie
K
Kelly-McNeil
Howard
H
Kipen
D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D002245:Carbon Dioxide / Q000032:analysis; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018777:Multiple Chemical Sensitivity / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D009812:Odorants; D010092:Oximetry; D018923:Persian Gulf Syndrome / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012143:Respiratory Physiological Phenomena; D012903:Smell / Q000502:physiology; D013315:Stress, Psychological / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D001335:Vehicle Emissions / Q000009:adverse effects*; D014728:Veterans / Q000523:psychology
D001335:Vehicle Emissions; D002245:Carbon Dioxide