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Responses to Controlled Diesel Vapor Exposure Among Chemically Sensitive Gulf War Veterans

From the Department of Environmental and Community Medicine of UMDNJ-RWJ Medical School (N.F., C.W., P. Lioy., K.K.-M., H.K.) Piscataway, NJ; Department of Psychology (N.G.), University of Cincinnati, Cincinnati, OH; Biometrics Division (P.O.-S.), UMDNJ-School of Public Health, Piscataway, NJ; Department of Neurosciences (B.N., J.E.O.), UMDNJ-New Jersey Medical School, East Orange, NJ; and Department of Psychiatry (P.Lehrer), UMDNJ-RWJ Medical School, Piscataway, NJ.

Address correspondence and reprint requests to Nancy Fiedler, PhD, UMDNJ-RWJ Medical School, 170 Frelinghuysen Road, Room 210, Piscataway, NJ 08854. E-mail: nfiedler{at}eohsi.rutgers.edu

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 CO₂ 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.

Key Words: GWVs, • chemical sensitivity, • psychophysiology, • diesel vapors, • hyperventilation.

Abbreviations: CDC = Centers for Disease Control;; CEF = Controlled Environment Facility;; CII = Chemical Odor Intolerance Index;; DIS = Diagnostic Interview Schedule;; DSM-III-R = Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, revised;; ETCO₂ = end-tidal CO₂;; ECG = electrocardiogram;; FFT = Fast Fourier Transformation;; GWV = Gulf War veterans;; GWV-H = Gulf War veterans-healthy;; GWV-I = Gulf War veterans-ill;; HEI = Health Effects Institute;; HEPA = high efficiency particulate air;; HF = high frequency;; MANOVA = multivariate analysis of variance;; POET = pulse oximeter end-tidal;; POL = Performance On-Line;; rMSSD = square root of the mean of squared successive differences;; VOC = volatile organic compounds.

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