RESUMEN
The objective of this study was to compare the driving habits and vehicle maintenance patterns of individuals who report symptoms when exposed to methyl tertiary-butyl ether (MTBE) and those who are asymptomatic when exposed to the oxygenate. Participants were healthy volunteers (CON) and self-reported MTBE-sensitive individuals (SRS) who participated in a controlled exposure study of MTBE in gasoline. A questionnaire was developed to gather information about each participant's automobile usage, engine maintenance habits and fueling and driving patterns. Results showed that the individuals who had self-reported heightened sensitivity to the oxygenate drove their vehicles more often and fueled their vehicles more frequently than asymptomatic individuals. In addition, the self-reported symptomatic individuals in this study were shown to be more likely to drive vehicles with some form of body damage and carbureted engines.
Asunto(s)
Contaminantes Atmosféricos/análisis , Conducción de Automóvil , Exposición a Riesgos Ambientales , Éteres Metílicos/análisis , Emisiones de Vehículos/análisis , Actividades Cotidianas , Adulto , Recolección de Datos , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVES: preliminary surveys of Persian Gulf veterans revealed a significant prevalence of self-reported symptoms consistent with chronic fatigue syndrome (CFS). The purpose of this study was to compare self-reported life stressors, combat, and chemical exposures, personality and coping between Gulf War veterans with CFS and healthy veterans. METHODS: following a complete physical, psychiatric, and neuropsychological evaluation, 45 healthy veterans, 35 veterans with CFS and co-morbid psychiatric disorder, and 23 veterans with CFS and no co-morbid psychiatric disorder completed questionnaires assessing war and non-war-related life stressors, self-reports of environmental exposure (e.g. oil well fires, pesticides), personality, and coping. RESULTS: measures of personality, self-reported combat and chemical exposures, and negative coping strategies significantly differentiated healthy veterans from those with CFS. CONCLUSION: a biopsychosocial model of veterans' illness was supported by the fact that personality, negative coping strategies, life stress after the war, and environmental exposures during the war were significant predictors of veterans' current physical function.
Asunto(s)
Adaptación Psicológica , Síndrome de Fatiga Crónica/psicología , Síndrome del Golfo Pérsico/psicología , Determinación de la Personalidad , Estrés Psicológico/complicaciones , Veteranos/psicología , Adulto , Trastornos de Combate/diagnóstico , Trastornos de Combate/psicología , Exposición a Riesgos Ambientales/efectos adversos , Síndrome de Fatiga Crónica/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Síndrome del Golfo Pérsico/diagnósticoRESUMEN
Control subjects (CON) and self-reported methyl tertiary butyl ether (MTBE)-sensitive subjects (SRS) were evaluated to distinguish between the following gasoline blends: gasoline versus gasoline + MTBE (15% MTBE v/v); and gasoline versus gasoline + MTBE + reodorant. The study also investigated the ability of a reodorant to conceal the odor of MTBE in a gasoline mixture. In each of two separate sessions, seven men (four CON, three SRS) and seven women (four CON, three SRS) were asked, in a forced-choice format, to sniff 28 randomized bottle pairs to determine if the odors in each pair were the same or different. Chi-square analyses revealed that, with the exception of one male CON, subjects were unable to distinguish between gasoline and gasoline with MTBE or gasoline with MTBE and the reodorant. Thus, a reodorant is of limited value as an additive which alters the ability of an individual to detect MTBE in a blended gasoline. The results suggest that at the level used in the experiment, no mask would be required to blind a participant from the odor of MTBE if that level is used in a controlled human health effects study of the additive.
Asunto(s)
Gasolina , Odorantes , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Umbral SensorialRESUMEN
The 1990 Clean Air Act mandated oxygenation of gasoline in regions where carbon monoxide standards were not met. To achieve this standard, methyl tertiary butyl ether (MTBE) was increased to 15% by volume during winter months in many locations. Subsequent to the increase of MTBE in gasoline, commuters reported increases in symptoms such as headache, nausea, and eye, nose, and throat irritation. The present study compared 12 individuals selected based on self-report of symptoms (self-reported sensitives; SRSs) associated with MTBE to 19 controls without self-reported sensitivities. In a double-blind, repeated measures, controlled exposure, subjects were exposed for 15 min to clean air, gasoline, gasoline with 11% MTBE, and gasoline with 15% MTBE. Symptoms, odor ratings, neurobehavioral performance on a task of driving simulation, and psychophysiologic responses (heart and respiration rate, end-tidal CO(2), finger pulse volume, electromyograph, finger temperature) were measured before, during, and immediately after exposure. Relative to controls, SRSs reported significantly more total symptoms when exposed to gasoline with 15% MTBE than when exposed to gasoline with 11% MTBE or to clean air. However, these differences in symptoms were not accompanied by significant differences in neurobehavioral performance or psychophysiologic responses. No significant differences in symptoms or neurobehavioral or psychophysiologic responses were observed when exposure to gasoline with 11% MTBE was compared to clean air or to gasoline. Thus, the present study, although showing increased total symptoms among SRSs when exposed to gasoline with 15% MTBE, did not support a dose-response relationship for MTBE exposure nor the symptom specificity associated with MTBE in epidemiologic studies.
Asunto(s)
Contaminantes Atmosféricos/farmacología , Gasolina , Éteres Metílicos/farmacología , Manifestaciones Neuroconductuales/efectos de los fármacos , Enfermedades Respiratorias/inducido químicamente , Adulto , Anciano , Estudios de Casos y Controles , Método Doble Ciego , Exposición a Riesgos Ambientales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y CuestionariosRESUMEN
Patients with multiple chemical sensitivities (MCS) often report heightened sensitivity to odors. Odor detection thresholds to phenyl ethyl alcohol (PEA) and pyridine (PYR) were evaluated as a measure of odor sensitivity for 33 MCS subjects, 13 chronic fatigue syndrome subjects, 16 asthmatic subjects, and 27 healthy controls. Odor identification ability (based on University of Pennsylvania Smell Identification Test results) and ratings in response to four suprathreshold levels of PEA and PYR were also assessed. Odor detection thresholds for PEA and PYR and odor identification ability were equivalent for all groups; however, when exposed to suprathreshold concentrations of PEA, MCS subjects reported significantly more trigeminal symptoms and lower esthetic ratings of PEA. No group differences were found in response to suprathreshold concentrations of PYR. In summary, MCS subjects did not demonstrate lower olfactory threshold sensitivity or enhanced ability to identify odors accurately. Furthermore, they were differentiated from the other groups in their symptomatic and esthetic ratings of PEA, but not PYR.
Asunto(s)
Asma/complicaciones , Síndrome de Fatiga Crónica/complicaciones , Sensibilidad Química Múltiple/complicaciones , Odorantes , Trastornos del Olfato/etiología , Umbral Sensorial/fisiología , Adulto , Análisis de Varianza , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos del Olfato/diagnóstico , Trastornos del Olfato/fisiopatología , Alcohol Feniletílico , Piridinas , Valores de Referencia , Sensibilidad y EspecificidadRESUMEN
Residents of a former factory building converted to apartments were exposed to mercury over a 2-year period. The neurobehavioral and emotional health effects of this exposure and subsequent evacuation are presented. Urine mercury levels were measured before (urine1) and 3-10 weeks after evacuation (urine2) of the building, when neurobehavioral and psychological measures were also completed. Performance on neurobehavioral and psychologic measures were compared between subjects above and below the median for urine1 (>=19 microg/g creatinine) and were correlated with urine1 mercury levels. The high urine mercury group made more errors on a test of fine motor function and 84% of the residents reported clinically significant elevations in somatic and psychologic symptoms. Although subclinical tremor from mercury exposure may have affected subtle hand-eye coordination, other tests of motor function were not affected. Therefore, the observation of reduced hand-eye coordination may be due to chance. Significant levels of psychosocial stress were more closely associated with the evacuation necessitated by mercury exposure rather than a direct effect of mercury exposure.
Asunto(s)
Exposición a Riesgos Ambientales , Mercurio/efectos adversos , Pruebas Neuropsicológicas , Características de la Residencia , Estrés Psicológico/diagnóstico , Adulto , Femenino , Humanos , Masculino , Mercurio/orina , Persona de Mediana Edad , Factores de RiesgoRESUMEN
This study evaluated neuropsychological effects due to chronic organophosphate use among farmers with no history of acute poisoning. Fifty-seven male tree fruit farmers (exposed) were compared with 42 age-matched male cranberry/blueberry growers and hardware store owners (unexposed). Univariate analyses of covariance (reading test as covariate) comparing exposed and unexposed subjects revealed significantly slower reaction time. No other significant differences were noted on tests of concentration, visuomotor skills, memory, expressive language, or mood. Based on an exposure metric derived from detailed exposure histories, farmers were divided into high exposure (n = 40) and low exposure (n = 59) groups, and their neuropsychological performance was compared. Analysis of covariance with age and reading test score as covariates revealed that the high exposure group had significantly slower reaction time, dominant hand. Long-term use of organophosphates without evidence of an acute poisoning episode appears to produce, at most, subtle changes in neuropsychological performance.
Asunto(s)
Enfermedades de los Trabajadores Agrícolas/epidemiología , Enfermedades del Sistema Nervioso Central/epidemiología , Insecticidas/efectos adversos , Exposición Profesional/efectos adversos , Compuestos Organofosforados , Adulto , Anciano , Enfermedades de los Trabajadores Agrícolas/inducido químicamente , Análisis de Varianza , Estudios de Casos y Controles , Enfermedades del Sistema Nervioso Central/inducido químicamente , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , New Jersey/epidemiología , Exposición Profesional/análisis , Desempeño Psicomotor/efectos de los fármacos , Tiempo de Reacción , Análisis de RegresiónRESUMEN
The present study had two objectives: 1) to determine the characteristics that differentiated subjects with multiple chemical sensitivities (MCS), chemical sensitivities (CS), and chronic fatigue syndrome (CFS); and 2) to evaluate the psychiatric and neuropsychological complaints of these groups relative to normal controls. A cross-sectional comparison was made of the following groups matched for age, sex, and education: 1) patients whose sensitivities to multiple low level chemical exposures began with a defined exposure (MCS; N = 23); 2) patients with sensitivities to multiple chemicals without a clear date of onset (CS; N = 13); 3) patients meeting CDC criteria for Chronic Fatigue Syndrome (CFS; N = 18); and 4) normal controls (N = 18). Subjects with sensitivities to chemicals (MCS and CS) reported significantly more lifestyle changes due to chemical sensitivities and significantly more chemical substances that made them ill compared with chronic fatigue and normal controls. MCS, CS, and CFS patients had significantly higher rates of current psychiatric disorders than normal controls and reported significantly more physical symptoms with no medical explanation. Seventy-four percent of MCS and 61% of CFS did not qualify for any current Axis I psychiatric diagnosis. Chemically sensitive subjects without a defined date of onset (CS) had the highest rate of Axis I psychiatric disorders (69%). On the MMPI-2, 44% of MCS, 42% of CS, 53% of CFS, and none of the controls achieved clinically significant elevations on scales associated with somatoform disorders. With the exception of one complex test of visual memory, no significant differences were noted among the groups on tests of neuropsychological function. Standardized measures of psychiatric and neuropsychological function did not differentiate subjects with sensitivities to chemicals from those with chronic fatigue. Subjects with sensitivities to chemicals and no clear date of onset had the highest rate of psychiatric morbidity. Standardized neuropsychological tests did not substantiate the cognitive impairment reported symptomatically. Cognitive deficits may become apparent under controlled exposure conditions.
Asunto(s)
Síndrome de Fatiga Crónica , Sensibilidad Química Múltiple , Adulto , Edad de Inicio , Estudios Transversales , Síndrome de Fatiga Crónica/psicología , Femenino , Humanos , Estilo de Vida , MMPI , Masculino , Persona de Mediana Edad , Sensibilidad Química Múltiple/psicología , Pruebas Neuropsicológicas , Escalas de Valoración Psiquiátrica , Trastornos Somatomorfos/diagnósticoRESUMEN
Because no information exists on the prevalence of chemical sensitivity syndromes such as multiple chemical sensitivities, a questionnaire for use in population studies was developed and tested to assess the presence or absence of chemical sensitivity. Seven hundred five individuals attending clinics answered a questionnaire asking whether each of 122 common substances caused symptoms. Results showed that patients with multiple chemical sensitivities and asthma had average total scores that were significantly different from each other and from those of each of the other diagnostic categories. Higher total scores were also reported by female patients. The instrument described here may facilitate meaningful prevalence studies of multiple chemical sensitivities. It will also allow study of chemically induced symptoms in other conditions such as asthma.
Asunto(s)
Métodos Epidemiológicos , Sensibilidad Química Múltiple/diagnóstico , Encuestas y Cuestionarios , Adolescente , Adulto , Anciano , Análisis de Varianza , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Sensibilidad Química Múltiple/epidemiología , Proyectos Piloto , PrevalenciaRESUMEN
Neurological symptoms are frequently reported by patients with multiple chemical sensitivities (MCS). Methods to compare the psychiatric, personality, and neuropsychological function of patients with MCS, chronic fatigue syndrome (CFS), and normal controls are described. Increased rates of Axis I psychiatric diagnoses are observed in the literature for MCS and CFS subjects relative to controls. Findings on the MMPI-2 and the Toronto Alexithymia Scale reveal profiles consistent with the tendency to report somatic rather than emotional symptoms in response to stress. However, many of the reported somatic symptoms also coincide with those found in neurologic disorders. The overall neuropsychological profile for MCS subjects does not reflect cognitive impairment. Relative to normal controls, the only difference in neuropsychological performance observed is reduced recognition of nontarget designs on a visual memory task. More fruitful areas for future psychological research will include measurement of the interaction between behavioral response styles and attentional processes in cognition, as well as observations under controlled challenge conditions.
Asunto(s)
Sistema Nervioso Central/efectos de los fármacos , Trastornos Mentales/inducido químicamente , Sensibilidad Química Múltiple/psicología , Síndrome de Fatiga Crónica/psicología , Humanos , Pruebas NeuropsicológicasRESUMEN
Employee assistance programs are offered by employers to assist employees with personal problems through professional evaluation of the problem and referral to an appropriate treatment source. Although some research has been conducted to document the effect of these programs on such variables as absenteeism and disciplinary action, little information is available regarding compliance with clinical recommendations, ie, initiating and remaining in prescribed treatment. The present study evaluated the effect of two different rates of insurance coverage for outpatient mental health services offered by two comparable blue-collar organizations. Employees from the organization with a higher rate of payment were significantly more likely to initiate treatment and to remain in treatment longer. This outcome was not accounted for by demographic differences between the groups or by differences in diagnostic categories or treatment approaches. Implications of this finding are discussed as well as the utility of an employee assistance program to prepare employees for treatment.