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Multiple Chemical Sensitivity Syndrome
Symptom Prevalence and Risk Factors in a Military Population
Donald W. Black, MD;
Bradley N. Doebbeling, MD, MS;
Margaret D. Voelker, MS;
William R. Clarke, PhD;
Robert F. Woolson, PhD;
Drue H. Barrett, PhD;
David A. Schwartz, MD, MPH
Arch Intern Med. 2000;160:1169-1176.
Objective To assess the prevalence of and risk factors for self-reported symptoms suggestive of multiple chemical sensitivities/idiopathic environmental intolerance (MCS/IEI) in Persian Gulf War (PGW) veterans from Iowa and a comparison group of PGW-era military personnel.
Methods A population-based sample of Iowa military personnel was surveyed using a cross-sectional telephone interview. Study participants were randomly drawn from 1 of 4 domains: PGW active duty, PGW National Guard/Reserve, non-PGW active duty, and non-PGW National Guard/Reserve. A complex sample survey design was used selecting participants from the following substrata: age, sex, race, rank, and military branch. The criteria for MCS/IEI were developed using expert consensus and the medical literature.
Results A total of 3695 study participants (76% of those eligible) completed the telephone survey. The prevalence of symptoms suggestive of MCS/IEI in all participants was 3.4%. Veterans of the PGW reported a significantly higher prevalence of symptoms suggestive of MCS/IEI than did non-PGW military personnel (5.4% vs 2.6%); greater sensitivity to organic chemicals, vehicle exhaust, cosmetics, and smog; and more lifestyle changes. The following risk factors for MCS/IEI were identified with univariate analysis: deployment to the Persian Gulf, age (>25 years), female sex, receiving a physician diagnosis of MCS, previous professional psychiatric treatment, previous psychotropic medication use, current psychiatric illness, and a low level of preparedness. Multiple logistic regression analysis identified several independent risk factors for MCS/IEI, including deployment to the Persian Gulf, age, sex, rank, branch of service, previous professional psychiatric treatment, and current mental illness.
Conclusions Self-reported symptoms suggestive of MCS/IEI are relatively frequent in a military population and are more common among PGW veterans than comparable controls. Reported chemical sensitivities and accompanying behavioral changes were also frequent. After adjusting for age, sex, and training preparedness, previous professional psychiatric treatment and previous psychotropic medication use (before deployment) showed a robust association with symptoms suggestive of MCS.
From the Departments of Psychiatry (Dr Black), Internal Medicine (Drs Doebbeling and Schwartz), and Preventive Medicine and Environmental Health (Ms Voelker and Drs Clarke and Woolson), University of Iowa College of Medicine, and the Iowa City Veterans Affairs Medical Center (Drs Doebbeling and Schwartz), Iowa City, Iowa; and the Centers for Disease Control and Prevention, Atlanta, Ga (Dr Barrett).
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