Stuart John A, Ursano Robert J, Fullerton Carol S, Norwood Ann E, Murray Kelly
Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University of Health Sciences, 4301 Jones Bridge Road, Bethesda, Maryland 20814-4799, USA.
J Nerv Ment Dis. 2003 Jul;191(7):431-6. doi: 10.1097/01.NMD.0000081634.28356.6B.
September 11 brought increased awareness that even the threat of chemical and biological terrorism can overwhelm this country's health care system. Belief in exposure to toxic agents, even when none is documented, is not uncommon in crisis and merits vigilant health care evaluation and services. This study examined risk factors (demographics, physical symptoms, clinical diagnosis, exposures, and health status) for belief in exposure to potential terrorist agents (nerve or mustard gas) using a large sample of Gulf War veterans who reported belief in exposure to nerve or mustard gas. We found that females, nonwhites, and those who were older (age 32 to 61 years) were more likely to report exposure. When adjusting for demographics and military service, these veterans reported more exposures (nonnerve or mustard gas) to potentially toxic agents and traumatic events (odds ratio [OR], 6.80; p<.001), reported more physical symptoms during the Gulf War (OR, 2.38; p<.001), were more likely to be diagnosed with a mental disorder (OR, 1.72; p<.001), and reported poorer current health status (OR, 3.47 to 1.22; p<.001). Not unlike previously reported studies of disasters, traumatic exposures, or risk exposures, belief in exposure to toxic agents suggests that certain people are at a greater health care risk. This knowledge will aid in better responding to rapid demands that may be placed on our health care delivery systems in times of potential terrorist activity.
9月11日事件让人们愈发意识到，即便只是化学和生物恐怖主义的威胁，都可能压垮美国的医疗体系。在危机中，即便没有证据证明接触过有毒制剂，但相信自己接触过的情况并不罕见，值得接受医疗保健方面的审慎评估和服务。本研究以大量报告称自己接触过神经性毒气或芥子气的海湾战争退伍军人为样本，调查了相信自己接触过潜在恐怖主义制剂（神经性毒气或芥子气）的风险因素（人口统计学特征、身体症状、临床诊断、接触情况和健康状况）。我们发现，女性、非白人以及年龄较大者（32至61岁）更有可能报告接触过。在对人口统计学特征和军事服役情况进行调整后，这些退伍军人报告称接触过更多可能有毒的制剂和创伤性事件（非神经性毒气或芥子气）（优势比[OR]为6.80；p<0.001），在海湾战争期间报告的身体症状更多（OR为2.38；p<0.001），更有可能被诊断患有精神障碍（OR为1.72；p<0.001），且报告的当前健康状况较差（OR为3.47至1.22；p<0.001）。与之前关于灾难、创伤性接触或风险接触的研究结果并无不同，相信自己接触过有毒制剂表明某些人面临更大的医疗保健风险。这一认识将有助于更好地应对在潜在恐怖主义活动期间可能对我们的医疗服务系统提出的快速需求。
