Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, United States.
VA Boston Healthcare System, 150 South Huntington Avenue, Boston, MA 02130, United States; Department of Neurology, Boston University School of Medicine, Boston, MA 02118, United States.
Neurotoxicol Teratol. 2018 Jan-Feb;65:1-13. doi: 10.1016/j.ntt.2017.11.002. Epub 2017 Nov 7.
1991 Gulf War (GW) veterans continue to experience debilitating cognitive and mood problems more than two decades following their return from deployment. Suspected causes for these cognitive complaints include additive and/or synergistic effects of the varying combinations of exposures to chemicals in theater, including pesticides and pyridostigmine bromide (PB) pills. This study was undertaken to address one of the key recommendations of the US Department of Defense Environmental Exposure Report on Pesticides, which was to conduct an epidemiological study to further evaluate the role of neurotoxicant exposures in the expression of central nervous system symptoms reported by GW veterans. This study evaluated the role of pesticides and/or PB in the development of chronic neuropsychological dysfunction in GW veterans. We examined the associations between self-reported measures of pesticide and PB exposures and performance on neuropsychological tests in a group of 159 GW-deployed preventative medicine personnel who had varying levels of pesticide exposures during their work as pesticide applicators or other preventative medicine roles. These veterans had a unique knowledge of pesticides and their usage during the war. It was hypothesized that pesticide applicator personnel with higher exposures would perform significantly worse on objective cognitive measures than lower-exposed personnel and that multiple chemical exposures (pesticide and PB) would further diminish cognitive functioning and increase mood complaints. Study results showed that the participants with both high pesticide and high PB exposure performed worse on specific measures than the groups with high single exposures or low exposures to both toxicants. High combined exposure was associated with significantly slower information processing reaction times, attentional errors, worse visual memory functioning, and increased mood complaints. In addition, stepwise regression analyses of individual pesticide exposures found that pest strip exposure was associated with slower reaction times and attentional errors, and that fly bait and delouser exposures predicted greater mood complaints.
1991 年海湾战争（GW）退伍军人在从部署中返回后二十多年仍继续经历衰弱的认知和情绪问题。这些认知问题的可疑原因包括在战区接触到的各种化学物质（包括杀虫剂和溴化吡斯的明（PB）药丸）的组合暴露的附加和/或协同作用。这项研究是为了回应美国国防部环境暴露报告中关于杀虫剂的一项关键建议而进行的，该建议是进行一项流行病学研究，以进一步评估神经毒素暴露在海湾战争退伍军人报告的中枢神经系统症状中的作用。这项研究评估了杀虫剂和/或 PB 在海湾战争退伍军人慢性神经心理功能障碍发展中的作用。我们在一组 159 名预防性医学部署人员中检查了自我报告的杀虫剂和 PB 暴露与神经心理学测试表现之间的关系，这些人员在作为杀虫剂施药者或其他预防性医学角色期间经历了不同程度的杀虫剂暴露。这些退伍军人对战争期间的杀虫剂及其使用有独特的了解。假设高暴露的杀虫剂施药人员在客观认知测量上的表现会明显比低暴露人员差，并且多种化学暴露（杀虫剂和 PB）会进一步降低认知功能并增加情绪抱怨。研究结果表明，与高单一暴露或两者暴露水平较低的组相比，具有高杀虫剂和高 PB 暴露的参与者在特定测量指标上的表现更差。高联合暴露与信息处理反应时间明显减慢、注意力错误、视觉记忆功能更差和情绪抱怨增加有关。此外，对个体杀虫剂暴露的逐步回归分析发现，虫带暴露与反应时间和注意力错误较慢有关，而蝇饵和灭虱剂暴露则预测情绪抱怨更大。
