Toxicant Exposures and Health Symptoms in Military Pesticide Applicators from the 1991 Gulf War

Objective The chronic impact of acetylcholinesterase inhibitors and other toxicants on Gulf War (GW) veterans’ health symptoms is unclear. Methods Building on reports of adverse neuropsychological outcomes in GW pesticide applicators exposed to pesticides and pyridostigmine bromide, we now report on health symptoms in this group. Results In adjusted analyses, applicators with high exposures/impact to pesticides reported significantly more symptoms (18/34 symptoms) than applicators with lower exposures/impact and were more likely to meet modified Kansas and CDC Gulf War Illness criteria. The high pyridostigmine bromide exposure/impact group was 3 times more likely to report irregular heart rates. With regard to specific pesticide types, fly baits, pest strips, and delousers were the most associated with increased health symptom reporting. Conclusions These results suggest that GW veterans with high acetylcholinesterase inhibitor and organochlorine exposures are most at risk for chronic health symptoms.