Date: February 5, 2014 7:24:22 PM PST

http://www.huffingtonpost.com/claudia-s-miller-md-ms/gulf-war-syndrome-comes-t_b_4698433.html?utm_hp_ref=green

Claudia S. Miller, M.D., M.S.
Professor, environmental and occupational medicine, University of Texas Health Science Center at San Antonio

Gulf War Syndrome Comes to the Gulf of Mexico?

A large cadre of marine scientists assembled this week in Mobile, Ala. to discuss the environmental fallout from the BP Deepwater Horizon disaster that occurred nearly four years ago off the Gulf Coast. Sadly, the impact on human health took a backseat at these meetings to fisheries, socio-economic effects, coastal ecosystems and the circulation of petrochemicals in the sea.

These are critical topics, to be sure, but the health of residents on and near the coast deserve as much attention. Unknown numbers may have been sickened by exposures to chemicals from the spill, including the highly toxic dispersant, Corexit. Those exposures can lead to subsequent intolerances to other substances, including common chemicals, through a newly described disease mechanism called TILT, or Toxicant Induced Loss of Tolerance.

Sadly, researchers and doctors remain unaware of this new mechanism for disease caused by chemical exposures. We’re like the doctors at the turn of the century who, lacking knowledge of the germ theory, had no idea what was causing rampant fevers and deaths during the Civil War.

There are individuals who were affected by the spill now being diagnosed with anxiety and depression. These are common effects of chemical exposures in susceptible persons, and can also be caused by stressful events.

Of course, at this late date, those exposed in the Gulf area no longer have increased levels of chemicals in their tissues. The petrochemicals and dispersants they were exposed to have left their bodies and are no longer measurable. This is not DDT which deposits in our fat stores and remains there for decades. These are synthetic organic chemicals that in susceptible persons cause TILT. They enter the body, do their damage, and leave within days. Subsequently, everyday exposures trigger symptoms in those affected.

It’s true that large sums of money are being spent to study the health impact on people–including fishermen, cleanup workers, volunteers and others–who were exposed to the spill. But researchers who are looking into the aftermath of the Deepwater Horizon spill are not asking some key questions.

In addition to fish and ecosystems, scientists at the Gulf of Mexico Oil Spill and Ecosystem Conference should have focused more on the toxic impact on people. They might have started by looking at its close cousin, Gulf War Syndrome, also involving petrochemical exposures.

Thousands of Gulf War veterans have been sick and undiagnosed for more than a decade as doctors search for answers. No one can convincingly explain their diverse, multi-system symptoms, which include pain, fatigue, mood changes and cognitive impairment–symptoms also reported by many of those exposed during the Gulf Coast spill.

But what can be done? There is now a free online self-evaluation that Gulf War veterans and Gulf of Mexico residents alike can access to help identify what’s making them sick and determine what subsequent chemical, food and drug intolerances may have developed long after combat and the oil spill ended. People who are concerned that they may have chemical intolerances can go online, answer a questionnaire called The Quick Environmental Exposure and Sensitivity Inventory (QEESI) and share the results with their doctors. Internationally, the QEESI is the most widely used screening instrument for chemical intolerance and TILT among physicians and health practitioners.

Only certain individuals are prone to TILT. Many experience long-lasting and diverse symptoms, including memory and concentration problems, fatigue, headaches, weakness and mood changes such as irritability and depression. They often report gastrointestinal, respiratory and skin problems, and some develop depression, addiction or violent behavior.

With the Gulf War veterans, whether they were exposed to pesticides, smoke from the oil fires or pyridostigmine bromide pills, the result was the same–a breakdown in their natural tolerance. Long after these substances have left their bodies, the aftermath of these exposures–the new-onset intolerances–perpetuate their symptoms.

The QEESI measures sensitivities through a self-evaluation based on four scales: Symptom Severity, Chemical Intolerances, Other Intolerances, and Life Impact.” Each scale contains 10 items, scored from 0 = “not a problem” to 10 = “severe or disabling problem.” Another 10-item tool called the “Masking Index” gauges ongoing exposures and overlapping symptoms that hide responses, blocking one’s awareness of their intolerances, and the intensity of their responses to exposures.

It’s important to help people on the Gulf sort out and “unmask” the causes or triggers of their symptoms. TILT will be overlooked without the use of appropriate tools, such as the QEESI. Also needed are environmental medical units, or EMUs–environmentally controlled inpatient hospital units designed to isolate patients from exposures, including foods, that trigger their symptoms. Congress once endorsed EMU research for the Gulf War veterans but never funded it.

It’s encouraging that some doctors along the Gulf Coast are treating people for problems that they blame on the spill. Dr. Michael Robichaux, from Raceland, LA, told The Huffington Post in 2012 that he treated 50 people for a range of health problems that he believes were caused by exposure to chemicals from the spill. “The illnesses are very real, and the people who are ill are apparently people who have sensitivities to these substances that not all of us are sensitive to,” he explained.

Millions of dollars from the BP Claims Fund are being spent to expand access to healthcare in underserved communities, assisting with behavioral and mental health needs, training community health care workers on “peer listening and community input” and improving “environmental health expertise, capacity and literacy.”

And yet, not one dime has been allocated to study how toxic exposures resulting from this disaster may have rendered thousands of individuals chemically intolerant and suffering from the same disabling multi-system symptoms that continue to afflict Gulf War veterans.

Nothing will change until medical science acknowledges that we are dealing with an entirely new disease paradigm. Today we recognize that germs cause infections and that protein antigens cause allergies and immune system disorders. Now we need to understand the full range of illnesses caused by chemical exposures.

> To take the free online QEESI test, please visit www.qeesi.org

Special thanks to Richard Charter