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Biomedical subjects

H Kipen

Publications and source records attributed to H Kipen.

18 recordsLinked to original sources
PubMed2000

Odor perception: multiple chemical sensitivities, chronic fatigue, and asthma.

Patients with multiple chemical sensitivities (MCS) often report heightened sensitivity to odors. Odor detection thresholds to phenyl ethyl alcohol (PEA) and pyridine (PYR) were evaluated as a measure of odor sensitivity for 33 MCS subjects, 13 chronic fatigue syndrome subjects, 16 asthmatic subjects, and 27 healthy controls. Odor identification ability (based on University of Pennsylvania Smell Identification Test results) and ratings in response to four suprathreshold levels of PEA and PYR were also assessed. Odor detection thresholds for PEA and PYR and odor identification ability were equivalent for all groups; however, when exposed to suprathreshold concentrations of PEA, MCS subjects reported significantly more trigeminal symptoms and lower esthetic ratings of PEA. No group differences were found in response to suprathreshold concentrations of PYR. In summary, MCS subjects did not demonstrate lower olfactory threshold sensitivity or enhanced ability to identify odors accurately. Furthermore, they were differentiated from the other groups in their symptomatic and esthetic ratings of PEA, but not PYR.

Adult↗
PubMed1999

Neuropsychological and stress evaluation of a residential mercury exposure.

Residents of a former factory building converted to apartments were exposed to mercury over a 2-year period. The neurobehavioral and emotional health effects of this exposure and subsequent evacuation are presented. Urine mercury levels were measured before (urine1) and 3-10 weeks after evacuation (urine2) of the building, when neurobehavioral and psychological measures were also completed. Performance on neurobehavioral and psychologic measures were compared between subjects above and below the median for urine1 (>=19 microg/g creatinine) and were correlated with urine1 mercury levels. The high urine mercury group made more errors on a test of fine motor function and 84% of the residents reported clinically significant elevations in somatic and psychologic symptoms. Although subclinical tremor from mercury exposure may have affected subtle hand-eye coordination, other tests of motor function were not affected. Therefore, the observation of reduced hand-eye coordination may be due to chance. Significant levels of psychosocial stress were more closely associated with the evacuation necessitated by mercury exposure rather than a direct effect of mercury exposure.

Adult↗
PubMed1998

Medical evaluation of Persian Gulf veterans with fatigue and/or chemical sensitivity.

The purpose of this study was to determine if Gulf War veterans with complaints of severe fatigue and/or chemical sensitivity (n = 72) fulfill case definitions for chronic fatigue syndrome (CFS) and/or multiple chemical sensitivity (MCS) and to compare the characteristics of those veterans who received a diagnosis of CFS (n = 24) to a group of non-veterans diagnosed with CFS (n = 95). Thirty-three veterans received a diagnosis of CFS with 14 having MCS concurrently; an additional six had MCS but did not fulfill a case definition for CFS. The group of fatigued veterans receiving a diagnosis of CFS was comprised of significantly fewer women and fewer Caucasians than the civilian group, and significantly fewer veterans reported a sudden onset to their illness. Veterans with CFS had a milder form of the illness than their civilian counterparts based on medical examiner assessment of the severity of the symptoms, reported days of reduced activity, and ability to work. Since CFS in veterans seems less severe than that seen in civilians, the prognosis for recovery of veterans with this disorder may be better.

Environmental Exposure↗
PubMed1997

Long-term use of organophosphates and neuropsychological performance.

This study evaluated neuropsychological effects due to chronic organophosphate use among farmers with no history of acute poisoning. Fifty-seven male tree fruit farmers (exposed) were compared with 42 age-matched male cranberry/blueberry growers and hardware store owners (unexposed). Univariate analyses of covariance (reading test as covariate) comparing exposed and unexposed subjects revealed significantly slower reaction time. No other significant differences were noted on tests of concentration, visuomotor skills, memory, expressive language, or mood. Based on an exposure metric derived from detailed exposure histories, farmers were divided into high exposure (n = 40) and low exposure (n = 59) groups, and their neuropsychological performance was compared. Analysis of covariance with age and reading test score as covariates revealed that the high exposure group had significantly slower reaction time, dominant hand. Long-term use of organophosphates without evidence of an acute poisoning episode appears to produce, at most, subtle changes in neuropsychological performance.

Adult↗
PubMed1997

Chemical sensitivity: the scientific literature.

This article provides an overview of the scientific literature in which chemically sensitive patients have been directly evaluated. For that purpose, consideration of various case definitions is offered along with summaries of subjects' demographic profiles, exposure characteristics, and symptom profiles across studies. Controlled investigations of chemically sensitive subjects without other organic illnesses are reviewed. To date, psychiatric, personality, cognitive/neurologic, immunologic, and olfactory studies have been conducted comparing subjects with primary chemical sensitivity to various control groups. Thus far, the most consistent finding is that chemically sensitive patients have a higher rate of psychiatric disorders across studies and relative to diverse comparison groups. However, since these studies are cross-sectional, causality cannot be implied. Demonstrating the role of low-level chemical exposure in a controlled environment has yet to be undertaken with this patient group and is crucial to the understanding of this phenomenon.

Environmental Health↗
PubMed1996

Chemical sensitivities and the Gulf War: Department of Veterans Affairs Research Center in basic and clinical science studies of environmental hazards.

The purpose of the New Jersey Center for Environmental Hazards Research is to define the illness referred to as Persian Gulf Syndrome (PGS). Our preliminary data indicated that more than half of the Persian Gulf Registry (PGR) veterans reported illness characterized by severe fatigue and symptoms consistent with chemical sensitivities. Therefore, our research approach focuses on investigations of veterans with chronic fatigue syndrome (CFS) and multiple chemical sensitivities (MCS). Project 1 is an epidemiological study of 2800 PGR veterans. Symptoms, indices of Chronic Fatigue (CF) and Chemical Sensitivity (CS), and risk factors will be surveyed with mailed questionnaires. Risk factors include demographics, past medical history, psychosocial variables, Gulf War experiences such as prophylactic medication use, occupational and environmental exposures, and pesticide exposures. Symptoms will be clustered to define Gulf War Syndromes. Significant associations between risk factors and these symptom clusters will also be investigated Subjects identified as CF, CS, or both will be recruited into Projects 2 and 3. In Project 2, healthy veterans will be compared to veterans with CF, CS, and CF concurrent with CS. Veterans will undergo four studies: (1) viral-immunological, (2) psychiatric, psychological, behavioral, and neuropsychological, (3) autonomic dysregulation, and (4) marker of P4501A2 induction resulting from exposure to combusting material. The purpose of Project 3 is to test the autonomic, immunologic, neuropsychologic, and psychologic responses of veterans with CS or CF to two stressors: controlled chemical exposure and exercise. CS subjects will undergo chemical exposures in our Controlled Environment Facility (CEF) to assess their biologic and psychologic response to low-level exposure. CF subjects will undergo a maximal treadmill exercise test. Circadian patterns of catecholamines and axillary temperature, viral burden, and cardiovascular and endocrine reactivity will be measured in response to this physical stressor. Project 4 is an animal study evaluating the interaction between stress and pathology/physiology when rats are predisposed to disease by exposure to Soman or to Dioxin. Two strains of rats that differ in stress reactivity will be used to determine the interaction of hereditary factors and chemical exposure.

Comorbidity↗
PubMed1995

Silicosis and workers' compensation in New Jersey.

The employer is expected to maintain responsibility for health care expenses and lost income that result from occupational injury and illness through the workers' compensation insurance system. However, financial support for individuals with occupational illnesses, especially those with long latency, is often from sources other than workers' compensation. Silicosis, a well defined, chronic, occupational lung disease, can be viewed as a sentinel for the inadequacy of the public policy to compensate workers for chronic occupational lung disease. Three hundred twenty-nine patients with confirmed silicosis were identified by the silicosis surveillance program in the New Jersey Department of Health using source data from 1979 through 1992. One hundred seventy-seven of these individuals provided information on the status of any compensation claims against their employer. Only 31% of these patients stated that a claim had been filed; 84% of those whose claims were settled were awarded payments. Severity of radiologic findings was not associated with the likelihood of filing a claim or with being awarded a payment; whereas, smoking was associated with these outcomes. The implications of these findings for the health care system are discussed.

Aged↗
PubMed1993

Human immunotoxicologic markers of chemical exposures: preliminary validation studies.

The circulating cells of the immune system are sensitive to environmental contaminants, and effects are often manifested as changes in the cell surface differentiation antigens of affected populations of cells, particularly lymphocytes. In this investigation, we explore the likelihood that variation in the expression of the surface markers of immune cells can be used as an index of exposure to toxic chemicals. We recruited 38 healthy New Jersey men to study pesticides effects: 19 orchard farmers (high exposure); 13 berry farmers (low exposure); and 6 hardware store owners (no exposure). Immunophenotyping was performed assaying the following cell surface antigens: CD2, CD4, CD8, CD14, CD20, CD26, CD29, CD45R, CD56, and PMN. Data were analyzed using univariate and multivariate methods. There were no significant differences among the groups with respect to routine medical histories, physical examinations, or routine laboratory parameters. No striking differences between groups were seen in univariate tests. Multivariate tests suggested some differences among groups and limited ability to correctly classify individuals based on immunophenotyping results. Immunophenotyping represents a fruitful area of research for improved exposure classification. Work is needed both on mechanistic understanding of the patterns observed and on the statistical interpretation of these patterns.

Agriculture↗
PubMed1992

Evaluation of chemically sensitive patients.

An increasing number of patients have been presenting with multiple symptoms they attribute to low-level chemical exposures, ie, multiple chemical sensitivities (MCS). Although some studies have evaluated such patients, the selection criteria has not been rigorously defined. The present study is the first to use a relatively rigorous definition of MCS to select patients for study. Comprehensive evaluation of medical, psychiatric, neuropsychological, and immunological status of a series of MCS patients is presented. In contrast to previous studies, patients in this study did not have a history of psychiatric disorder. However, some patients were currently depressed. Neuropsychological assessment did not reveal any abnormalities with the exception of one test of verbal memory for which performance was consistently poor relative to the normative sample. No significant immunological abnormalities were noted.

Adult↗
PubMed1991

The study of cancer in minorities.

Data inventories provide a concise reference base for researchers. The authors created a set of reference volumes listing databases used for studying cancer in New Jersey minorities. The process followed can be adapted for other disease outcomes or other regions.

Data Collection↗
PubMed1988

Reactive airways dysfunction syndrome.

A possible variant of occupational asthma is induced by acute exposure to high concentrations of nonsensitizing respiratory irritants. This entity is referred to as reactive airways dysfunction syndrome. A case is presented in which the patient developed this syndrome secondary to exposure to a floor sealant. A portable peak expiratory flow meter was used to assess and document work-related airway reactivity changes.

Adult↗
PubMed1978

Mechanism of the dipsogenic action of tetradecapeptide renin substrate.

The mechanism of the dipsogenic action of synthetic tetradecapeptide renin substrate (TDP) was studied in rats with chronically implanted lateral ventricular cannulae. All hormones and drugs were injected via the ventricular cannulae. The dipsogenic action of TDP was unaffected by the renin inhibitor pepstatin but was markedly reduced by the angiotensin converting enzyme inhibitor SQ 20881. Homogenates of rat brain readily formed angiotensin II from TDP in vitro and this was likewise unaffected by pepstatin but was reduced or abolished by SQ 20881 or by chelating agents. Natural renin substrate did not cause drinking and did not generate angiotensin II when incubated with brain homogenates. These results demonstrate that rat brain converting enzyme can generate angiotensin II from TDP and that this effect is responsible for the dipsogenic action of TDP.

Angiotensin II↗
PubMedDate not supplied

Building-related illness and employee lost time following application of hot asphalt roof: a call for prevention.

Industrial hygiene sampling within an office building during and following a roof renovation revealed low-level exposure to high-boiling organic compounds, associated with complaints of eye and upper respiratory tract irritation among building occupants. Health complaints continued substantially beyond the time frame of the renovation completion, despite a lack of objective industrial hygiene findings for volatile organic compounds (VOCs) and microbiological contamination, and a lack of consistent medical findings among employees evaluated by an occupational physician. An analysis of employee attendance records suggests lost attendance and reduced productivity costs. Preventive strategies include proper planning and scheduling of building renovations to prevent employee exposure to asphalt roof emissions.

Adult↗
PubMedDate not supplied

Neuropsychology and psychology of MCS.

Neurological symptoms are frequently reported by patients with multiple chemical sensitivities (MCS). Methods to compare the psychiatric, personality, and neuropsychological function of patients with MCS, chronic fatigue syndrome (CFS), and normal controls are described. Increased rates of Axis I psychiatric diagnoses are observed in the literature for MCS and CFS subjects relative to controls. Findings on the MMPI-2 and the Toronto Alexithymia Scale reveal profiles consistent with the tendency to report somatic rather than emotional symptoms in response to stress. However, many of the reported somatic symptoms also coincide with those found in neurologic disorders. The overall neuropsychological profile for MCS subjects does not reflect cognitive impairment. Relative to normal controls, the only difference in neuropsychological performance observed is reduced recognition of nontarget designs on a visual memory task. More fruitful areas for future psychological research will include measurement of the interaction between behavioral response styles and attentional processes in cognition, as well as observations under controlled challenge conditions.

Central Nervous System↗