Posttraumatic stress disorder symptoms, physical health, and health care utilization 50 years after repeated exposure to a toxic gas.

The posttraumatic sequelae of contaminant exposure are a contemporary international concern due to the threats posed to military personnel and civilians by war and bioterrorism. The role of PTSD symptoms as a mediator between potentially traumatic toxin exposure and physical health outcomes was examined with structural equation modeling in a probability sample of 302 male World War II-era U.S. military veterans 50 years after exposure to mustard gas tests. Controlling for age and psychological distress, the most parsimonious structural model involved PTSD symptoms mediating the relationship between toxin exposure and physical health problems, and physical health problems mediating the relationship between PTSD symptoms and outpatient health care utilization. Implications for researchers, mental health clinicians, and health care providers are discussed.