OBJECTIVE: To determine whether serum levels of chlorinated hydrocarbons are elevated in patients with chronic fatigue syndrome. METHODS: Chlorinated hydrocarbon levels were measured in 22 patients with chronic fatigue syndrome (CFS) (as defined by the Centers for Disease Control [CDC]); in 17 patients with CFS symptoms whose history of exposure to toxic chemicals excluded them from the research definition of CFS; and in 34 non-CFS control subjects matched for age and sex. RESULTS: DDE (1,1-dichloro-2,2-bis (p-chlorophenyl) ethene) was detected in all serum samples at levels over 0.4 ppb. The incidence of hexachlorobenzene (HCB) contamination (> 2.0 ppb) was 45% in the CFS group, compared with 21% in the non-CFS control group (P < 0.05). The CFS group had a significantly higher total organochlorine level (15.9 ppb; SEM, 4.4) than the control group (6.3 ppb; SEM, 1.1; P < 0.05). The toxic exposure group also had a higher mean organochlorine level (13.6 ppb; SEM, 6.2) than the control group, but the difference was not statistically significant. DDE and HCB comprised more than 90% of the total organochlorines measured in each of the groups. CONCLUSION: The results suggest that recalcitrant organochlorines may have an aetiological role in CFS. There were no significant differences in serum organochlorine concentrations between CFS patients and chronic fatigue patients with a history of toxic chemical exposure. Therefore, exclusion of patients from the CDC research definition of CFS on the basis of a reported history of known exposure to toxic chemicals is not valid. The role of low-level organochlorine bioaccumulation in the development of CFS symptoms requires further investigation.
OBJECTIVE: To determine whether serum levels of chlorinated hydrocarbons are elevated in patients with chronic fatigue syndrome. METHODS: Chlorinated hydrocarbon levels were measured in 22 patients with chronic fatigue syndrome (CFS) (as defined by the Centers for Disease Control [CDC]); in 17 patients with CFS symptoms whose history of exposure to toxic chemicals excluded them from the research definition of CFS; and in 34 non-CFS control subjects matched for age and sex. RESULTS:DDE (1,1-dichloro-2,2-bis (p-chlorophenyl) ethene) was detected in all serum samples at levels over 0.4 ppb. The incidence of hexachlorobenzene (HCB) contamination (> 2.0 ppb) was 45% in the CFS group, compared with 21% in the non-CFS control group (P < 0.05). The CFS group had a significantly higher total organochlorine level (15.9 ppb; SEM, 4.4) than the control group (6.3 ppb; SEM, 1.1; P < 0.05). The toxic exposure group also had a higher mean organochlorine level (13.6 ppb; SEM, 6.2) than the control group, but the difference was not statistically significant. DDE and HCB comprised more than 90% of the total organochlorines measured in each of the groups. CONCLUSION: The results suggest that recalcitrant organochlorines may have an aetiological role in CFS. There were no significant differences in serum organochlorine concentrations between CFS patients and chronic fatiguepatients with a history of toxic chemical exposure. Therefore, exclusion of patients from the CDC research definition of CFS on the basis of a reported history of known exposure to toxic chemicals is not valid. The role of low-level organochlorine bioaccumulation in the development of CFS symptoms requires further investigation.