Reid, S, Hotopf, M, Hull, L et al. · American journal of epidemiology · 2001 · DOI
This study looked at how often ME/CFS and multiple chemical sensitivity (MCS—a condition where people react badly to everyday chemicals) occurred in British military personnel who served in the Gulf War. Researchers compared three groups: those deployed to the Gulf, those sent to Bosnia, and those who served during the Gulf War period but weren't deployed. They found that both conditions were more common in Gulf veterans, and MCS was strongly linked to pesticide exposure.
This study provides epidemiological evidence that ME/CFS and MCS are genuine clinical entities occurring at elevated rates following specific exposures and environmental stressors. It suggests a potential environmental trigger (pesticides) for at least some cases of MCS, and demonstrates that both conditions cluster with Gulf War deployment, supporting the legitimacy of symptom-based diagnoses often questioned in the medical literature.
This study does not prove that pesticide exposure directly causes MCS or CFS—it only shows an association. The cross-sectional design cannot establish temporal relationships or rule out reverse causation. Additionally, because data relied on self-reported exposures collected months or years after deployment, recall bias may inflate the strength of observed associations.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Reid, S, Hotopf, M, Hull, L, Ismail, K, Unwin, C, & Wessely, S (2001). Multiple chemical sensitivity and chronic fatigue syndrome in British Gulf War veterans.. American journal of epidemiology. https://doi.org/10.1093/aje/153.6.604
BibTeX
@article{mecfsatlas-reid-2001-multiple-chemical,
author = {Reid, S and Hotopf, M and Hull, L and Ismail, K and Unwin, C and Wessely, S},
title = {Multiple chemical sensitivity and chronic fatigue syndrome in British Gulf War veterans.},
journal = {American journal of epidemiology},
year = {2001},
doi = {10.1093/aje/153.6.604},
note = {PubMed: 11257069},
url = {https://www.mecfsatlas.com/evidence/reid-2001-multiple-chemical},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/reid-2001-multiple-chemical
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