Echoes of Gulf War Illness: A Case Study of Chronic Symptoms from Toxic Exposure in East Palestine, Ohio

Mixed toxic chemical exposures are a common problem, but challenging because different chemical mixtures for each may forestall progress of relevant science. Here, we evaluate a woman exposed to multiple toxic chemicals following the February 2023 East Palestine, Ohio train derailment and toxicant release/burn, to evaluate for concordance of ensuing health problems with diagnostic criteria for Gulf War illness (GWI) - i.e. for chronic multisymptom illness following a wholly distinct mixed toxic exposure. This woman in her 30s fully met criteria for all six "Kansas criteria" symptom domains required for diagnosing mixed toxicant illness in Gulf War veterans: fatigue/sleep, neurological/cognitive/mood, pain, respiratory, gastrointestinal, and dermatologic. (Kansas symptom criteria require qualifying symptoms, of at least moderate severity and/or multiple, in at least three domains; she met criteria for all six.) She additionally had a highly distinctive problem - new post-derailment breakage and loss of teeth (culminating in removal of all teeth within the year) that was previously reported by a number of Gulf War veterans. We propose that since most chemicals' toxicity includes mitochondrial mechanisms (severity of which relates to GWI severity), this toxic mechanism may add/synergize across chemicals for many chemical mixes, producing a shared chronic health profile. Conformity of persistent health problems in this woman to the signature illness affecting Gulf War veterans suggests that knowledge from one mixed chemical exposure may be ported to others, allowing science to advance - and enabling prophylaxis and treatment measures to be developed.