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Risk factors for CFS: a case control study.
Reyes M, Dobbins JG, Mawle AC, Steele L, Gary HE, Malani H, Schmid S, Fukuda K, Stewart J, Nisenbaum R, Reeves WC.Risk factors for CFS: a case control study.
Journal of Chronic Fatigue Syndrome, vol. 2, pages 17-33, 1996.
Summary
The objective of this study was to examine various factors previously reported to put an individual at risk for developing CFS. A broad panel of factors were analyzed in this study, including exposures to various chemicals and sick animals; consumption of certain foods; history of selected medical procedures or allergies; and types of travel, occupation, or recreational activities. Several factors were found to be preferentially associated with CFS cases, but none that could be used to effectively distinguish CFS cases from controls. However, the study did produce evidence that gradual and sudden onset CFS may constitute distinct subclassifications of the illness.
Abstract
Objective: To study various risk factors previously reported to be associated with chronic fatigue syndrome (CFS).
Design: Case-control study
Setting: Metropolitan Atlanta CFS surveillance registry consisting of physicians and clinics that evaluate patients with fatiguing illness.
Patients: Twenty-five CFS patients identified from the Centers for Disease Control and Prevention, Atlanta CFS study site, were matched by race, sex, and age to two randomly selected controls. Cases were further subgrouped by type of onset - sudden, occurring within a few days, or gradual, occurring over a longer period. Main outcome measures: A broad panel of risk factors previously associated with CFS.
Results: CFS patients were significantly more likely than controls to report a history of stress, persistent nasal symptoms, ear infections, and ingestion of B-complex vitamins during the year prior to the case's onset of illness. In addition, many women patients were significantly more likely to have had a hysterectomy. The subset of patients (n = 17) who reported a gradual onset were significantly more likely than patients reporting a sudden onset of illness or controls to report stressful events in the year prior to onset, certain dental procedures, sinusitis, exposures to herbicides, pesticides or insecticides, and a history of hysterectomy. We could not confirm previously reported associations of CFS with a history of asthma or eczema; exposure to sick animals, exposure to solvents, paint or other chemicals; ingestion of raw milk; or travel, occupation or recreational activity.
Conclusions: While no risk factors were identified that effectively distinguish CFS cases from controls, the data do suggest that gradual and sudden onset CFS constitute distinct subclasses of the syndrome. Further studies should subgroup patients based on type of illness onset and further evaluate risk factors of interest, focusing on the role of stress, exposure to herbicides, pesticides, and insecticides, and dental and medical histories.
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