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7 June 2005 | Volume 142 Issue 11 | Pages 881-890
Background: United States military personnel reported various symptoms after deployment to the Persian Gulf during the 1991 Gulf War. However, the symptoms' long-term prevalence and association with deployment remain controversial.
Objective: To assess and compare the prevalence of selected medical conditions in a national cohort of deployed and nondeployed Gulf War veterans who were evaluated by direct medical and teledermatologic examinations.
Design: A cross-sectional prevalence study performed 10 years after the 1991 Gulf War.
Setting: Veterans were examined at 1 of 16 Veterans Affairs medical centers.
Participants: Deployed (n = 1061) and nondeployed (n = 1128) veterans of the 1991 Gulf War.
Measurements: Primary outcome measures included fibromyalgia, the chronic fatigue syndrome, dermatologic conditions, dyspepsia, physical health–related quality of life (Short Form-36 [SF-36]), hypertension, obstructive lung disease, arthralgias, and peripheral neuropathy.
Results: Of 12 conditions, only 4 conditions were more prevalent among deployed than nondeployed veterans: fibromyalgia (deployed, 2.0%; nondeployed, 1.2%; odds ratio, 2.32 [95% CI, 1.02 to 5.27]); the chronic fatigue syndrome (deployed, 1.6%; nondeployed 0.1%; odds ratio, 40.6 [CI, 10.2 to 161]); dermatologic conditions (deployed, 34.6%; nondeployed, 26.8%; odds ratio, 1.38 [CI, 1.06 to 1.80]), and dyspepsia (deployed, 9.1%; nondeployed, 6.0%; odds ratio, 1.87 [CI, 1.16 to 2.99]). The mean physical component summary score of the SF-36 for deployed and nondeployed veterans was 49.3 and 50.8, respectively.
Limitations: Relatively low participation rates introduce potential participation bias, and deployment-related illnesses that resolved before the research examination could not, by design, be detected.
Conclusions: Ten years after the Gulf War, the physical health of deployed and nondeployed veterans is similar. However, Gulf War deployment is associated with an increased risk for fibromyalgia, the chronic fatigue syndrome, skin conditions, dyspepsia, and a clinically insignificant decrease in the SF-36 physical component score.
*For a list of the Gulf War Study Participating Investigators, see the Appendix.
Editors' Notes
Context
Contribution
Cautions
Implications
–The Editors
Author and Article Information
From Veterans Affairs Medical Center, Washington University School of Medicine, and Saint Louis University, St. Louis, Missouri; Veterans Health Administration, Environmental Epidemiology Service, U.S. Department of Veterans Affairs, and Uniformed Services University of the Health Sciences, Washington, DC; Cooperative Studies Program Coordinating Center, Hines Veterans Affairs Hospital, Hines, Illinois; Brockton Veterans Affairs Medical Center, Brockton, Massachusetts; Harvard Medical School, Massachusetts Mental Health Center, Harvard Institute of Psychiatric Epidemiology and Genetics, Veterans Affairs Medical Center, and Boston University School of Medicine, Boston, Massachusetts; Miami Veterans Affairs Medical Center and University of Miami, Miami, Florida; Brooke Army Medical Center, Fort Sam Houston, Texas; and Veterans Affairs Salt Lake City Health Care System and University of Utah Health Sciences Center, Salt Lake City, Utah.
Grant Support: By the Cooperative Studies Program of the U.S. Department of Veterans Affairs Office of Research and Development.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Seth A. Eisen, MD, MSc, St. Louis Veterans Affairs Medical Center (151 JC), 915 North Grand Avenue, St. Louis, MO 63106; e-mail, seth.eisen{at}med.va.gov.
Current Author Addresses: Drs. Eisen and Blanchard: St. Louis Veterans Affairs Medical Center (151 JC), 915 North Grand Boulevard, St. Louis, MO 63106.
Dr. Kang: U.S. Department of Veterans Affairs, 1722 I Street, Washington, DC 20006.
Dr. Murphy: U.S. Department of Veterans Affairs, 811 Vermont Avenue NW, Washington, DC 20420.
Dr. Reda, Ms. Alpern, and Ms. Hall: Hines Veterans Affairs Hospital, CSPCC (151-K), PO Box 5000, Hines, IL 60141.
Dr. Henderson: University of Colorado Health Care Outcomes Program, Mail Stop F-443, PO Box 6508, Aurora, CO 80045-0508.
Dr. Toomey: Boston University, 648 Beacon Street, 6th Floor, Boston, MA 02215.
Dr. Jackson: Department of Epidemiology, John Hopkins University Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205.
Dr. Parks: Department of Neurology, Washington University School of Medicine, 660 South Euclid, St. Louis, MO 63110.
Dr. Klimas: Miami Veterans Affairs Medical Center, 1201 NW 16th Street, (111-I), Miami, FL 33125.
Dr. Pak: Wilford Hall Air Force Medical Center, 2200 Bergquist Drive, Lackland AFB, TX 78236.
Ms. Hunter: Deaconess College of Nursing, 6150 Oakland Avenue, St. Louis, MO 63139.
Dr. Karlinsky: Veterans Affairs Boston Healthcare System, West Roxbury Campus, 1400 VFW Parkway, West Roxbury, MA 02132.
Dr. Battistone: Salt Lake City Veterans Affairs Medical Center, 500 Foothill Drive, Salt Lake City, UT 84148.
Dr. Lyons: Boston University, 648 Beacon Street, 2nd Floor, Boston, MA 02215.
Author Contributions: Conception and design: S.A. Eisen, H.K. Kang, F.M. Murphy, M.S. Blanchard, D.J. Reda, W.G. Henderson, B.J. Parks, H.S. Pak, M.J. Lyons.
Analysis and interpretation of the data: S.A. Eisen, H.K. Kang, F.M. Murphy, M.S. Blanchard, D.J. Reda, W.G. Henderson, R. Toomey, L.W. Jackson, R. Alpern, B.J. Parks, N. Klimas, C. Hall, H.S. Pak, J. Karlinsky, M.J. Battistone.
Drafting of the article: S.A. Eisen, F.M. Murphy, M.S. Blanchard, L.W. Jackson, R. Alpern, J. Karlinsky.
Critical revision of the article for important intellectual content: S.A. Eisen, F.M. Murphy, M.S. Blanchard, D.J. Reda, W.G. Henderson, R. Toomey, L.W. Jackson, N. Klimas, H.S. Pak, J. Karlinsky, M.J. Battistone, M.J. Lyons.
Final approval of the article: S.A. Eisen, F.M. Murphy, M.S. Blanchard, D.J. Reda, W.G. Henderson, R. Toomey, L.W. Jackson, R. Alpern, N. Klimas, H.S. Pak, J. Hunter, J. Karlinsky, M.J. Battistone, M.J. Lyons.
Provision of study materials or patients: S.A. Eisen, N. Klimas, J. Hunter, M.J. Battistone.
Statistical expertise: S.A. Eisen, D.J. Reda, W.G. Henderson, R. Alpern.
Obtaining of funding: S.A. Eisen, H.K. Kang, F.M. Murphy, W.G. Henderson.
Administrative, technical, or logistic support: S.A. Eisen, H.K. Kang, M.S. Blanchard, D.J. Reda, W.G. Henderson, L.W. Jackson, J. Hunter, M.J. Battistone.
Collection and assembly of data: S.A. Eisen, H.K. Kang, R. Toomey, B.J. Parks, J. Hunter, J. Karlinsky, M.J. Battistone. ARTICLE
Gulf War Veterans' Health: Medical Evaluation of a U.S. Cohort
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