Gulf War veterans’ health: medical evaluation of a U.S. cohort

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Abstract

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 non-deployed Gulf War veterans who were evaluated by direct medical and 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 non-deployed (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 non-deployed veterans: fibromyalgia (deployed, 2.0%; non-deployed, 1.2%; odds ratio, 2.32 [95% CI, 1.02 to 5.27]); the chronic fatigue syndrome (deployed, 1.6%; non-deployed 0.1%; odds ratio, 40.6 [CI, 10.2 to 161]); dermatologic conditions (deployed, 34.6%; non-deployed, 26.8%; odds ratio, 1.38 [CI, 1.06 to 1.80]), and dyspepsia (deployed, 9.1%; non-deployed, 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 non-deployed 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 non-deployed veterans is similar. However, Gulf War deployment is associated with an increased risk for fibromyalgia, chronic fatigue syndrome, skin conditions, dyspepsia, and a clinically insignificant decrease in the SF-36 physical component score.

Source: Eisen SA1, Kang HK, Murphy FM, Blanchard MS, Reda DJ, Henderson WG, Toomey R, Jackson LW, Alpern R, Parks BJ, Klimas N, Hall C, Pak HS, Hunter J, Karlinsky J, Battistone MJ, Lyons MJ; Gulf War Study Participating Investigators. Gulf War veterans’ health: medical evaluation of a U.S. cohort. Ann Intern Med. 2005 Jun 7;142(11):881-90.

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