Journal: Am J Epidemiol 2002 Jun 1;155(11):1033-1044
Authors: Gregory C. Gray [1,2], Robert J. Reed , Kevin S. Kaiser , Tyler C. Smith  and Victor M. Gastañaga 
 Department of Defense Center for Deployment Health Research, Naval Health Research Center, San Diego, CA.  Current affiliation: Department of Epidemiology, College of Public Health, University of Iowa, 200 Hawkins Drive, C21-K GH, Iowa City, IA 52242 (e-mail: mailto:email@example.com). (Correspondence to Dr. Gregory Gray at this address).
US Navy Seabees have been among the most symptomatic Gulf War veterans. Beginning in May 1997, the authors mailed Gulf War-era Seabees a health survey in serial mailings. As of July 1, 1999, 68.6% of 17,559 Seabees contacted had returned the questionnaire.
Compared with other Seabees, Gulf War Seabees reported poorer general health, a higher prevalence of all 33 medical problems assessed, more cognition difficulties, and a higher prevalence of four physician-diagnosed multisymptom conditions: chronic fatigue syndrome, posttraumatic stress disorder, multiple chemical sensitivity, and irritable bowel syndrome.
Because the four multisymptom conditions were highly associated with one another, the authors aggregated them into a working case definition of Gulf War illness. Among the 3,831 (22% cases) Gulf War Seabee participants, multivariable modeling revealed that female, Reserve, and enlisted personnel and participants belonging to either of two particular Seabee units were most likely to meet the case definition.
Twelve of 34 self-reported Gulf War exposures were mildly associated with meeting the definition of Gulf War illness, with exposure to fumes from munitions having the highest odds ratio (odds ratio = 1.9, 95% confidence
interval: 1.5, 2.4).
While these data do not implicate a specific etiologic exposure, they demonstrate a strong association and a high prevalence of self-reported multisymptom conditions in a large group of symptomatic Gulf War veterans.
Key Words: cross-sectional studies • health surveys • military medicine • military personnel • Persian Gulf syndrome • public health • veterans
Abbreviations: NMCB, Naval Mobile Construction Battalion