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Health status of Persian Gulf War veterans: self-reported symptoms, environmental exposures and the effect of stress.
Int J Epidemiol. 1998 Dec; 27(6):1000-10.IJ

Abstract

BACKGROUND

Most US troops returned home from the Persian Gulf War (PGW) by Spring 1991 and many began reporting increased health symptoms and medical problems soon after. This investigation examines the relationships between several Gulf-service environmental exposures and health symptom reporting, and the role of traumatic psychological stress on the exposure-health symptom relationships.

METHODS

Stratified, random samples of two cohorts of PGW veterans, from the New England area (n = 220) and from the New Orleans area (n = 71), were selected from larger cohorts being followed longitudinally since arrival home from the Gulf. A group of PGW-era veterans deployed to Germany (n = 50) served as a comparison group. The study protocol included questionnaires, a neuropsychological test battery, an environmental interview, and psychological diagnostic interviews. This report focuses on self-reported health symptoms and exposures of participants who completed a 52-item health symptom checklist and a checklist of environmental exposures.

RESULTS

The prevalence of reported symptoms was greater in both Persian Gulf-deployed cohorts compared to the Germany cohort. Analyses of the body-system symptom scores (BSS), weighted to account for sampling design, and adjusted by age, sex, and education, indicated that Persian Gulf-deployed veterans were more likely to report neurological, pulmonary, gastrointestinal, cardiac, dermatological, musculoskeletal, psychological and neuropsychological system symptoms than Germany veterans. Using a priori hypotheses about the toxicant effects of exposure to specific toxicants, the relationships between self-reported exposures and body-system symptom groupings were examined through multiple regression analyses, controlling for war-zone exposure and post-traumatic stress disorder (PTSD). Self-reported exposures to pesticides, debris from Scuds, chemical and biological warfare (CBW) agents, and smoke from tent heaters each were significantly related to increased reporting of specific predicted BSS groupings.

CONCLUSIONS

Veterans deployed to the Persian Gulf have higher self-reported prevalence of health symptoms compared to PGW veterans who were deployed only as far as Germany. Several Gulf-service environmental exposures are associated with increased health symptom reporting involving predicted body-systems, after adjusting for war-zone stressor exposures and PTSD.

Authors+Show Affiliations

Boston Environmental Hazards Center, School of Public Health (Environmental Health), Boston University, MA 02130-4893, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

10024195

Citation

Proctor, S P., et al. "Health Status of Persian Gulf War Veterans: Self-reported Symptoms, Environmental Exposures and the Effect of Stress." International Journal of Epidemiology, vol. 27, no. 6, 1998, pp. 1000-10.
Proctor SP, Heeren T, White RF, et al. Health status of Persian Gulf War veterans: self-reported symptoms, environmental exposures and the effect of stress. Int J Epidemiol. 1998;27(6):1000-10.
Proctor, S. P., Heeren, T., White, R. F., Wolfe, J., Borgos, M. S., Davis, J. D., Pepper, L., Clapp, R., Sutker, P. B., Vasterling, J. J., & Ozonoff, D. (1998). Health status of Persian Gulf War veterans: self-reported symptoms, environmental exposures and the effect of stress. International Journal of Epidemiology, 27(6), 1000-10.
Proctor SP, et al. Health Status of Persian Gulf War Veterans: Self-reported Symptoms, Environmental Exposures and the Effect of Stress. Int J Epidemiol. 1998;27(6):1000-10. PubMed PMID: 10024195.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Health status of Persian Gulf War veterans: self-reported symptoms, environmental exposures and the effect of stress. AU - Proctor,S P, AU - Heeren,T, AU - White,R F, AU - Wolfe,J, AU - Borgos,M S, AU - Davis,J D, AU - Pepper,L, AU - Clapp,R, AU - Sutker,P B, AU - Vasterling,J J, AU - Ozonoff,D, PY - 1999/2/19/pubmed PY - 1999/2/19/medline PY - 1999/2/19/entrez SP - 1000 EP - 10 JF - International journal of epidemiology JO - Int J Epidemiol VL - 27 IS - 6 N2 - BACKGROUND: Most US troops returned home from the Persian Gulf War (PGW) by Spring 1991 and many began reporting increased health symptoms and medical problems soon after. This investigation examines the relationships between several Gulf-service environmental exposures and health symptom reporting, and the role of traumatic psychological stress on the exposure-health symptom relationships. METHODS: Stratified, random samples of two cohorts of PGW veterans, from the New England area (n = 220) and from the New Orleans area (n = 71), were selected from larger cohorts being followed longitudinally since arrival home from the Gulf. A group of PGW-era veterans deployed to Germany (n = 50) served as a comparison group. The study protocol included questionnaires, a neuropsychological test battery, an environmental interview, and psychological diagnostic interviews. This report focuses on self-reported health symptoms and exposures of participants who completed a 52-item health symptom checklist and a checklist of environmental exposures. RESULTS: The prevalence of reported symptoms was greater in both Persian Gulf-deployed cohorts compared to the Germany cohort. Analyses of the body-system symptom scores (BSS), weighted to account for sampling design, and adjusted by age, sex, and education, indicated that Persian Gulf-deployed veterans were more likely to report neurological, pulmonary, gastrointestinal, cardiac, dermatological, musculoskeletal, psychological and neuropsychological system symptoms than Germany veterans. Using a priori hypotheses about the toxicant effects of exposure to specific toxicants, the relationships between self-reported exposures and body-system symptom groupings were examined through multiple regression analyses, controlling for war-zone exposure and post-traumatic stress disorder (PTSD). Self-reported exposures to pesticides, debris from Scuds, chemical and biological warfare (CBW) agents, and smoke from tent heaters each were significantly related to increased reporting of specific predicted BSS groupings. CONCLUSIONS: Veterans deployed to the Persian Gulf have higher self-reported prevalence of health symptoms compared to PGW veterans who were deployed only as far as Germany. Several Gulf-service environmental exposures are associated with increased health symptom reporting involving predicted body-systems, after adjusting for war-zone stressor exposures and PTSD. SN - 0300-5771 UR - https://www.unboundmedicine.com/medline/citation/10024195/Health_status_of_Persian_Gulf_War_veterans:_self_reported_symptoms_environmental_exposures_and_the_effect_of_stress_ DB - PRIME DP - Unbound Medicine ER -