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Neurological status of Australian veterans of the 1991 Gulf War and the effect of medical and chemical exposures.
Int J Epidemiol. 2005 Aug; 34(4):810-9.IJ

Abstract

BACKGROUND

Since the 1991 Gulf War, concerns have been voiced about the effects on the health of veterans of Gulf War related medical and chemical exposures.

METHODS

Our cross-sectional study compared 1424 male Australian Gulf War veterans and a randomly sampled military comparison group (n = 1548). A postal questionnaire asked about the presence of current neurological type symptoms, medically diagnosed neurological conditions, and medical and chemical exposures. A neurological examination was performed as part of a physical assessment.

RESULTS

Veterans have a higher prevalence of neurological type symptoms (ratio of means 1.4, 95% confidence interval (CI) 1.2-1.5). Although the odds ratio (OR) of lower limb neurological type symptoms and signs in veterans compared with the comparison group was increased (OR = 1.6, 95% CI 1.0-2.7), it was of borderline significance, and there was no difference between groups according to a Neuropathy Score based on neurological signs alone (ratio of means 1.1, 95% CI 0.9-1.3). The increased OR of neurological type symptoms and signs suggestive of a central nervous system disorder (OR = 1.8, 95% CI 1.0-3.1) was also of borderline significance. Veterans were not more likely to have self-reported medically diagnosed neurological conditions, or to have neurological type symptoms and signs suggestive of an anterior horn cell disorder (OR = 0.9, 95% CI 0.5-1.6). The total number of neurological type symptoms reported by veterans, but not the Neuropathy Score, was associated with Gulf War related exposures including immunizations and pyridostigmine bromide in dose-response relationships, anti-biological warfare tablets, solvents, pesticides, and insect repellents.

CONCLUSIONS

This study shows increased reporting of neurological type symptoms in Gulf War veterans, but no evidence for increased neurological effects based on objective physical signs. There may be a number of factors, including information bias, relating to increased neurological type symptom reporting in veterans.

Authors+Show Affiliations

Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia. helen.kelsall@med.monash.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15851393

Citation

Kelsall, Helen, et al. "Neurological Status of Australian Veterans of the 1991 Gulf War and the Effect of Medical and Chemical Exposures." International Journal of Epidemiology, vol. 34, no. 4, 2005, pp. 810-9.
Kelsall H, Macdonell R, Sim M, et al. Neurological status of Australian veterans of the 1991 Gulf War and the effect of medical and chemical exposures. Int J Epidemiol. 2005;34(4):810-9.
Kelsall, H., Macdonell, R., Sim, M., Forbes, A., McKenzie, D., Glass, D., Ikin, J., & Ittak, P. (2005). Neurological status of Australian veterans of the 1991 Gulf War and the effect of medical and chemical exposures. International Journal of Epidemiology, 34(4), 810-9.
Kelsall H, et al. Neurological Status of Australian Veterans of the 1991 Gulf War and the Effect of Medical and Chemical Exposures. Int J Epidemiol. 2005;34(4):810-9. PubMed PMID: 15851393.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neurological status of Australian veterans of the 1991 Gulf War and the effect of medical and chemical exposures. AU - Kelsall,Helen, AU - Macdonell,Richard, AU - Sim,Malcolm, AU - Forbes,Andrew, AU - McKenzie,Dean, AU - Glass,Deborah, AU - Ikin,Jillian, AU - Ittak,Peter, Y1 - 2005/04/25/ PY - 2005/4/27/pubmed PY - 2008/1/8/medline PY - 2005/4/27/entrez SP - 810 EP - 9 JF - International journal of epidemiology JO - Int J Epidemiol VL - 34 IS - 4 N2 - BACKGROUND: Since the 1991 Gulf War, concerns have been voiced about the effects on the health of veterans of Gulf War related medical and chemical exposures. METHODS: Our cross-sectional study compared 1424 male Australian Gulf War veterans and a randomly sampled military comparison group (n = 1548). A postal questionnaire asked about the presence of current neurological type symptoms, medically diagnosed neurological conditions, and medical and chemical exposures. A neurological examination was performed as part of a physical assessment. RESULTS: Veterans have a higher prevalence of neurological type symptoms (ratio of means 1.4, 95% confidence interval (CI) 1.2-1.5). Although the odds ratio (OR) of lower limb neurological type symptoms and signs in veterans compared with the comparison group was increased (OR = 1.6, 95% CI 1.0-2.7), it was of borderline significance, and there was no difference between groups according to a Neuropathy Score based on neurological signs alone (ratio of means 1.1, 95% CI 0.9-1.3). The increased OR of neurological type symptoms and signs suggestive of a central nervous system disorder (OR = 1.8, 95% CI 1.0-3.1) was also of borderline significance. Veterans were not more likely to have self-reported medically diagnosed neurological conditions, or to have neurological type symptoms and signs suggestive of an anterior horn cell disorder (OR = 0.9, 95% CI 0.5-1.6). The total number of neurological type symptoms reported by veterans, but not the Neuropathy Score, was associated with Gulf War related exposures including immunizations and pyridostigmine bromide in dose-response relationships, anti-biological warfare tablets, solvents, pesticides, and insect repellents. CONCLUSIONS: This study shows increased reporting of neurological type symptoms in Gulf War veterans, but no evidence for increased neurological effects based on objective physical signs. There may be a number of factors, including information bias, relating to increased neurological type symptom reporting in veterans. SN - 0300-5771 UR - https://www.unboundmedicine.com/medline/citation/15851393/Neurological_status_of_Australian_veterans_of_the_1991_Gulf_War_and_the_effect_of_medical_and_chemical_exposures_ L2 - https://academic.oup.com/ije/article-lookup/doi/10.1093/ije/dyi084 DB - PRIME DP - Unbound Medicine ER -