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Mortality among U.S. veterans of the Persian Gulf War.
N Engl J Med 1996; 335(20):1498-504NEJM

Abstract

BACKGROUND

Since the 1990-1991 Persian Gulf War, there has been persistent concern that U.S. war veterans may have had adverse health consequences, including higher-than-normal mortality.

METHODS

We conducted a retrospective cohort study of postwar mortality according to cause among 695,516 Gulf War veterans and 746,291 other veterans. The follow-up continued through September 1993. A stratified, multivariate analysis (with Cox proportional-hazards models) controlled for branch of service, type of unit, age, sex, and race in comparing the two groups. We used standardized mortality ratios to compare the groups of veterans with the general population of the United States.

RESULTS

Among the Gulf War veterans, there was a small but significant excess of deaths as compared with the veterans who did not serve in the Persian Gulf (adjusted rate ratio, 1.09; 95 percent confidence interval, 1.01 to 1.16). The excess deaths were mainly caused by accidents (1.25; 1.13 to 1.39) rather than disease (0.88; 0.77 to 1.02). The corresponding rate ratios among 49,919 female veterans of the Gulf War were 1.32 (0.95 to 1.83) for death from all causes, 1.83 (1.02 to 3.28) for accidental death, and 0.89 (0.45 to 1.78) for death from disease. In both groups of veterans the mortality rates were significantly lower overall than those in the general population. The adjusted standardized mortality ratios were 0.44 (95 percent confidence interval, 0.42 to 0.47) for Gulf War veterans and 0.38 (0.36 to 0.40) for other veterans.

CONCLUSIONS

Among veterans of the Persian Gulf War, there was a significantly higher mortality rate than among veterans deployed elsewhere, but most of the increase was due to accidents rather than disease, a finding consistent with patterns of postwar mortality among veterans of previous wars.

Authors+Show Affiliations

Department of Veterans Affairs, Environmental Epidemiology Service, Washington, DC 20036-3406, USA.No affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

8890102

Citation

Kang, H K., and T A. Bullman. "Mortality Among U.S. Veterans of the Persian Gulf War." The New England Journal of Medicine, vol. 335, no. 20, 1996, pp. 1498-504.
Kang HK, Bullman TA. Mortality among U.S. veterans of the Persian Gulf War. N Engl J Med. 1996;335(20):1498-504.
Kang, H. K., & Bullman, T. A. (1996). Mortality among U.S. veterans of the Persian Gulf War. The New England Journal of Medicine, 335(20), pp. 1498-504.
Kang HK, Bullman TA. Mortality Among U.S. Veterans of the Persian Gulf War. N Engl J Med. 1996 Nov 14;335(20):1498-504. PubMed PMID: 8890102.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mortality among U.S. veterans of the Persian Gulf War. AU - Kang,H K, AU - Bullman,T A, PY - 1996/11/14/pubmed PY - 1996/11/14/medline PY - 1996/11/14/entrez SP - 1498 EP - 504 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 335 IS - 20 N2 - BACKGROUND: Since the 1990-1991 Persian Gulf War, there has been persistent concern that U.S. war veterans may have had adverse health consequences, including higher-than-normal mortality. METHODS: We conducted a retrospective cohort study of postwar mortality according to cause among 695,516 Gulf War veterans and 746,291 other veterans. The follow-up continued through September 1993. A stratified, multivariate analysis (with Cox proportional-hazards models) controlled for branch of service, type of unit, age, sex, and race in comparing the two groups. We used standardized mortality ratios to compare the groups of veterans with the general population of the United States. RESULTS: Among the Gulf War veterans, there was a small but significant excess of deaths as compared with the veterans who did not serve in the Persian Gulf (adjusted rate ratio, 1.09; 95 percent confidence interval, 1.01 to 1.16). The excess deaths were mainly caused by accidents (1.25; 1.13 to 1.39) rather than disease (0.88; 0.77 to 1.02). The corresponding rate ratios among 49,919 female veterans of the Gulf War were 1.32 (0.95 to 1.83) for death from all causes, 1.83 (1.02 to 3.28) for accidental death, and 0.89 (0.45 to 1.78) for death from disease. In both groups of veterans the mortality rates were significantly lower overall than those in the general population. The adjusted standardized mortality ratios were 0.44 (95 percent confidence interval, 0.42 to 0.47) for Gulf War veterans and 0.38 (0.36 to 0.40) for other veterans. CONCLUSIONS: Among veterans of the Persian Gulf War, there was a significantly higher mortality rate than among veterans deployed elsewhere, but most of the increase was due to accidents rather than disease, a finding consistent with patterns of postwar mortality among veterans of previous wars. SN - 0028-4793 UR - https://www.unboundmedicine.com/medline/citation/8890102/Mortality_among_U_S__veterans_of_the_Persian_Gulf_War_ L2 - http://www.nejm.org/doi/full/10.1056/NEJM199611143352006?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -