Gulf War veterans' health: medical evaluation of a U.S. cohort.
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 nondeployed Gulf War veterans who were evaluated by direct medical and teledermatologic examinations.


METHODS
A cross-sectional prevalence study performed 10 years after the 1991 Gulf War.


METHODS
Veterans were examined at 1 of 16 Veterans Affairs medical centers.


METHODS
Deployed (n = 1061) and nondeployed (n = 1128) veterans of the 1991 Gulf War.


METHODS
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 nondeployed veterans: fibromyalgia (deployed, 2.0%; nondeployed, 1.2%; odds ratio, 2.32 [95% CI, 1.02 to 5.27]); the chronic fatigue syndrome (deployed, 1.6%; nondeployed 0.1%; odds ratio, 40.6 [CI, 10.2 to 161]); dermatologic conditions (deployed, 34.6%; nondeployed, 26.8%; odds ratio, 1.38 [CI, 1.06 to 1.80]), and dyspepsia (deployed, 9.1%; nondeployed, 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 nondeployed veterans was 49.3 and 50.8, respectively.


CONCLUSIONS
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 nondeployed veterans is similar. However, Gulf War deployment is associated with an increased risk for fibromyalgia, the chronic fatigue syndrome, skin conditions, dyspepsia, and a clinically insignificant decrease in the SF-36 physical component score.
Eisen
Seth A
SA
Veterans Affairs Medical Center, Washington University School of Medicine, St. Louis, Missouri 63106, USA. seth.eisen@med.va.gov
Kang
Han K
HK
Murphy
Frances M
FM
Blanchard
Melvin S
MS
Reda
Domenic J
DJ
Henderson
William G
WG
Toomey
Rosemary
R
Jackson
Leila W
LW
Alpern
Renee
R
Parks
Becky J
BJ
Klimas
Nancy
N
Hall
Coleen
C
Pak
Hon S
HS
Hunter
Joyce
J
Karlinsky
Joel
J
Battistone
Michael J
MJ
Lyons
Michael J
MJ
D000328:Adult; D015982:Bias; D003430:Cross-Sectional Studies; D004415:Dyspepsia / Q000453:epidemiology; D015673:Fatigue Syndrome, Chronic / Q000453:epidemiology; D005260:Female; D005356:Fibromyalgia / Q000453:epidemiology; D047830:Gulf War; D006801:Humans; D008297:Male; D010523:Peripheral Nervous System Diseases / Q000453:epidemiology; D018923:Persian Gulf Syndrome / Q000453:epidemiology*; D015995:Prevalence; D011788:Quality of Life; D012871:Skin Diseases / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014728:Veterans; D014857:Warfare