INDEX
A
Abortions, spontaneous, 193, 194, 195, 201-202, 231
Acetylcholinesterase (AChE), 265-266, 275, 276
Alcohol abuse, 8, 49, 75, 80, 90, 99, 100, 101, 102, 104, 106, 108, 109, 110, 112, 113, 121, 126, 132, 134, 177, 208, 232
Allergies
chronic respiratory, 148
skin, 165
Alzheimer’s disease, 8, 121, 129-130
Amyotrophic lateral sclerosis (ALS)
combat exposure and, 121
female veterans, 231
hospitalization study, 128
mortality studies, 75, 125, 128
neurotoxin exposure and, 128-129
primary studies, 127, 129, 133-134
research recommendations, 9, 10, 260-261
updated and supplemental literature, 128-129
Volume 4 summary, 4, 15, 19, 127-128
Anemia, 83
Animal studies, 3, 15, 25, 129, 275-276
Anxiety disorders, 17, 19, 42, 50, 63, 99, 100, 101, 102, 103-104, 105, 106, 107, 110, 111, 113, 114, 154, 160, 207, 214.
See also Generalized anxiety disorder;
Obsessive-compulsive disorder;
Panic disorder;
Posttraumatic stress disorder;
Social phobia
Asthma and bronchitis, 4, 5, 20, 33-34, 42, 50, 145, 146, 148, 150, 152, 153, 208
Atherosclerosis, 135
Atopic dermatitis, 19, 165, 167, 168
Australian Veteran Studies, 43, 54-56
chronic fatigue syndrome, 213, 219
diseases of the digestive system, 158
mental and behavioral disorders, 101-102, 104-106, 112
multisymptom illnesses, 207
B
Bipolar disorder, 99
Birth defects, 231
deployment status of parents and, 189, 190-191, 192, 231, 234
derivative studies, 42, 43, 45, 54
environmental exposures and, 190
miscarriages and stillbirths, 193, 201
primary studies, 189-190, 191, 200-201
secondary studies, 190-191, 192
updated and supplemental literature, 191-192
Volume 4 summary, 4, 19, 189-191
Blood and blood-forming organs, diseases of, 7
latency, 85
mortality studies, 85
nerve-agent exposure and, 84, 87
oil-well fire smoke exposure and, 84, 87
secondary studies, 84
updated and supplemental literature, 83-84
Body mass index (BMI), 92
Borderline personality disorder, 42, 50-51, 107-108
Botulinum toxoid vaccine, 14, 57
Bradford Hill aspects, 27, 28, 35
Brain cancer, 2, 9, 10, 20, 73-74, 75, 76, 78, 79, 125, 231, 261
Bronchitis. See Asthma and bronchitis
Butyrylcholinesterase (BuChE), 61, 277
C
C-reactive protein, 213
CAGE questionnaire, 49
Canadian Gulf War Veterans Study, 44, 58
diseases of the digestive system, 158, 166
mental and behavioral disorders, 105
chronic fatigue syndrome, 213
Cancer
all cancers, 8, 74-75, 80-82, 257
brain cancer, 2, 9, 10, 20, 73-74, 75, 76, 78, 79, 125, 231, 261
derivative studies, 42, 44, 52
digestive tract, 76
hospitalization studies, 73, 74, 75-76, 80, 81
latency, 8, 28, 41, 73, 74, 78
leukemias and lymphomas, 73
mortality studies, 73, 74-75, 76, 78, 79, 80, 81, 82, 125, 226-227
nerve agent exposure and, 73-74, 75, 77, 78, 79
oil-well fire smoke and, 74, 75, 78
pesticide exposure and, 78
primary studies, 75-76, 79-82, 125
recommendation, 78
registry data, 9
research recommendations, 9, 10
testicular, 2, 4, 15, 19, 73, 74, 76, 78, 79-80, 81, 208
updated and supplemental literature, 75-78
vaccines/vaccination and, 77
Volume 4 summary, 4, 19, 20, 73-75
Cardiac dysrhythmia, 135, 140, 141
Cardiovascular disease. See Circulatory system diseases
Cause-specific mortality. See External causes of mortality
Centers for Disease Control and Prevention (CDC), 47, 49, 52, 59, 116, 200, 205, 208, 210, 211, 212, 213, 219, 220, 256, 270
Central nervous system (CNS), 160, 267, 270, 275, 276, 278, 279
Chalder Fatigue Scale, 213
Chemical agent exposure, and neurological diseases, 47, 59-60, 121, 133
Chemical and biologic warfare
threat of, 14-15, 55, 212, 213
Chlorinated hydrocarbons, 14
Cholinesterase inhibitors.
See also Pesticide/insecticide
exposures;
Pyridostigmine bromide
exposures during Gulf War, 266-270
genetic susceptibility, 61, 276-278
illnesses associated with, 60, 267-268
long-term effects of low doses, 270
multisymptom illnesses, 57, 61, 62, 278-279
studies in Gulf War populations, 60, 271-274
Chronic dysphoria, 105
Chronic fatigue syndrome (CFS), 7.
See also Multisymptom illnesses
chemical sensitivity and, 45
in disabled veterans, 52, 214, 220
identification of predictors, 42
mental and behavioral disorders and, 102
multisymptom illnesses, 60, 207, 211
oil-fire smoke exposure and, 214
pesticide exposure and, 52, 55, 213, 214
prevalence, 46, 47, 53, 55, 60, 61, 213, 214
primary studies, 211-212, 219-220
pyridostigmine bromide and, 55, 213, 214
threat of chemical weapons and, 55, 212, 213
updated and supplemental literature, 213-214, 220
Chronic multisymptom illness (CMI). See Multisymptom illnesses
Chronic obstructive pulmonary disease, 145, 148, 150
Chronic widespread pain (CWP).
See also Fibromyalgia
alcohol use and, 177
cognitive performance, 50, 118
combat exposure and, 50, 177, 178
comorbid with mental disorders, 102
delayed-onset, 177
identification of predictors of, 42, 50
pesticide exposure and, 178
pyridostigmine bromide exposure and, 178
musculoskeletal, 1, 3, 10, 18, 19, 47, 57, 118, 120
primary studies, 176-177, 178, 179
self-reports of, 18, 42, 43, 57
stress perceptions and, 177, 178
Volume 4 summary, 3
Circulatory system diseases.
See also specific diseases and conditions
female veterans, 138
hospitalization studies, 135, 136, 137, 140, 141, 142, 218
latency, 28
mortality studies, 8, 135, 136, 137, 138, 140, 142, 143, 144
nerve-agent exposure and, 135, 136, 137-138, 139, 140, 141, 143
oil-well fire smoke and, 137, 142
prevalence, 135
primary studies, 135, 136-138, 140, 141-144
research recommendations, 10
risk factors, 135
secondary studies, 135-136, 138-140
updated and supplemental literature, 136-140
Volume 4 summary, 4, 19, 135-136
Clinician Administered PTSD Scale (CAPS), 58, 101, 102-103, 107, 111, 114
Cognitive dysfunction, 1, 10, 19, 50, 51, 101, 102, 118, 119-120, 121, 129, 175.
See also Neurocognitive and neurobehavioral performance
Colitis, 157
Comprehensive Clinical Evaluation Program (CCEP), 4, 32, 175-176
Contact dermatitis, 164
Coronary heart disease, 135
Crohn’s disease, 155
Cyclosarin. See Nerve-agent exposure
Cytomegalovirus, 213
D
Danish Peacekeeper Studies, 43, 56
diseases of the digestive system, 156-157
multisymptom illnesses, 206, 217
Defence Analytical Services Agency (UK), 76, 159, 223
Defense Medical Surveillance System, 154
Department of National Defence (Canada), 58
Department of Veterans Affairs (VA)
charge to IOM committee, 2, 11-12, 15-16
National Health Survey of Gulf War Veterans and Their Families, 42, 45-48
Research Advisory Committee on Gulf War Veterans’ Illnesses, 2, 3, 16, 259
Depleted uranium (DU) exposure
endocrine and metabolic diseases, 90, 92, 97
external causes of mortality, 53
fertility problems, 196, 197, 203
genitourinary system diseases, 180-181, 185, 186
neurological symptoms, 47
Depression, 8, 10, 19, 50, 51, 63, 99, 101, 102, 103, 104, 105, 107, 108, 111, 113, 114, 115, 116, 118, 119, 154, 207, 214, 229, 230, 232.
See also Major depressive disorder
Dermatitis, 164, 165, 166, 206.
See also Skin diseases;
specific diseases
Diabetes
cardiovascular disease, 135
depleted uranium exposure and, 90
hospitalizations, 91
nerve-agent exposure and, 89-90, 91
primary studies, 89, 90, 95, 96
updated and supplemental literature, 90-91
Diagnostic and Statistical Manual of Mental Disorders (DSM), 33, 99
Digestive system diseases.
See also specific diseases
cancer, 76
birth defects, 201
hospitalization studies, 155-156, 158, 162
neurobehavioral performance, 118, 120
pesticide/insecticide exposure and, 56
prevalence, 57
primary studies, 155-156, 162-163
pyridostigmine bromide exposure and, 159
research needs, 261
secondary studies, 156
smoke from buring waste or manure and, 56
updated and supplemental epidemiologic literature, 156-159
Volume 4 summary, 3, 19, 155-156
Distal symmetric polyneuropathy (DSP), 42, 46, 122-123, 132
Down syndrome, 192
Drug abuse and dependence, 99, 100, 104, 112, 113, 208, 232
Dyspepsia, 8, 10, 19, 46, 155, 157, 160, 207
E
Ectopic pregnancies, 194, 195, 201-202
Emphysema, 145, 146, 148, 150, 152
Endocrine, nutritional, and metabolic diseases.
See also Diabetes;
Obesity;
Thyroid disease
depleted uranium exposure and, 90, 92, 97
hospitalization studies, 93-95, 96, 97, 98
mortality studies, 95
nerve-agent exposure and, 89-90, 91, 93, 97
oil-well fire smoke exposure and, 94, 98
prevalence, 96
updated and supplemental literature, 90-92, 93-95
Enteritis, 157
Epilepsy, 121
Exposure to harmful agents.
See also Nerve-agent exposure;
Oil-well fire smoke exposure;
Pesticide/insecticide exposures;
Pyridostigmine
bromide
interactions of multiple simultaneous exposures, 17
limitations of information, 17-18
External causes of mortality
female veterans, 234
intentional self-harm, 222, 223, 226
nerve-agent exposure and, 223, 225, 227
primary studies, 221-223, 225-227
research recommendations, 9
secondary studies, 222, 223-224
suicides, 221, 223, 225, 226-227
transportation accidents, 3-4, 8, 19, 221, 222, 223, 224, 225, 226, 227, 234
updated and supplemental literature, 222-224
Volume 4 summary, 3-4, 19, 221-222
F
Fatigue symptoms, 1, 46, 55, 103, 116, 118, 120, 123, 124, 175, 210.
See also Chronic fatigue syndrome
Female veteran health.
See also Pregnancy outcomes;
Women
circulatory system diseases, 138
deployment experiences, 228-229
digestive disorders, 157
genitourinary system diseases, 180, 181, 182-183, 184-185, 186, 196-197, 230, 233
health care utilization, 229
hospitalization studies, 233
mental and behavioral disorders, 47, 106, 107, 229, 230, 231-232, 234
mortality studies, 234
multisymptom illnesses, 229, 231
obesity, 93
PTSD, 42, 47, 103, 106, 111, 231-232, 234
respiratory illnesses, 230
sexual assault and harassment (military), 42, 47, 228, 232-233, 234
size of Gulf War force, 228, 234
summary and conclusions, 234
Fertility problems
defined, 195
depleted uranium exposure and, 196, 197, 203
primary studies, 183, 186, 196, 202-203
updated and supplemental literature, 196-197
Volume 4 summary, 196
Fibromyalgia.
See also Chronic widespread pain
hospitalization studies, 175-176, 178, 179
multisymptom illnesses, 207
neurologic etiology, 121
psychiatric comorbidities, 101
symptoms, 175
updated and supplemental literature, 176-178
Fibrositis, 175
Folliculitis, 164
Fort Devens and New Orleans Cohort Study, 44, 59-60
mental and behavioral disorders, 102-103, 111
multisymptom illnesses, 210
Functional gastrointestinal disorders (FGID), 8, 10, 154-155, 157, 159, 160, 256, 261
G
Gastroesophageal reflux disease, 155
Gastrointestinal. See Digestive system diseases;
Functional gastrointestinal disorders
Generalized anxiety disorder (GAD), 8, 99, 101, 108, 109, 110
Genetic susceptibility, 10, 18, 44, 61, 129, 261
Genitourinary system diseases
birth defects, 189, 190, 192, 200, 201
depleted uranium exposure and, 180-181, 185, 186
female veterans, 180, 181, 182-183, 184-185, 186, 196-197, 230, 233
hospitalization studies, 8, 183-184, 185, 186, 187, 188, 196
nerve-agent exposure and, 182, 183, 184, 185, 188
oil-well fire smoke exposure and, 183, 184, 187
updated and supplemental literature, 180-183
Volume 4 summary, 19
Goiter, 92
Goldenhar syndrome, 190, 192, 200
Gulf War syndrome, 1, 9, 11, 42, 50, 52, 59, 61, 77, 115, 116, 118, 123.
See also Multisymptom illnesses
Guillain Barré syndrome, 121
H
Hair loss and hair diseases, 165, 168
Hawaii and Pennsylvania Active Duty and Reserve
Healthy warrior effect, 29, 31, 35, 40, 51, 74, 99, 100, 127, 158, 209
Heart attacks, 138
High blood pressure, 135-136, 138, 139, 144
Hospitalizations.
See also Utilization of health services
blood and blood-forming organs, diseases of, 83-88
cancer studies, 73, 74, 75-76, 80, 81
circulatory systems disease studies, 135, 136, 137, 140, 141, 142
discharge diagnoses, 7, 9, 80, 86, 93, 94, 97
endocrine and metabolic diseases, 93-95, 96, 97, 98
female veterans, 233
fibromyalgia, 175-176, 178, 179
genitourinary system diseases, 8, 180, 181, 182-183, 184-185, 186, 196
limitations of studies, 95
mental and behavioral disorders, 104, 112
multisymptom illnesses, 207-208, 218-219
musculoskeletal diseases, 170, 171, 172, 173-174
neurological diseases, 128
proportional morbidity ratios, 94
respiratory system diseases, 145, 146, 147, 151, 152, 153
Volume 4 summary, 19
Hypercholesterolemia, 135
Hypertension, 7, 135, 136, 138, 139, 140, 141, 144, 206, 214
Hypothalamic-pituitary-adrenal axis dysfunction, 154, 160, 205, 211
I
Immunizations. See Vaccines/vaccination
Infectious disease/agents, 1, 12, 17, 46, 49, 58, 71, 121, 125, 128, 154, 180, 181, 182
Iowa Persian Gulf Study, 42, 49-51
mental and behavioral disorders, 101, 110
multisymptom illnesses, 206
Irritable bowel syndrome (IBS), 8, 10, 18, 32-33, 154-155, 156, 157, 158, 159, 160, 163, 261
Ischemic heart disease, 137
K
Kansas Veteran Study, 44, 58-59
diseases of the digestive system, 157
mental and behavioral disorders, 105
multisymptom illnesses 77
Khamisiyah demolition. See Nerve-agent exposure
Kidney disease, 180, 181, 184, 187
L
Lead exposure, 14, 49, 126, 129
Leukemias and lymphomas, 73
Lou Gehrig’s disease. See Amyotrophic lateral sclerosis
M
Major depressive disorder (MDD) and major depression, 99, 101, 102, 103, 104, 105, 106, 107, 108, 110, 111, 112, 113, 114.
See also Depression
Mental and behavioral disorders.
See also Posttraumatic stress disorder;
other specific disorders
anxiety disorders, 17, 19, 42, 50, 63, 99, 100, 101, 102, 103-104, 105, 106, 107, 110, 111, 113, 114.
See also Generalized anxiety disorder;
Obsessive-compulsive disorder;
Panic disorder;
Posttraumatic stress disorder;
Social phobia
chronic fatigue syndrome, 102
cognitive dysfunction, 101, 102
combat exposure and, 101, 102, 103-104, 105, 108, 114
comorbidities, 19, 50, 101, 102, 107
disabled veterans, 106, 108-109, 113
female veterans, 47, 106, 107, 229, 230, 231-232, 234
fibromyalgia, 101
mood disorders, 1, 19, 52, 99, 100, 106, 108, 115-116, 118, 119, 120.
See also Bipolar disorder;
Depression;
Major depressive disorder
multisymptom syndromes, 154, 207
neurocognitive and neurobehavioral performance, 101, 102, 118, 120
perceptions of stressors and, 55
primary studies, 100-104, 105-107, 110-114
quality of life status and, 42, 48
research recommendations, 9
secondary studies, 72, 105, 107-108
somatoform disorders, 99, 104, 106, 107, 108, 109, 113.
See also Hypochondriasis;
Somatization disorder
updated and supplemental literature, 105-108
Metabolic diseases. See Endocrine, nutritional, and metabolic diseases;
specific diseases
Metabolic syndrome, 207
Miscarriages and stillbirths, 8, 9, 43, 54, 55, 193, 194, 195, 201, 231, 234
Moodiness and mood disorders, 1, 19, 52, 99, 100, 106, 108, 115-116, 118, 119, 120, 195.
See Bipolar disorder;
Depression;
Major depressive disorder;
Mental and behavioral disorders
Mortality.
See also External causes of mortality
blood and blood-forming organs, diseases of, 85
cancer studies, 73, 74-75, 76, 78, 79, 80, 81, 82, 125
circulatory system disease studies, 8, 135, 136, 137, 138, 140, 142, 143, 144
endocrine and metabolic disease, 95
neurological diseases, 125, 128, 129-130, 133
respiratory system diseases, 147, 148-149, 151, 153
self-reported exposure and, 43, 52-53, 57
Multiple chemical sensitivity (MCS), 7, 19, 42, 44, 45, 50, 52, 60, 157, 163, 206, 255, 271
Multiple sclerosis (MS)
combat exposure and, 121
female veterans, 231
mortality studies, 75, 125, 133
pathogenesis, 124
research recommendations, 9
secondary study, 125
updated and supplemental literature, 125
Multisymptom illnesses.
See also Chronic fatigue
syndrome
biologic and chemical weapons threat and, 62, 205
chemical sensitivity and, 44, 60, 206
cholinesterase inhibitors and, 57, 61, 62, 278-279
chronic fatigue syndrome and, 60, 207, 211
chronic widespread pain, 209-210
factor analyses and surveys, 42, 43, 44, 50, 52, 61-62, 204-207, 215-217
fibromyalgia, 207
genetic susceptibility, 261-262, 276-278
hospitalization studies, 207-208, 218-219
nerve agent exposure and, 47, 48, 57, 58, 263, 271-274
neurobehavioral performance, 115-116, 118, 120
pesticide/insecticide exposure and, 62, 205, 259, 265, 266-270, 271-274, 278-279
prevalence, 11, 42, 48, 58, 62, 77, 209
pyridostigmine bromide use and, 205, 259, 265, 271-274
research recommendations, 9, 10, 260, 261-262
symptom clusters, 204-207, 216-218
vaccination and, 44, 52, 57, 58
Musculoskeletal diseases.
See also Fibromyalgia;
Multisymptom illnesses
hospitalization studies, 170, 171, 172, 173-174
nerve-agent exposure and, 59-60, 170-171, 173-174
oil-well fire smoke exposure and, 171, 173
primary studies, 169, 170-171, 172-174
updated and supplemental literature, 170-171
Myasthenia gravis, 268
N
National Health Survey of Gulf War Veterans and Their Families, 42, 45-48
diseases of the digestive system, 155, 157, 162
mental and behavioral disorders, 102, 105, 107, 108, 114
multisymptom illnesses, 206, 208-209, 211, 212
Nerve-agent exposure
blood and blood-forming organs, diseases of, 84, 87
cholinesterase inhibitors, 269-270
chronic multisymptom illness, 47, 48, 58
circulatory system diseases, 135, 136, 137-138, 139, 140, 141, 143
endocrine and metabolic diseases, 89-90, 91, 93, 97
genitourinary system diseases, 182, 183, 184, 185, 188
modeling, 15, 17-18, 32, 41, 46, 47-48, 73-74, 84, 116, 122, 147, 170, 184, 269
musculoskeletal diseases, 59-60, 170-171, 173-174
neurological diseases, 45, 47, 60, 122-123, 128, 129, 130, 132
neuropsychological functioning, 44, 55, 60
prophylaxis. See Pyridostigmine bromide
reproductive outcomes, 199
respiratory symptom system diseases, 20, 47, 145, 147, 148, 153
signs and symptoms of toxic effects, 267, 269-270
Volume 4 summary, 20
Nervous system diseases.
See also Alzheimer’s disease;
Amyotrophic lateral sclerosis;
Multiple sclerosis;
Parkinson’s;
Peripheral neuropathy and myopathy;
other specific diseases
brain injury and, 129
chemical agent exposure and, 47, 59-60, 121, 133
combat stress and, 125
environmental factors, 124-125, 129
factor-derived syndromes, 130-131
genetic susceptibility, 44, 61, 129
hospitalization studies, 128
mortality studies, 125, 128, 129-130, 133
neuromuscular symptoms, 43, 52, 123, 210
neurotoxicant exposure and, 45, 47, 60, 122-123, 128, 129, 130, 132
pesticide/insecticide exposure and, 51, 55, 121, 122, 123-124, 129, 133
pyridostigmine bromide and, 55, 121, 123-124
research recommendations, 9, 126, 261
vaccines/vaccination and, 121, 123-124, 125, 133
Neurocognitive and neurobehavioral performance conclusions, 8, 118, 257
deployment status and, 115, 117, 118, 119
derivative studies, 42, 43, 44, 48, 52, 56, 58-60
mental and behavioral disorders and, 101, 102, 118, 120
nerve-agent exposure and, 44, 56, 59-60, 116-117, 118
primary studies, 115, 116, 119-120
psychological stressors and, 56
secondary studies, 115, 116, 117
updated and supplemental literature, 116-118
New Orleans Reservist Studies, 45, 63
mental and behavioral disorders, 102-103, 111
multisymptom illnesses, 210
Nuclear Industry Family Study, 194
Nutritional diseases. See Endocrine, nutritional, and metabolic diseases;
specific diseases
O
Obsessive-compulsive disorder, 99, 104
Oil-well fire smoke exposure
blood and blood-forming organs, diseases of, 84, 87
chronic fatigue syndrome, 214
circulatory system diseases, 137, 142
endocrine and metabolic diseases, 94, 98
external causes of mortality, 53
genitourinary system diseases, 183, 184, 187
modeling, 18, 32, 45, 46, 49, 50, 84, 94, 137, 142, 146, 171, 184
musculoskeletal diseases, 171, 173
reproductive outcomes, 192
respiratory system diseases, 4, 20, 42, 50, 55, 145, 146, 152-153
Operation Desert Shield, 1, 11, 13, 17
Operation Desert Storm, 1, 11, 13, 17
Oregon and Washington Veteran Studies, 43-44, 57
multisymptom illnesses, 274
Organophosphate-induced delayed polyneuropathy, 265, 268
Organophosphates, 14, 18, 20, 60, 61, 78, 130, 266, 267, 268, 270
Osteoarthritis, 171
P
Pain.
See also Chronic widespread pain;
Fibromyalgia disorder, 107
nervous system diseases and, 122, 124
systemic, 177
Paints, exposure to chemical-agent-resistant compounds, 14, 17, 47, 206
Panic disorder, 99, 101, 104, 110
Paraoxonase-1 (PON1), 52, 61, 130, 276-277
Parkinson’s disease, 2, 8, 15, 75, 121, 125, 129-130, 231, 270, 278
Pennsylvania Air National Guard Study, 44, 61-62
Perinatal outcomes. See Birth defects
Peripheral neuropathy and myopathy
defined, 121
diagnosis, 122
nerve-agent exposure and, 122-123, 132
primary studies, 122-123, 132-133
pyridostigmine bromide and, 122
secondary studies, 123
updated and supplemental literature, 123-124
Volume 4 summary, 4, 19, 122-123
Persian Gulf War Veterans Act, 1, 11
Personality disorders, 42, 50-51, 102, 107-108
Pesticide/insecticide exposures.
See also specific classes of pesticides
cancer, 78
chronic fatigue syndrome, 52, 55, 213, 214
chronic widespread pain, 178
external causes of mortality, 53
illnesses associated with, 267-268
multiple chemical sensitivity, 52
multisymptom illnesses, 62, 205, 259, 266-270, 278-279
neurological diseases, 51, 55, 121, 122, 123-124, 129, 133
psychological health, 55
reproductive outcomes, 192
respiratory system diseases, 51, 145
types, 266
Petroleum-based combustion products, exposure to, 14, 17, 46, 49, 57, 229
Polyneuropathy, 122.
See also Distal symmetric polyneuropathy
Posttraumatic stress disorder (PTSD)
borderline personality disorder and, 107-108
comorbidities, 102, 107-108, 111, 118, 154, 157, 163
diagnosis, 99-100, 101, 102-103
female veterans, 42, 47, 103, 106, 111, 231-232, 234
multisymptom illnesses, 206, 207
personality and coping factors and, 63
predictors of, 103, 104, 107, 111
prevalence, 47, 50, 61, 62-63, 101, 102, 103, 104, 106, 111, 112
sexual assault and harassment and, 42, 47
Pregnancy outcomes, adverse.
See also Birth defects
mood problems, 195
reference study, 51, 53-54, 61
updated and supplemental literature, 194-195
Psychiatric conditions. See Mental and behavioral disorders;
Posttraumatic stress disorder;
other specific disorders
Pyridostigmine bromide (PB), 132
adverse health outcomes, 57
assessment of exposure, 18, 32, 45, 46, 49
chronic fatigue syndrome, 55, 213, 214
chronic multisymptom illness, 62
chronic widespread pain, 178
multisymptom illnesses, 205, 259
neurological symptoms, 55, 121, 123-124
psychological health, 55
toxicity symptoms from overexposure, 1, 267, 268-269
Q
Quality-of-life studies, 78
assessment, 44
multiple chemical sensitivity and, 42, 50
R
Rashes, 46, 57, 164, 165, 166, 229, 230
Reproductive outcomes.
See also Fertility problems;
Perinatal outcomes;
Pregnancy outcomes;
Sexual dysfunction
cohort study, 6
female, 231
Respiratory system diseases
deployment status and, 145-146, 147, 148-149, 150, 151
derivative studies, 42, 43, 47, 52, 53-54, 55
female veterans, 230
hospitalization studies, 145, 146, 147, 151, 152, 153
mortality studies, 147, 148-149, 151, 153
nerve agent exposure and, 20, 47, 145, 147, 148, 153
oil-well fire smoke exposure and, 4, 20, 42, 50, 55, 145, 146, 152-153
pesticide exposure and, 51, 145
primary studies, 145-146, 147, 150-153
research recommendations, 10
Volume 4 summary, 3, 19, 20, 145-147
Rheumatic diseases, 171
S
Sarin. See Nerve-agent exposure
Scud missile smoke and debris, exposure to, 53, 60, 214
diseases of the digestive system, 157, 163
Seborrheic dermatitis, 164, 168
Serum hormone-binding globulin, 196
Sexual assault and harassment (military), 42, 47, 228, 232-233, 234
Sexual dysfunction
combat exposure and, 198
nerve-agent exposure and, 199
primary studies, 203
updated and supplemental literature, 198-199
Volume 4 summary, 198
Skin diseases.
See also specific disorders
disabled veterans, 164, 165, 168
neurobehavioral performance, 118, 120
pesticide/insecticide exposure and, 56, 164
primary studies, 164, 165, 167, 168
secondary studies, 164, 165-167
smoke from burning waste or manure and, 56
solvent exposure and, 164
updated and supplemental literature, 165-167
vaccines and, 51
Volume 4 summary, 3, 19, 164-165
Sleep disturbance/disorder, 1, 10, 62, 99, 103, 106, 118, 120, 175, 210, 230
Small-fiber polyneuropathy, 124
Social phobia, 99
Solvents, exposures to, 1, 11, 12, 14-15, 17, 25, 49, 133, 164, 206
Somatization disorder, 99, 106-107, 109, 154, 160
Somatoform disorders, 99, 104, 106, 107, 108, 109, 113, 207
Smoke from burning waste or manure, 56.
See also Oil-well fire smoke exposure
Spondyloarthropathy, 171
Standardized mortality ratio (SMR), 31, 128
Standardized mortality studies, 31
Stress. SeePosttraumatic stress disorder
Structured Clinical Interview for DSM (SCID), 33, 50, 58, 59, 101, 102, 110, 111
Substance abuse, 8, 19, 100, 108, 109.
See also Alcohol abuse
Substance use disorders, 99, 100, 102, 106
Sympathetic-adrenal-medullary axis dysfunction, 205
T
Test of Memory Malingering (TOMM), 119
Testicular cancer, 2, 4, 15, 19, 73, 74, 76, 78, 79-80, 81, 208
Testosterone, 196
Thyroid disease
depleted uranium and, 92
secondary studies, 92
updated and supplemental literature, 91-92
Thyroxine-stimulating hormone, 93
Traumatic brain injury (TBI), 1, 12, 26, 31, 121
U
Ulcerative colitis, 155
United Kingdom Veterans Studies
chronic fatigue syndrome, 213-214
derivative studies, 42-43, 52-53, 54
diseases of the digestive system, 158-159
London School of Hygiene and Tropical Medicine, 43, 53-54, 90
mental and behavioral disorders, 105, 113
multisymptom illnesses, 206, 209-210, 215, 217
University of London, 42-43, 51-53, 93, 119, 123, 132
University of Manchester, 43, 53
Urinary tract infections, 180, 181
US Agricultural Health Study, 270, 278
US National Comorbidity Survey Replication, 100
Utilization of health services, 42, 45, 50, 229.
See also Hospitalizations
V
Vaccines/vaccination
cancer,77
chronic multisymptom illness, 44
limitations of studies, 32
multisymptom illnesses, 44, 52, 57, 58
musculoskeletal diseases, 51, 60
neurological diseases, 55, 121, 123-124, 125, 133
skin diseases, 51
Veterans Programs Enhancement Act, 1, 11
Visceral hypersensitivity, 154, 159, 160
Volume 4, Gulf War and Health
assessment of studies cited in, 3, 12, 16, 255
recommendations, 20
summary of findings and recommendations, 19-20, 255-256
W
Wechsler Adult Intelligence Scale (WAIS), 115, 116-117, 119
Wechsler Memory Scale (WMS), 119
Wisconsin Card Sorting Test (WCST), 119
Women.
See also Female veteran health;
Pregnancy outcomes
troops deployed to Persian Gulf, 13, 228
World Health Organization (WHO), 105
Wound healing, retarded, 165
