Gulf War Veterans Measuring Health (1999) / Chapter Skim
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2 Studies of the Health of Gulf War Veterans
2 Studies of the Health of Gulf War Veterans
Pages 24-37
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From page 24... ...
They found reports of symptoms include fatigue, shortness of breath, headache, sleep disturbance, forgetfulness, and impaired concentration. No single etiologic entity has been discovered to account for these symptoms in conflicts prior to the Gulf War, and no generally accepted diagnostic label or set of clear clinical criteria has been developed out of earlier conflicts to use in the assessment of health problems among Gulf War veterans.
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From page 25... ...
to track deaths in nearly the entire population of deployed Gulf War veterans. Death rates in the deployed group were compared with the rate in a similar-sized control group of active duty, National Guard, and reserve personnel who served during the Gulf War period but were not deployed.
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From page 26... ...
, the relative prevalence of various diagnoses is informative, but no conclusions can be drawn about risk for various diseases among Gulf War veterans versus nondeployed veterans or a civilian population with similar demographic characteristics. Data obtained in a similar manner were reported in a study of British Gulf War veterans by Coker and colleagues (1999~.
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From page 27... ...
Birth defects were identified from medical records that included any ICD-9-CM codes in the range 74~759, plus codes for neoplasms or hereditary diseases. The study included 33,998 infants born to veterans deployed to the Gulf and 41,463 infants born to nondeployed veterans.
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From page 28... ...
Both studies noted relatively high prevalence of PTSD symptoms among deployed veterans, and the Perconte study also noted higher levels of depression and general psychiatric symptomatology in deployed veterans than in a comparison group of nondeployed veterans. Sostek and colleagues (1996)
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From page 29... ...
compared the symptom experience of Gulf War veterans from New England and New Orleans to that of members of a single National Guard unit who had been sent to Germany during the same time period. Symptoms from the 52-item Expanded Health Symptom Checklist were grouped into nine body-system clusters; scores for the bodysystem groupings were the sum of 0-4 frequency ratings for either the three symptoms in the group or, if more than three symptoms were included in a body-system group, the three most representative symptoms (determined by expert judgment)
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From page 30... ...
The investigators used factor analysis to identify underlying relationships among the individual symptoms and identified six possible clusters. The investigators did not find an association between psychological factors and having one or more of the six clusters; they concluded that the six symptom clusters could represent six syndromes or six variants on a single syndrome.
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From page 31... ...
Clinical and laboratory findings were generally not different between the deployed and nondeployed groups, and no specific characteristics of service in the Gulf were predictive of the multisymptom illness. Perhaps the strongest study on Gulf War veterans' experience of symptoms related to deployment in the Gulf is the "Iowa Study," a population-based study of all military personnel who listed Iowa as the home of record at enlistment (Iowa Persian Gulf Study Group, 1997~.
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From page 32... ...
However, the consistency of reports across services, parts of the country, and across countries suggests that these are very real experiences, even if not fully understood. Gulf War veterans who participated in the CCEP program completed detailed symptom surveys.
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From page 33... ...
(1998) found that PTSD symptoms among deployed veterans were more severe during months associated with the anniversary of particularly stressful events such as seeing a fellow soldier killed or being in a missile attack.
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From page 34... ...
Examples of the specific conditions included infectious and parasitic diseases, cancers, nervous system diseases, and musculoskeletal diseases. The basic finding of the study was that risk of hospitalization for deployed veterans in the immediate postwar period was no different from that of nondeployed veterans, either for any cause or for virtually all the specific disease conditions.
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From page 35... ...
of suffering one or more of a set of symptoms that include fatigue, memory loss, difficulty concentrating, pains in muscles and joints, and rashes. Other symptoms are noted with reduced frequency, but still may be experienced more often by deployed than nondeployed veterans.
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From page 36... ...
For example, veterans still on active duty or attached to reserve or National Guard units may be easier to locate than those who have been discharged. Gulf War veterans on active duty may be reluctant to identify conditions that could lead to a change in their duty status, whereas those veterans who perceive that they have servicerelated health problems may have a greater incentive to participate in studies than those who do not have health problems.
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From page 37... ...
Our overall aims are to develop a conceptual and operational framework that will produce a population-based assessment of the nature and extent of health problems among Gulf War veterans, assess the impact of these health problems on veterans' health status, and monitor changes in the health status of these veterans over time. Such a framework will generate information necessary for policymaking, clinical decision making, and shared decision making between health care providers and patients.
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