Illness in Gulf War Veterans: Causes and Consequences

Details

• Personal Author:
  Landrigan, Philip J.
• Description:
  In 1990 and 1991, 697 000 men and women of the US armed forces served in the Persian Gulf. During their service these veterans were exposed to a wide array of known and potential hazards to health. These risk factors included extremes of heat and cold, blowing dust, smoke from oil well fires, petroleum fuels and their combustion products, pyridostigmine bromide (administered as pretreatment for potential poison gas exposure), anthrax and botulinum toxoid vaccines, depleted uranium (used in certain artillery shells), infectious diseases, chemical warfare agents, pesticides, and pervasive psychological and physiological stress. Since returning home, many Persian Gulf War veterans have developed illness. Some have specific diseases that clearly resulted from their military service. For example, 32 veterans have been diagnosed with leishmaniasis, and have developed malaria. Several dozen retain fragments of depleted uranium embedded in their bodies, and others sustained traumatic injuries. But perhaps most notably, many more veterans have returned with an array of symptoms- including fatigue, joint pain, gastrointestinal complaints, memory problems, emotional change, impotence, and insomnia-that defy diagnostic classification. Epidemiologic studies designed to answer fundamental questions about the prevalence, distribution, and causes of illness among Gulf War veterans have been initiated and will continue for many years. A recently published analysis found a 9% higher death rate in Persian Gulf War veterans as compared with other veterans of the same era. This excess mortality was entirely attributable to "external causes," with a particularly striking excess of deaths from motor vehicle injuries, although no excesses of deaths from suicide, homicide, or specific diseases were observed. A study of hospitalization in military hospitals of 547 000 Gulf War veterans who had remained on active duty in the 2 years following the war found no consistent pattern for excess of any particular diseases. Other analyses of illness in specific groups of veterans who had reported high rates of symptoms have confirmed the existence of fatigue, headache, emotional change, and joint pain in these men and women. While carefully done, all of these cluster studies have involved relatively small groups of veterans, and all have 2 basic limitations: the groups under investigation are self-selected and their symptoms are self-reported. Consequently, none of these studies has identified specific diagnoses or specific etiologic factors responsible for the veterans' symptoms. Additional epidemiologic studies that have examined cognitive function in selected groups of Gulf War veterans 810 have shown slight decrements in memory and concentration. The 3 reports in this issue of THE JOURNAL by Haley and colleagues as well as the study by Schwartz et al represent further important efforts to classify and categorize symptoms in Gulf War veterans. [Description provided by NIOSH]
• Subjects:
  Accidents, Occupational Epidemiology Mortality Nervous System Occupational Exposure Occupational Health Safety
• Keywords:
  Accident Rates Cognitive Function Military Personnel Mortality Data Occupational Exposure Psychological Responses Traumatic Injuries
• ISSN:
  0098-7484
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  259-261
• Volume:
  277
• Issue:
  3
• NIOSHTIC Number:
  nn:20059913
• Citation:
  JAMA 1997 Jan; 277(3):259-261
• Contact Point Address:
  Philip J. Landrigan, MD, MSc, Department of Community Medicine, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, New York, NY 10029-6594
• Email:
  plandrigan@smtplink.mssm.edu
• Federal Fiscal Year:
  1997
• Performing Organization:
  Mount Sinai School of Medicine, New York
• Peer Reviewed:
  False
• Start Date:
  19920701
• Source Full Name:
  Journal of the American Medical Association
• End Date:
  19970630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:9f39767fa419ab73e8d58f9c6851d3ae6dfe58f52732e5a8c2f58139ff51cd58735e72d76a1ec3ae2415da833dc7515061d9c127333be8cab75f41109a81f7bc
• Download URL:
  https://stacks.cdc.gov/view/cdc/223967/cdc_223967_DS1.pdf
• File Type:
  [PDF - 453.92 KB ]