ORIGINAL ARTICLE

Symptoms and medical conditions in Australian veterans of the 1991 Gulf War: relation to immunisations and other Gulf War exposures

H L Kelsall¹, M R Sim¹, A B Forbes¹, D C Glass¹, D P McKenzie¹, J F Ikin¹, M J Abramson¹, L Blizzard², P Ittak¹

¹ Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
² Menzies Centre for Population Health Research, University of Tasmania, Hobart, Tasmania, Australia

Correspondence to:
Correspondence to:
Dr H Kelsall
Department of Epidemiology and Preventive Medicine, Monash University–Central and Eastern Clinical School, Alfred Hospital, Commercial Road, Melbourne, VIC 3004, Australia; helen.kelsall{at}med.monash.edu.au

Aims: To investigate whether Australian Gulf War veterans have a higher than expected prevalence of recent symptoms and medical conditions that were first diagnosed in the period following the 1991 Gulf War; and if so, whether these effects were associated with exposures and experiences that occurred in the Gulf War.

Methods: Cross-sectional study of 1456 Australian Gulf War veterans and a comparison group who were in operational units at the time of the Gulf War, but were not deployed to that conflict (n = 1588). A postal questionnaire was administered and the likelihood of the diagnosis of self-reported medical conditions was assessed and rated by a medical practitioner.

Results: Gulf War veterans had a higher prevalence of all self-reported health symptoms than the comparison group, and more of the Gulf War veterans had severe symptoms. Increased symptom reporting was associated with several exposures, including having more than 10 immunisations, pyridostigmine bromide tablets, anti-biological warfare tablets, pesticides, insect repellents, reportedly being in a chemical weapons area, and stressful military service experiences in a strong dose-response relation. Gulf War veterans reported psychological (particularly post-traumatic stress disorder), skin, eye, and sinus conditions first diagnosed in 1991 or later more commonly than the comparison group. Over 90% of medical conditions reported by both study groups were rated by a medical practitioner as having a high likelihood of diagnosis.

Conclusion: More than 10 years after the 1991 Gulf War, Australian veterans self-report all symptoms and some medical conditions more commonly than the comparison group. Further analysis of the severity of symptoms and likelihood of the diagnosis of medical conditions suggested that these findings are not due to over-reporting or to participation bias.

Abbreviations: ADF, Australian Defence Force; adj OR, adjusted odds ratio; DU, depleted uranium; DVA, Department of Veterans’ Affairs; HSA, Health Services Australia; MSE questionnaire, Military Service Experience questionnaire; OR, odds ratio; PTSD, post-traumatic stress disorder; SD, standard deviation; SF-12, 12-item version of the Short-Form Health Survey

Keywords: Gulf War; symptoms; medical conditions

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