Health status of Persian Gulf War veterans: self-reported symptoms, environmental exposures and the effect of stress

Background Most US troops returned home from the Persian Gulf War (PGW) by Spring 1991 and many began reporting increased health symptoms and medical problems soon after. This investigation examines the relationships between several Gulf-service environmental exposures and health symptom reporting, and the role of traumatic psychological stress on the exposure-health sympt om relationships. Methods Stratified, random samples of two cohorts of PGW veterans, from the New England area (n = 220) and from the New Orleans area (n = 71), were se lected from larger cohorts being followed longitudinally since arrival home from the Gulf. A group of PGW-era veterans deployed to Germany (n = 50) se rved as a comparison group. The study protocol included questionnaires, a n europsychological test battery an environmental interview, and psychologica l diagnostic interviews. This report focuses on self-reported health sympto ms and exposures of participants who completed a 52-item health symptom che cklist and a checklist of environmental exposures. Results The prevalence of reported symptoms was greater in both Persian Gul f-deployed cohorts compared to the Germany cohort, Analyses of the body-sys tem symptom scores (BSS), weighted to account for sampling design, and adju sted by age, sex, and education, indicated that Persian Gulf-deployed veter ans were more likely to report neurological, pulmonary, gastrointestinal, c ardiac, dermatological, musculoskeletal, psychological and neuropsychologic al system symptoms than Germany veterans. Using a priori hypotheses about t he toxicant effects of exposure to specific toxicants, the relationships be tween self-reported exposures and body-system symptom groupings were examin ed through multiple regression analyses, controlling for war-zone exposure and post-traumatic stress disorder (PTSD). Self-reported exposures to pesti cides, debris from Scuds, chemical and biological warfare (CBW) agents, and smoke from tent heaters each were significantly related to increased repor ting of specific predicted BSS groupings. Conclusions Veterans deployed to the Persian Gulf have higher self-reported prevalence of health symptoms corn-pared to PGW veterans who were deployed only as far as Germany. Several Gulf-service environmental exposures are a ssociated with increased health symptom reporting involving predicted body- systems, after adjusting for war-zone stressor exposures and PTSD.