Mortality among US veterans of the Persian Gulf War: 7-year follow-up

To assess the long-term health consequences of the 1991 Persian Gulf War, t he authors compared cause-specific mortality rates of 621,902 Gulf War vete rans with those of 746,248 non-Gulf veterans, by gender, with adjustment fo r age, race, marital status, branch of service, and type of unit. Vital sta tus follow-up began with the date of exit from the Persian Gulf theater (Gu lf veterans) or May 1, 1991 (control veterans). Follow-up for both groups e nded on the date of death or December 31, 1997, whichever came first. Cox p roportional hazards models were used for the multivariate analysis. For Gul f veterans, mortality risk was also assessed relative to the likelihood of exposure to nerve gas at Khamisiyah, Iraq. Among Gulf veterans, the signifi cant excess of deaths due to motor vehicle accidents that was observed duri ng the earlier postwar years had decreased steadily to levels found in non- Gulf veterans. The risk of death from natural causes remained lower among G ulf veterans compared with non-Gulf veterans. This was mainly accounted for by the relatively higher number of deaths related to human immunodeficienc y virus infection among non-Gulf veterans. There was no statistically signi ficant difference in cause-specific mortality among Gulf veterans relative to potential nerve gas exposure. The risk of death for both Gulf veterans a nd non-Gulf veterans stayed less than half of that expected in their civili an counterparts. The authors conclude that the excess risk of mortality fro m motor vehicle accidents that was associated with Gulf War service has dis sipated after 7 years of follow-up.