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Neurologic Diseases in Gulf War Veterans

Post War Mortality from Neurologic Diseases in Gulf War Veterans investigates Veterans' risk of death from neurological disease after service in the Gulf War between 1990-1991.

2017 Update: Researchers studied the risk of death from brain cancer over 21 years after the Gulf War (1991-2011). They did not find increased death rates from brain cancer in the long term among:
• Army Veterans with service at Khamisiyah compared to other deployed U.S. Army Gulf War Veterans
• Veterans deployed to the Gulf War compared to Veterans who were not deployed but served during the same era .

Background

Veterans who deployed to the Gulf War in 1990-1991 may be at increased risk for amyotrophic lateral sclerosis, multiple sclerosis, Parkinson's disease, or brain cancer.

These risks may be related to potentially hazardous environmental exposures during the war, such as oil well fire smoke, chemical and biological warfare agents, prophylactic agents against chemical and biological warfare, multiple vaccinations, depleted uranium, pesticides, and endemic infectious diseases.

Participants

The study group includes 620,000 Veterans who deployed to the Gulf War in 1990-1991 and 750,000 Veterans who served elsewhere in 1990-1991. We are not accepting volunteers for this study.

Methods

We have been following this same group of Veterans since the end of Gulf War deployments in 1990-1991 and periodically update our knowledge on this group.

We update vital status, collect death certificates, and determine the cause of death of study participants using the Centers for Disease Control and Prevention’s National Death Index. For Veterans whose cause of death is listed as amyotrophic lateral sclerosis, multiple sclerosis, Parkinson’s disease, or brain cancer, we contact the next of kin in order to request medical records to validate the cause of death.

Researchers have expanded the time frame for investigating post-war mortality through 2014.

Findings

Research through 2004 found that there were few changes in mortality rates among Veterans deployed to the Gulf War in 1990-1991 and non-deployed Veterans since the previous findings through 1997.

Controlling for oil well fire smoke exposure, deployed Army Veterans who were potentially exposed to nerve agents at Khamisiyah had a higher mortality rate from brain cancer immediately following the war compared to Army Veterans who were not considered exposed. In the long term, deployed Army Veterans with service at Khamisiyah had a similar mortality rate from brain cancer compared to Army Veterans without Khamisiyah service. Additional information about Khamisiyah and chemical storage demolition is available at https://www.publichealth.va.gov/exposures/gulfwar/sources/chem-bio-weapons.asp.

Previous reports on the mortality of this group of Veterans were published in 1996, 1998, 2001, 2005, 2009, and 2016.

Investigators

Shannon Barth, M.P.H.
Aaron Schneiderman, Ph.D., M.P.H., R.N.
Tim Bullman, M.S.
Mitchell Wallin, M.D., M.P.H.

Publications

Barth SK, Dursa EK, Bossarte RM, Schneiderman AI. Trends in brain cancer mortality among U.S. Gulf War Veterans: 21 year follow-up. Cancer Epidemiol 2017; 50 (Pt A): 22-29.

Barth SK, Kang HK, Bullman T. All-cause mortality among US Veterans of the Persian Gulf War: 13-year follow-up.  Public Health Rep 2016; 131:822-830.

Barth SK, Kang HK, Bullman TA, Wallin MT. Neurological mortality among U.S. veterans of the Persian Gulf War: 13-year follow-up. Am J Ind Med 2009;52:663-670.

Bullman TA, Mahan CM, Kang HK, Page WF. Mortality in US Army Gulf War veterans exposed to 1991 Khamisiyah chemical munitions destruction. Am J Public Health 2005;95:1382-1388.

Kang HK, Bullman TA. Mortality among US veterans of the Persian Gulf War: 7-year follow-up. Am J Epidemiol 2001;154:399–405.

Kang HK, Bullman TA. Counterpoint: Negligible "healthy-warrior effect" on Gulf War Veterans' mortality. Am J Epidemiol 1998;148:324–325.

Kang HK, Bullman TA. Mortality among U.S. veterans of the Persian Gulf War. N Engl J Med 1996;335:1498–1504.