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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 1990-1991 Gulf War.

Background

Gulf War Veterans 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 Gulf War Veterans and 750,000 non-Gulf War Veterans. We are not accepting volunteers for this study.

Methods

We have been following this same group of Veterans since the end of the 1990-1991 Gulf War 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 2012.

Findings

Research through 2004 found that there were few changes in mortality rates among Gulf War and non-Gulf War Veterans since the previous findings through 1997. Controlling for oil well fire smoke exposure, Army Gulf War Veterans who were potentially exposed to nerve agents at Khamisiyah had a higher mortality rate from brain cancer compared to Army Veterans who were not considered exposed. The risk of death due to motor vehicle accidents is still higher among female Gulf War Veterans compared to female non-Gulf War Veterans, though no longer statistically significant among male Gulf War Veterans.

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

Investigators

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

Publications

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 U.S. 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 U.S. veterans of the 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.