September 11 brought increased awareness that even the threat of chemical and biological terrorism can overwhelm this country's health care system. Belief in exposure to toxic agents, even when none is documented, is not uncommon in crisis and merits vigilant health care evaluation and services. This study examined risk factors (demographics, physical symptoms, clinical diagnosis, exposures, and health status) for belief in exposure to potential terrorist agents (nerve or mustard gas) using a large sample of Gulf War veterans who reported belief in exposure to nerve or mustard gas. We found that females, nonwhites, and those who were older (age 32 to 61 years) were more likely to report exposure. When adjusting for demographics and military service, these veterans reported more exposures (nonnerve or mustard gas) to potentially toxic agents and traumatic events (odds ratio [OR], 6.80; p<.001), reported more physical symptoms during the Gulf War (OR, 2.38; p<.001), were more likely to be diagnosed with a mental disorder (OR, 1.72; p<.001), and reported poorer current health status (OR, 3.47 to 1.22; p<.001). Not unlike previously reported studies of disasters, traumatic exposures, or risk exposures, belief in exposure to toxic agents suggests that certain people are at a greater health care risk. This knowledge will aid in better responding to rapid demands that may be placed on our health care delivery systems in times of potential terrorist activity.
This study compared general psychological symptoms measures on all Brief Symptom Inventory symptom dimensions and the Global Severity Index from samples of deployed and nondeployed U.S. Army soldiers. Psychological symptom measures were taken from samples of soldiers during deployment to operations in the Persian Gulf, Somalia, Kuwait, Haiti, and Bosnia. The purpose of this study was to determine whether deployment and gender had an effect on levels of symptom measures. Results indicated that soldiers who deployed to the Persian Gulf, Somalia, and Bosnia had significantly elevated measures of general psychological distress compared with nondeployed soldiers. Gender difference had little to no effect on reported symptom measures among deployed soldier samples. All female soldiers, whether deployed or not, had elevated measures of interpersonal sensitivity and somatization symptoms. Further research is warranted to address which factors, to include yet not be limited to mission, life events-related, and physical symptoms, may relate to why some deployments are more stressful than others on Army soldiers.
This study examined the health status of 46,633 Persian Gulf War theater veterans who received full clinical evaluations in the Department of Defense's Gulf War Comprehensive Clinical Evaluation Program (CCEP) as of spring 2000. Clinical data analyzed included demographic information, 15 health symptoms, 19 wartime exposures, and primary and secondary physician-determined medical diagnoses based on International Classification of Diseases, 9th Revision, Clinical Modification, criteria. Findings and discussions are arrayed, by gender, with comparative 1996 data from the Department of Veterans Affairs Health Examination Registry Program. Many veterans reported fewer physical symptoms now than during the time of the Gulf War. Many endorsed symptoms of joint pain, fatigue, weight change, and sleep disturbances. Most reported exposure to diesel fuel and the nerve agent antidote pyridostigmine bromide; far fewer female veterans reported combat involvement. The most frequent primary or secondary diagnosed medical conditions were musculoskeletal/connective tissue diseases, ill-defined conditions, and mental disorders. Female veterans were diagnosed more frequently with mental disorders. Symptom endorsement and diagnosis rates between the CCEP and the Department of Veterans Affairs registry were not dissimilar. Overall, the self-reported general health of veterans with symptoms was much poorer (females had higher rates of "fair to poor" health than males) than that of veterans with no reported symptoms.
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