Health Status and Clinical Diagnoses of 3000 UK Gulf War Veterans

Lee, Harry A; Gabriel, Roger; Bolton, Jpg; Bale, Amanda J; Jackson, Mark

doi:10.1177/014107680209501004

Cited by 21 publications

(20 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An analysis of death certificates also showed that veterans with post-combat syndromes did not develop a particular organic illness or suffered an increased mortality (Grant 1925;Kang & Bullman 2001;Jones et al 2003b). This symptom-based investigation confirmed epidemiological and clinical studies that there is no unique illness related to service in the Gulf in 1991 (Unwin 1999;Lee et al 2002) and yet the term 'GWS' continues to enjoy popular support (Lloyd 2004, pp. 41, 56, 57).…”

Section: Gulf War Syndromesupporting

confidence: 62%

Historical approaches to post-combat disorders

Jones¹

2006

Phil. Trans. R. Soc. B

View full text Add to dashboard Cite

Almost every major war in the last century involving western nations has seen combatants diagnosed with a form of post-combat disorder. Some took a psychological form (exhaustion, combat fatigue, combat stress reaction and post-traumatic stress disorder), while others were characterized by medically unexplained symptoms (soldier's heart, effort syndrome, shell shock, non-ulcer dyspepsia, effects of Agent Orange and Gulf War Syndrome). Although many of these disorders have common symptoms, the explanations attached to them showed considerable diversity often reflected in the labels themselves. These causal hypotheses ranged from the effects of climate, compressive forces released by shell explosions, side effects of vaccinations, changes in diet, toxic effects of organophosphates, oil-well fires or depleted-uranium munitions. Military history suggests that these disorders, which coexisted in the civilian population, reflected popular health fears and emerged in the gaps left by the advance of medical science. While the current Iraq conflict has yet to produce a syndrome typified by medically unexplained symptoms, it is unlikely that we have seen the last of post-combat disorders as past experience suggests that they have the capacity to catch both military planners and doctors by surprise.

show abstract

Section: Gulf War Syndromesupporting

confidence: 62%

Historical approaches to post-combat disorders

Jones¹

2006

Phil. Trans. R. Soc. B

View full text Add to dashboard Cite

show abstract

“…This group was selected because PTSD was the most frequent diagnosis amongst the unwell. 9,10 None of these veterans had organic disease that could have biased the results. This group was specifically analysed because of reports suggesting low serum cortisol concentrations in such patients.…”

Section: Blood Testsmentioning

confidence: 99%

“…10 They were analysed for any abnormalities. This study was undertaken as claims had been made by some veterans' groups that there was an increased incidence of liver and renal scarring.…”

Section: Ultrasound Studies Of Abdominal Visceramentioning

confidence: 99%

Results of investigations on Gulf War veterans

2005

Self Cite

View full text Add to dashboard Cite

-Investigations were undertaken on veterans of the Gulf conflict of 1990/91 at the Gulf Veterans' Medical Assessment Programme (GVMAP), to determine whether routine investigations should be carried out on these veterans. Blood investigations were analysed of a 10% random sample of veterans and also of two veteran groups -one group was well (asymptomatic) and the other unwell (post-traumatic stress disorder). Neurological investigations were carried out as well as 1,000 ultrasound studies and 3,000 ECGs. Almost all blood tests proved normal. The only significant differences found between the two groups were for the alanine/ aspartate transaminase and gamma glutamyl transaminase values, where there were more abnormal findings in the unwell group. Abnormal, but expected, neurological investigations were found in those referred for these tests. Ultrasound abnormalities were related to known established clinical diagnoses, apart from three cases. ECG abnormalities were only present in those with known clinical diagnoses. It was concluded that reducing the number of investigations would not only be cost effective but should help to lessen veterans' anxieties. KEY WORDS: Gulf War veterans 1990/91, implications, results, routine investigations, way forwardA short time after their return from the Gulf War of 1990/1, some veterans began to complain of symptoms of ill health, which became popularly known as 'Gulf War Syndrome' . There have been unsubstantiated claims in the media and by some veterans' activist groups that Gulf War service is linked to increased rates of mortality, birth defects, pregnancy problems and other more specific illnesses. Elsewhere claims of specific illnesses or unique syndromes have been made 1,2 and carefully reviewed, 3,4 finding little, if any, evidence of these links. In the UK, in response to these symptoms, the Ministry of Defence established in October 1993 the Gulf Veterans' Medical Assessment Programme (GVMAP), which was much heralded by the media. Similarly, in the USA, the Department for Veterans' Affairs Gulf Registry Health Examination Program (VA Registry) also started assessing veterans who had left the armed services in 1992. In 1994, the Department of Defense set up the Gulf veterans Comprehensive Clinical Evaluation Program (CCEP).The GVMAP was never intended as a screening programme but, since it is the only programme available to Gulf veterans, it acted as a surrogate screening programme. Investigations were undertaken to help the medical assessments when it was thought that there may have been a condition specifically related to the Gulf War. Initial research, [5][6][7][8] and that carried out later, 9,10 benefiting from the results of almost a decade of research and assessment, found no evidence to support the concept of 'Gulf War Syndrome' or any unique Gulf War related illness. Similar conclusions have been reached at CCEP. 11 The diagnosis of 'symptoms, signs and ill defined conditions' (SSIDC) has now virtually disappeared in recent literature compared with ea...

show abstract

“…The most commonly reported symptoms included fatigue, headaches, joint pains, skin rash, shortness of breath, sleep disturbances, difficulty concentrating, depression and forgetfulness (DeFraites et al 1992;Persian Gulf Veterans Coordinating Board 1995). Subsequently, there were reports of British, Canadian and Australian veterans with similarly idiopathic symptoms (Goss Gilroy, Inc & Canadian Department of National Defence 1998; Ikin et al 2004;Lee et al 2002).…”

Section: Introductionmentioning

confidence: 99%

“…Owing to concerns about the health of Gulf War veterans, the US Department of Veterans Affairs (VA) and Department of Defense (DoD) and the British and Canadian Ministries of Defence established special clinical evaluation programmes to assess veterans' health problems (Joseph et al 1998;Lee et al 2002). To date over 100 000 veterans have been systematically evaluated in these programmes (Department of Veteran Affairs 2002).…”

Section: Introductionmentioning

confidence: 99%

Managing future Gulf War Syndromes: international lessons and new models of care

Engel

Hyams

Scott

2006

Phil. Trans. R. Soc. B

View full text Add to dashboard Cite

After the 1991 Gulf War, veterans of the conflict from the United States, United Kingdom, Canada, Australia and other nations described chronic idiopathic symptoms that became popularly known as 'Gulf War Syndrome'. Nearly 15 years later, some 250 million dollars in United States medical research has failed to confirm a novel war-related syndrome and controversy over the existence and causes of idiopathic physical symptoms has persisted. Wartime exposures implicated as possible causes of subsequent symptoms include oil well fire smoke, infectious diseases, vaccines, chemical and biological warfare agents, depleted uranium munitions and post-traumatic stress disorder. Recent historical analyses have identified controversial idiopathic symptom syndromes associated with nearly every modern war, suggesting that war typically sets into motion interrelated physical, emotional and fiscal consequences for veterans and for society. We anticipate future controversial war syndromes and maintain that a population-based approach to care can mitigate their impact. This paper delineates essential features of the model, describes its public health and scientific underpinnings and details how several countries are trying to implement it. With troops returning from combat in Afghanistan, Iraq and elsewhere, the model is already getting put to the test.

show abstract

Health Status and Clinical Diagnoses of 3000 UK Gulf War Veterans

Cited by 21 publications

References 27 publications

Historical approaches to post-combat disorders

Historical approaches to post-combat disorders

Results of investigations on Gulf War veterans

Managing future Gulf War Syndromes: international lessons and new models of care

Contact Info

Product

Resources

About