Gulf War (GW) veterans report nonspecific symptoms significantly more often than their
nondeployed peers. However, no specific disorder has been identified, and the etiologic
basis and clinical significance of their symptoms remain unclear.
To organize symptoms reported by US Air Force GW veterans into a case definition,
to characterize clinical features, and to evaluate risk factors.
Cross-sectional population survey of individual characteristics and symptoms and clinical
evaluation (including a structured interview, the Medical Outcomes Study Short Form
36, psychiatric screening, physical examination, clinical laboratory tests, and serologic
assays for antibodies against viruses, rickettsia, parasites, and bacteria) conducted
in 1995.
The cross-sectional questionnaire survey included 3723 currently active volunteers,
irrespective of health status or GW participation, from 4 air force populations. The
cross-sectional clinical evaluation included 158 GW veterans from one unit, irrespective
of health status.
Symptom-based case definition; case prevalence rate for GW veterans and nondeployed
personnel; clinical and laboratory findings among veterans who met the case definition.
We defined a case as having 1 or more chronic symptoms from at least 2 of 3 categories
(fatigue, mood-cognition, and musculoskeletal). The prevalence of mild-to-moderate
and severe cases was 39% and 6%, respectively, among 1155 GW veterans compared with
14% and 0.7% among 2520 nondeployed personnel. Illness was not associated with time
or place of deployment or with duties during the war. Fifty-nine clinically evaluated
GW veterans (37%) were noncases, 86 (54%) mild-to-moderate cases, and 13 (8%) severe
cases. Although no physical examination, laboratory, or serologic findings identified
cases, veterans who met the case definition had significantly diminished functioning
and well-being.
Among currently active members of 4 Air Force populations, a chronic multisymptom
condition was significantly associated with deployment to the GW. The condition was
not associated with specific GW exposures and also affected nondeployed personnel.