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Few epidemiological studies have been conducted that have incorporated clinical evaluations of Gulf War veterans with unexplained health symptoms and healthy controls. We conducted a mail survey of 2022 Gulf War veterans residing in the northwest United States and clinical examinations on a subset of 443 responders who seemed to have unexplained health symptoms or were healthy. Few clinical differences were found between cases and controls. The most frequent unexplained symptoms were cognitive/psychological, but significant overlap existed with musculoskeletal and fatigue symptoms. Over half of the veterans with unexplained musculoskeletal pain met the criteria for fibromyalgia, and a significant portion of the veterans with unexplained fatigue met the criteria for chronic fatigue syndrome. Similarities were found in the clinical interpretation of unexplained illness in this population and statistical factor analysis performed by this study group and others.

Migrant farmworker communities present distinct challenges that require new approaches for community participation in research. In the State of Oregon an agency that advocates for the migrant farmworker community has collaborated successfully with university researchers to implement a research program directed to reducing pesticide exposures among the children of migrant farmworkers. The research process has included both qualitative research methods with members of the community and quantitative approaches to measure pesticide dust residues in homes, biomarkers of pesticide exposure, and effects on health. A committee of university and community stakeholders advises the research. Evaluative processes have been initiated to assess the effectiveness of the participatory model used in this project. The components of the preliminary process evaluation and results are presented. Evaluative data show that researchers and community members differ on perceptions of community involvement and the extent to which communication problems have been resolved between the two groups. Suggestions for improved community involvement and communication are given.