A Case-Control Study of Asthma among U.S. Army Gulf War Veterans and Modeled Exposure to Oil Well Fire Smoke

Cowan, David N.; Lange, J; Heller, Jack M.; Kirkpatrick, Jeff; DeBakey, Samar F.

doi:10.1093/milmed/167.9.777

Cited by 29 publications

(23 citation statements)

References 15 publications

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“…Analysis of individual diagnoses within the broad diagnostic categories of hospitalizations significantly associated with response focused on the five most frequent three-digit diagnostic codes to examine their association with response. Additionally, specific ICD-9-CM diagnoses that have previously been indicative of chronic multisymptom illness were explored [14][15][16][17][18][19][20][21][22][23][24][25]. To further evaluate health care usage differences between responders and nonresponders, the mean number of days spent hospitalized or in outpatient care during the year prior to enrollment was also compared.…”

Section: Health Care Datamentioning

confidence: 99%

Prior health care utilization as a potential determinant of enrollment in a 21-year prospective study, the Millennium Cohort Study

et al. 2008

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Results obtained from self-reported health data may be biased if those being surveyed respond differently based on health status. This study was conducted to investigate if health, as measured by health care use preceding invitation, influenced response to invitation to a 21-year prospective study, the Millennium Cohort Study. Inpatient and outpatient diagnoses were identified among more than 68,000 people during a one-year period prior to invitation to enroll. Multivariable logistic regression defined how diagnoses were associated with response. Days spent hospitalized or in outpatient care were also compared between responders and nonresponders. Adjusted odds of response to the questionnaire were similar over a diverse range of inpatient and outpatient diagnostic categories during the year prior to enrollment. The number of days hospitalized or accessing outpatient care was very similar between responders and nonresponders. Study findings demonstrate that, although there are some small differences between responders and nonresponders, prior health care use did not affect response to the Millennium Cohort Study, and it is unlikely that future study findings will be biased by differential response due to health status prior to enrollment invitation.

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Section: Health Care Datamentioning

confidence: 99%

Prior health care utilization as a potential determinant of enrollment in a 21-year prospective study, the Millennium Cohort Study

et al. 2008

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“…There are several studies that indicate an association between exposure to oil well fire smoke during the Gulf War and health conditions, such as acute respiratory and lung conditions like asthma and bronchitis [24-26]. There is evidence to suggest that the inhalation of particulate matter may have long-term health effects, particularly on the neurological system [27-34].…”

Section: Introductionmentioning

confidence: 99%

Trends in brain cancer mortality among U.S. Gulf War veterans: 21 year follow-up

Barth

Dursa

Bossarte

et al. 2017

Cancer Epidemiology

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Objective Previous mortality studies of U.S. Gulf War veterans through 2000 and 2004 have shown an increased risk of brain cancer mortality among some deployed individuals. When veterans possibly exposed to environmental contaminants associated with demolition of the Khamisiyah Ammunition Storage Facility at Khamisiyah, Iraq, have been compared to contemporaneously deployed unexposed veterans, the results have suggested increased risk for mortality from brain cancer among the exposed. Brain cancer mortality risk in this cohort has not been updated since 2004. Methods This study analyzes the risk for brain cancer mortality between 1991–2011 through two series of comparisons: U.S. Gulf War deployed and non-deployed veterans from the same era; and veterans possibly exposed to environmental contaminants at Khamisiyah compared to contemporaneously deployed but unexposed U.S. Gulf War veterans. Risk of brain cancer mortality was determined using logistic regression. Life test hazard models were created to plot comparisons of annual hazard rates. Joinpoint regression models were applied to assess trends in hazard rates for brain cancer mortality. Results U.S. Army veterans possibly exposed at Khamisiyah had similar rates of brain cancer mortality compared to those not possibly exposed; however, veterans possibly exposed had a higher risk of brain cancer in the time period immediately following the Gulf War. Conclusion Results from these analyses suggest that veterans possibly exposed at Khamisiyah experienced different patterns of brain cancer mortality risk compared to the other groups.

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“…[33][34][35] Odds ratios for self-reported asthma and bronchitis increased with increasing self-reported, but not modelled, SMOIL exposure in Iowa veterans. 33 Physician diagnosed asthma in participants in a clinical evaluation programme was associated with cumulative SMOIL exposure and days exposed to high levels in a dose-response relationship.…”

Section: Discussionmentioning

confidence: 90%

“…33 Physician diagnosed asthma in participants in a clinical evaluation programme was associated with cumulative SMOIL exposure and days exposed to high levels in a dose-response relationship. 34 No increased risk of post-war respiratory admissions to hospital was found in US veterans with increasing levels of exposure. 35 Our study has a number of strengths including the use of objective measures of health and of exposure assessment where possible, and a recognised approach for comparing groups using various definitions.…”

Section: Discussionmentioning

confidence: 97%

Respiratory health status of Australian veterans of the 1991 Gulf War and the effects of exposure to oil fire smoke and dust storms

Kelsall

2004

Thorax

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Background: Since the 1991 Gulf War concerns have been raised about the effects on veterans' health of exposures to Kuwaiti oil fire smoke and to dust storms. Methods: A cross sectional study compared 1456 Australian Gulf War veterans with a randomly sampled military comparison group (n = 1588). A postal questionnaire asked about respiratory conditions, exposures, medications, tobacco use, demographic characteristics, and military service details. During a medical assessment, spirometric tests and a physical examination were performed and a respiratory questionnaire was administered. Results: The response rate for the Gulf War veteran group was 80.5% and for the comparison group 56.8%. Australian Gulf War veterans had a higher than expected prevalence of respiratory symptoms and respiratory conditions suggesting asthma (OR 1.4; 95% CI 1.1 to 1.9) and bronchitis first diagnosed since the Gulf War (OR 1.9; 95% CI 1.2 to 3.1) but did not have poorer lung function or more ventilatory abnormalities than the comparison group. Veterans who reported exposure to oil fire smoke had slightly poorer forced vital capacity (difference between means -0.10 l; 95% CI -0.18 to -0.03) and those exposed to dust storms had a slightly better peak expiratory flow rate (difference between means 12.0 l/ min; 95% CI 0.6 to 23.4) than veterans who did not report exposure. Veterans who were in the Gulf at or after the start of the oil fires had more respiratory conditions suggesting asthma (OR 1.7; 95% CI 1.0 to 2.9) than those who completed their deployment before this time. Conclusions: Increased self-reporting of respiratory symptoms, asthma, and bronchitis by veterans was not reflected in poorer lung function. The findings do not suggest major long term sequelae of exposure to oil fire smoke or dust storms.

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A Case-Control Study of Asthma among U.S. Army Gulf War Veterans and Modeled Exposure to Oil Well Fire Smoke

Abstract: We found significant associations between asthma and oil fire smoke exposure. Because much of the medical history was not available, an etiological association cannot be determined from this study, and additional research is needed.

Cited by 29 publications

References 15 publications

Prior health care utilization as a potential determinant of enrollment in a 21-year prospective study, the Millennium Cohort Study

Prior health care utilization as a potential determinant of enrollment in a 21-year prospective study, the Millennium Cohort Study

Trends in brain cancer mortality among U.S. Gulf War veterans: 21 year follow-up

Respiratory health status of Australian veterans of the 1991 Gulf War and the effects of exposure to oil fire smoke and dust storms

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