Danish Gulf War Veterans Revisited: No Evidence of Increased Sickness Absence or Reduced Labor Market Outcome After Deployment to the Persian Gulf

Nissen, Lars Ravnborg; Stoltenberg, Christian; Nielsen, Anni Brit Sternhagen; Vedtofte, Mia Sadowa; Marott, Jacob Louis; Gyntelberg, Finn; Guldager, B

doi:10.7205/milmed-d-15-00534

Cited by 5 publications

(8 citation statements)

References 24 publications

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“…A major strength of the study was its exclusive use of Danish data depositories, which allowed objective information to be gathered (3,(30)(31)(32). Further, the access to a large control population allowed us to select a highly matched control group based on several key variables, thus limiting bias/differences between FDS and the control population.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…Labor market affiliation (LMA) after military deployment into war zones is an area of concern as military deployments may affect LMA (1)(2)(3)(4)(5) and poor LMA may be related to additional distress, mental health problems (6,7), mortality (8), and societal costs (4). Yet little is known regarding formerly deployed soldiers' (FDS) dynamic transitions between employment, unemployment, and long-term sickness absence (LTSA) in the years following their homecoming.…”

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confidence: 99%

“…Yet little is known regarding formerly deployed soldiers' (FDS) dynamic transitions between employment, unemployment, and long-term sickness absence (LTSA) in the years following their homecoming. To date the dynamic transitioning from employment to LTSA has been researched in a single study (3).…”

mentioning

confidence: 99%

“…First, problems exist with respect to the availability and selection of civilian comparison groups that are equivalent to the soldier populations in terms of being fit for the military and other background factors (23,28). Second, previous studies have used fol-low-up periods of different and variable durations [from weeks (28) to decades (3)] during different economic periods (3,5,23) or have employed single-point outcome measures (26), all of which may limit the interpretation and comparison of the findings. Third, in relation to differences in deployment experiences only, one study that included a civilian comparison group accounted for the specific country of deployment among the FDS population by including only soldiers deployed to Iraq in the first Gulf War (3).…”

mentioning

confidence: 99%

“…Second, previous studies have used fol-low-up periods of different and variable durations [from weeks (28) to decades (3)] during different economic periods (3,5,23) or have employed single-point outcome measures (26), all of which may limit the interpretation and comparison of the findings. Third, in relation to differences in deployment experiences only, one study that included a civilian comparison group accounted for the specific country of deployment among the FDS population by including only soldiers deployed to Iraq in the first Gulf War (3). Furthermore, the majority of studies are from the US, where military enlistment and deployments provide access to social and healthcare benefits (1,24), which in turn may negatively affect the labor market affiliation of military personnel (29).…”

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confidence: 99%

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Labor market affiliation after deployment: Danish soldiers fare well, but face increased risk of long-term sickness absence when returning from Afghanistan

Elrond¹,

Stoltenberg²,

Nissen³

et al. 2018

Scand J Work Environ Health

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Section: Strengths and Limitationsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Labor market affiliation after deployment: Danish soldiers fare well, but face increased risk of long-term sickness absence when returning from Afghanistan

Elrond¹,

Stoltenberg²,

Nissen³

et al. 2018

Scand J Work Environ Health

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Effect of Predeployment Psychiatric Diagnoses on Postdeployment Long‐Term Sickness Absence and Mental Health Problems Among Danish Military Personnel

Stoltenberg

Nissen

Nielsen

et al. 2020

Journal of Traumatic Stress

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Military personnel may withhold information on mental health problems (MHPs) for fear of not being permitted to deploy. Past or current MHPs may, however, increase the risk of postdeployment MHPs. Using psychiatric diagnoses rather than self‐report assessments in predeployment screening may be a more effective screening strategy for determining deployment fitness. This retrospective follow‐up study investigated (a) the extent to which predeployment childhood and adult psychiatric diagnoses predicted postdeployment MHPs, measured as psychiatric diagnosis and the purchase of psychiatric drugs, and long‐term sickness absence among formerly deployed Danish military personnel and (b) whether perceived combat exposure moderated or mediated the effect of predeployment psychiatric diagnoses. Complete data were available for 7,514 Danish military personnel who answered questions on perceived combat exposure between 6–8 months after returning from their first deployment to the Balkans, Iraq, or Afghanistan. Data on all psychiatric diagnoses given at Danish hospitals, all medicine purchases, and all sickness absences were retrieved from nationwide research registers. Personnel with predeployment psychiatric diagnoses had a statistically significant higher risk for both postdeployment long‐term sickness absence, hazard ratio (HR) = 2.06, 95% CI [1.52, 2.80]; and postdeployment MHPs, HR = 2.38, 95% CI [1.73, 3.27], than personnel without a predeployment psychiatric diagnosis. Personnel with a predeployment psychiatric diagnosis demonstrated a higher risk of reporting high levels of perceived combat exposure. Perceived combat exposure was not found to moderate or mediate the effect of a predeployment psychiatric diagnosis on the two outcomes. Additional findings, limitations, and implications are discussed.

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Deployment experiences and mental health problems as predictors of post-deployment unemployment length: a prospective, register-based study among Danish soldiers

et al. 2020

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ObjectivesTo test responses of formerly deployed soldiers (FDS) to a questionnaire on deployment experiences in combination with screening levels of post-traumatic stress disorder (PTSD) and depression approximately 6 months after homecoming as predictors of the subsequent probability of gaining employment when unemployed within 5 years post-deployment.Design, setting and participantsDanish FDS responders (n=3935) and non-responders (n=3046) to a 6-month post-deployment screening questionnaire after returning from a first-ever deployment to Kosovo, Iraq or Afghanistan (2002 to 2012) were included in the study and followed in public registers from 6 months to 5 years post-deployment.Primary and secondary outcome measuresWe tested Cox regression models including deployment experiences (1a), screening levels of PTSD and depressive symptoms (1b), and their combination (2) for FDS responders. For all FDS, a secondary model included a measure on whether they responded to the questionnaire (3).ResultsNeither the deployment experiences (1a) of exposure to danger and combat (HR=1.00, 95% CI=0.97 to 1.03) and witnessing consequences of war (HR=1.01, 95% CI=0.96 to 1.06), or the screening levels (1b) of PTSD (HR=1.06, 95% CI=0.84 to 1.33) and depressive symptoms (HR=0.82, 95% CI=0.64 to 1.06) were significant predictors of transitioning from unemployment to employment. Similar results were found for the combined model (2). A tendency among non-respondents (3) to have a lower probability of transitioning from unemployment to employment was found (HR=0.90, 95% CI=0.81 to 1.00).ConclusionDeployment experiences, PTSD and depressive symptoms, as measured at 6-month screening questionnaire, did not predict differences in the probability of gaining employment when unemployed within 5 years post-deployment. However, the findings suggest that those with the least probability of transitioning from unemployment to employment can be found among the non-responders to the post-deployment screening questionnaire.

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Danish Gulf War Veterans Revisited: No Evidence of Increased Sickness Absence or Reduced Labor Market Outcome After Deployment to the Persian Gulf

Abstract: Among Danish Gulf War Veterans, no postdeployment increased risk of long-term sickness absence or long-term absence from work was found as compared with nonveterans.

Cited by 5 publications

References 24 publications

Labor market affiliation after deployment: Danish soldiers fare well, but face increased risk of long-term sickness absence when returning from Afghanistan

Labor market affiliation after deployment: Danish soldiers fare well, but face increased risk of long-term sickness absence when returning from Afghanistan

Effect of Predeployment Psychiatric Diagnoses on Postdeployment Long‐Term Sickness Absence and Mental Health Problems Among Danish Military Personnel

Deployment experiences and mental health problems as predictors of post-deployment unemployment length: a prospective, register-based study among Danish soldiers

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