Belief in exposure to chemical and biological agents in Persian Gulf War soldiers.

This is the first longitudinal cohort study of Persian Gulf War US soldiers to examine belief in exposure to chemical and biological weapons before and shortly after combat. A longitudinal sample of n = 1250 male Persian Gulf War US Army soldiers were surveyed 3 to 4 months before and 6 to 10 months after the 1991 War. Six to 10 months after combat, 4.6% of the cohort believed they had been exposed to chemical and biological weapons. Adjusting for demographics only, those who reported a greater number of combat exposures (odds ratio, OR: 18.8), or higher combat stress (OR: 12.27) were more likely to believe they were exposed. Adjusting for all variables soldiers who reported higher combat stress continued to be most likely (OR: 6.58) to believe they had been exposed to chemical and biological weapons. Individuals reporting higher combat stress are at substantially greater risk of reporting they have been exposed to chemical or biological weapons.

Stress and stressors of the early phases of the Persian Gulf War.

Soldiers who deployed to Saudi Arabia in support of Operation Desert Shield were exposed to a wide variety of stressors. These stressors from the pre-combat phase of the deployment undoubtedly affect the current health of Gulf War veterans, but the exact mechanisms and linkages are not known. This article examines the nature of those stressors and possible effects on later health of veterans.

Belief in exposure to terrorist agents: reported exposure to nerve or mustard gas by Gulf War veterans.

September 11 brought increased awareness that even the threat of chemical and biological terrorism can overwhelm this country's health care system. Belief in exposure to toxic agents, even when none is documented, is not uncommon in crisis and merits vigilant health care evaluation and services. This study examined risk factors (demographics, physical symptoms, clinical diagnosis, exposures, and health status) for belief in exposure to potential terrorist agents (nerve or mustard gas) using a large sample of Gulf War veterans who reported belief in exposure to nerve or mustard gas. We found that females, nonwhites, and those who were older (age 32 to 61 years) were more likely to report exposure. When adjusting for demographics and military service, these veterans reported more exposures (nonnerve or mustard gas) to potentially toxic agents and traumatic events (odds ratio [OR], 6.80; p<.001), reported more physical symptoms during the Gulf War (OR, 2.38; p<.001), were more likely to be diagnosed with a mental disorder (OR, 1.72; p<.001), and reported poorer current health status (OR, 3.47 to 1.22; p<.001). Not unlike previously reported studies of disasters, traumatic exposures, or risk exposures, belief in exposure to toxic agents suggests that certain people are at a greater health care risk. This knowledge will aid in better responding to rapid demands that may be placed on our health care delivery systems in times of potential terrorist activity.

The Department of Defense's Persian Gulf War registry year 2000: an examination of veterans' health status.

This study examined the health status of 46,633 Persian Gulf War theater veterans who received full clinical evaluations in the Department of Defense's Gulf War Comprehensive Clinical Evaluation Program (CCEP) as of spring 2000. Clinical data analyzed included demographic information, 15 health symptoms, 19 wartime exposures, and primary and secondary physician-determined medical diagnoses based on International Classification of Diseases, 9th Revision, Clinical Modification, criteria. Findings and discussions are arrayed, by gender, with comparative 1996 data from the Department of Veterans Affairs Health Examination Registry Program. Many veterans reported fewer physical symptoms now than during the time of the Gulf War. Many endorsed symptoms of joint pain, fatigue, weight change, and sleep disturbances. Most reported exposure to diesel fuel and the nerve agent antidote pyridostigmine bromide; far fewer female veterans reported combat involvement. The most frequent primary or secondary diagnosed medical conditions were musculoskeletal/connective tissue diseases, ill-defined conditions, and mental disorders. Female veterans were diagnosed more frequently with mental disorders. Symptom endorsement and diagnosis rates between the CCEP and the Department of Veterans Affairs registry were not dissimilar. Overall, the self-reported general health of veterans with symptoms was much poorer (females had higher rates of "fair to poor" health than males) than that of veterans with no reported symptoms.

Effect of alpha thalassaemia on the rheology of homozygous sickle cell disease

A study of rheological determinants (plasma viscosity, whole-blood viscosity, and erythrocyte deformability) was made in 24 matched pairs of patients with homozygous sickle cell disease, with and without homozygous x-thalassaemia. Patients with coexisting x-thalassaemia showed a significant increase in erythrocyte deformability measured as filtration of washed erythrocytes through 5 um diameter pores and also as viscosity of whole blood at high shear rate (230s-1) and standard haematocrit (0.45). This rheological advantage may explain the beneficial effect of x-thalassaemia 2 on haematological parameters and clinical events in homozygous sickle cell disease (AU)