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Self-Reported Exposures and Their Association With Unexplained Illness in a Population-Based Case-Control Study of Gulf War Veterans

Spencer, Peter S. PhD; McCauley, Linda A. PhD; Lapidus, Jodi A. PhD; Lasarev, Michael MS; Joos, Sandra K. PhD; Storzbach, Daniel PhD

Journal of Occupational and Environmental Medicine: December 2001 - Volume 43 - Issue 12 - p 1041-1056
Original Articles
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Many factors have been considered as possible causes of the unexplained illness reported by veterans of the Gulf War (GW). In this study, we report an analysis of risk factors and unexplained illness in a population-based sample of GW veterans who underwent clinical evaluation. Multiple risk factors were compared in 241 veterans who met criteria for unexplained illness and 113 healthy controls. Results suggest that GW unexplained illness is most highly associated with combat conditions, heat stress, and having sought medical attention during the GW. When controlling for multiple simultaneous exposures during the GW, interactions around pyridostigmine bromide, insecticides and repellents, and stress were not significant. These results indicate that most unexplained illness in GW veterans cannot be explained by neurotoxic effects of exposures to chemicals that inhibit cholinesterase activity.

From the Center for Research on Occupational and Environmental Toxicology (Dr Spencer, Dr McCauley, Mr Lasarev, Dr Storzbach); Public Health and Preventive Medicine (Dr Lapidus), Oregon Health & Science University; and Portland Veterans Affairs Medical Center (Dr Joos, Dr Storzbach).

Address correspondence to: Dr Peter S. Spencer, Center for Research on Occupational and Environmental Toxicology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, CROET Mailcode L606, Portland, OR 97201; spencer@ohsu.edu.

Funded by the Department of Veterans Affairs to the Portland Environmental Hazards Research Center, a joint project of the Portland Veterans Affairs Medical Center and the Center for Research on Occupational and Environmental Toxicology, Oregon Health & Science University, Portland, Oregon.

© 2001 Lippincott Williams & Wilkins, Inc.