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New Onset of Chronic Diseases and Changes in Lifestyle Risk Factors Among Gulf War Veterans: A Longitudinal Comparison of High and Low Symptom Reporters

Gwini, Stella M. MSc; Kelsall, Helen L. PhD; Ikin, Jil F. PhD; Sim, Malcolm R. PhD; McFarlane, Alexander C. PhD; Forbes, Andrew B. PhD

Journal of Occupational and Environmental Medicine: August 2016 - Volume 58 - Issue 8 - p 770–777
doi: 10.1097/JOM.0000000000000799

Objective: The aim of this study was to compare new chronic diseases onset and longitudinal changes in lifestyle risk factors between Gulf War veterans with different symptom reporting.

Methods: Data were collected from Gulf War veterans over two periods, and participants were grouped according to baseline symptom reporting. Logistic, nominal, and ordinal regressions were used for between-group comparisons.

Results: The veterans comprised low, moderate, and high symptom reporters. New onset of sleep apnea [odds ratio (OR) = 9.49; 95% confidence interval (CI) = 3.48 to 25.86], musculoskeletal (OR = 8.70; 95% CI = 4.17 to 18.17), psychological (OR = 5.36; 95% CI = 2.46 to 11.70), and cardiovascular (OR = 3.86; 95% CI = 1.33 to 11.23) conditions was elevated in high versus low symptom reporters. Although odds of obesity and alcohol use increased over time and smoking halved, the changes were similar across groups.

Conclusions: These findings show increasing obesity and alcohol use, and indicate that high symptomatology among veterans may predict future disease onset.

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Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria (Ms Gwini, Drs Kelsall, Ikin, Sim, Forbes); and Centre for Traumatic Stress Studies, University of Adelaide, South Australia (Dr McFarlane).

Address correspondence to: Stella M. Gwini, MSc, Monash University, Department of Epidemiology & Preventive Medicine, The Alfred Centre, 99 Commercial Road, Melbourne, VIC 3004, Australia (

This study was funded by the Australian Department of Veterans’ Affairs (grant ARP0907) and an Australian Postgraduate Award (grant 120636).

The views expressed in the Article do not necessarily represent the views of the Minister for Veterans’ Affairs or the Department of Veterans’ Affairs. The Commonwealth of Australia does not give any warranty nor accept any liability in relation to the contents of the work.

The authors have no conflicts of interest.

Supplemental digital contents are available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

Copyright © 2016 by the American College of Occupational and Environmental Medicine