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  • In Gulf War Veterans, High Symptoms Predict Future Chronic Disease

    Study Shows Rising Rates of Obesity and Alcohol Use over Time

    Gulf War veterans who report many different symptoms are at high risk of developing various chronic diseases during long-term follow-up, reports a study in the August Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and Environmental Medicine (ACOEM).

    The study by Stella M. Gwini and colleagues of Monash University, Melbourne, Australia, included 697 Australian veterans of the 1990-91 Gulf War—first assessed in the early 2000s and then followed up ten years later. Based on an extensive symptom checklist, about 12 percent of veterans were classified as having a "high" symptom count, averaging 34 different symptoms. Symptom count was moderate (average 16 symptoms) in 48 percent of veterans and low (five symptoms) in 40 percent.

    At follow-up, veterans with high symptom counts were more likely to be diagnosed with several types of chronic diseases. Risks of sleep apnea and musculoskeletal diseases were about nine times higher than in the low-symptom group; risks of psychological and cardiovascular conditions were about four and five times higher, respectively. Veterans in the high-symptom group were also more likely to be diagnosed with unexplained multisymptom illness (sometimes called Gulf War syndrome) and chronic fatigue syndrome.

    For all three groups of veterans, rate of obesity and harmful alcohol use increased over time (although smoking decreased). Even in the moderate- and low-symptom groups, mental and physical health declined during follow-up.

    The study highlights the "enormous burden of ill-health" in veterans with high levels of symptoms. Added to previous data, the results suggest that Gulf War veterans with high symptom counts are likely to have delayed onset or delayed diagnosis of chronic diseases.

    "The combination of poorer health and elevated unhealthy lifestyle factors in the group with the highest symptom reporting suggests that this group may benefit from an integrated approach to health promotion and disease prevention and management of existing conditions," Ms. Gwini and coauthors write. They add that the increase in health risk factors among workers with low to moderate symptoms "warrants monitoring of chronic disease incidence."

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    Citation -- Gwini SM, Kelsall HL, Ikin JF, Sim MR, McFarlane AC, Forbes AB. New onset of chronic diseases and changes in lifestyle risk factors among Gulf War veterans: a longitudinal comparison of high and low symptom reporters. J Occup Environ Med. 2016;58(8):770-7.

    About the Author -- Ms. Gwini may be contacted for interviews at stella.gwini@monash.edu

    About ACOEM -- ACOEM (www.acoem.org), an international society of 4,500 occupational physicians and other health care professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments.

    About the Journal of Occupational and Environmental Medicine -- The Journal of Occupational and Environmental Medicine (www.joem.org) is the official journal of the American College of Occupational and Environmental Medicine. Edited to serve as a guide for physicians, nurses, and researchers, the clinically oriented research articles are an excellent source for new ideas, concepts, techniques, and procedures that can be readily applied in the industrial or commercial employment setting.