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Meta-analysis of self-reported health symptoms in 1990-1991 Gulf War and Gulf War-era veterans.

Meta-analysis of self-reported health symptoms in 1990-1991 Gulf War and Gulf War-era veterans.
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Maule AL, Janulewicz PA, Sullivan KA, Krengel MH, Yee MK, McClean M, White RF,


Maule AL, Janulewicz PA, Sullivan KA, Krengel MH, Yee MK, McClean M, White RF, (click to view)

Maule AL, Janulewicz PA, Sullivan KA, Krengel MH, Yee MK, McClean M, White RF,

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BMJ open 2018 02 138(2) e016086 doi 10.1136/bmjopen-2017-016086
Abstract
OBJECTIVES
Across diverse groups of Gulf War (GW) veterans, reports of musculoskeletal pain, cognitive dysfunction, unexplained fatigue, chronic diarrhoea, rashes and respiratory problems are common. GW illness is a condition resulting from GW service in veterans who report a combination of these symptoms. This study integrated the GW literature using meta-analytical methods to characterise the most frequently reported symptoms occurring among veterans who deployed to the 1990-1991 GW and to better understand the magnitude of ill health among GW-deployed veterans compared with non-deployed GW-era veterans.

DESIGN
Meta-analysis.

METHODS
Literature databases were searched for peer-reviewed studies published from January 1990 to May 2017 reporting health symptom frequencies in GW-deployed veterans and GW-era control veterans. Self-reported health symptom data were extracted from 21 published studies. A binomial-normal meta-analytical model was used to determine pooled prevalence of individual symptoms in GW-deployed veterans and GW-era control veterans and to calculate combined ORs of health symptoms comparing GW-deployed veterans and GW-era control veterans.

RESULTS
GW-deployed veterans had higher odds of reporting all 56 analysed symptoms compared with GW-era controls. Odds of reporting irritability (OR 3.21, 95% CI 2.28 to 4.52), feeling detached (OR 3.59, 95% CI 1.83 to 7.03), muscle weakness (OR 3.19, 95% CI 2.73 to 3.74), diarrhoea (OR 3.24, 95% CI 2.51 to 4.17) and rash (OR 3.18, 95% CI 2.47 to 4.09) were more than three times higher among GW-deployed veterans compared with GW-era controls.

CONCLUSIONS
The higher odds of reporting mood-cognition, fatigue, musculoskeletal, gastrointestinal and dermatological symptoms among GW-deployed veterans compared with GW-era controls indicates these symptoms are important when assessing GW veteran health status.

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