J Epidemiol Community Health 2000;54:834-838 ( November )

Research report

Occupational risk factors for ill health in Gulf veterans of the United Kingdom Khalida Ismail^a, Nick Blatchley^b, Matthew Hotopf^a, Lisa Hull^a, Ian Palmer^c, Catherine Unwin^a, Anthony David^a, Simon Wessely^a

^a Gulf War Illness Research Unit, Guy's King's and St Thomas' Medical School, Denmark Hill Campus, 103 Denmark Hill, London SE5 8AZ, ^b Ministry of Defence, Whitehall, London, ^c Royal Defence Medical College, Fort Blockhouse, Gosport, Hampshire

Correspondence to: Dr Ismail (khalida.ismail{at}iop.kcl.ac.uk)

Accepted for publication 20 May 2000

OBJECTIVESTo study the association between occupational factors specific to the Armed Forces (rank, functional roles, Service, regular or reservist status and deployment factors) and symptomatic health problems in Gulf veterans, after sociodemographic and lifestyle factors have been accounted for.
DESIGNA postal cross sectional survey of randomly selected UK Gulf veterans was conducted six to seven years after the Gulf conflict. Physical ill health was measured using the Fatigue Questionnaire and a measure of the Centers for Disease Control and Prevention (CDC) multi-symptom syndrome. Psychological ill health was measured using the General Health Questionnaire and a post-traumatic stress measure.
SETTINGPopulation of servicemen who were serving in the UK Armed Forces during the Gulf conflict between 1 September 1990 and 30 June 1991.
PARTICIPANTS3297 Gulf veterans.
MAIN RESULTSIn multivariate logistic regression, there was an inverse relation between higher rank and psychological and physical ill health (test of trend: General Health Questionnaire, p=0.004 ; post-traumatic stress, p=0.002; fatigue, p=0.015; CDC case, p=0.002). Having left the Armed Forces was associated with a two to three times increase in reporting ill health. Of the deployment factors, there was a weak association between being deployed as an individual reinforcement in a combat role and post-traumatic stress but there was no association between receiving pre-deployment training or post-deployment leave and ill health. Marital status and smoking were associated with psychological and physical ill health.
CONCLUSIONSRank was the main occupational factor associated with both psychological and physical ill health in Gulf veterans. This may parallel the associations between socioeconomic status and morbidity in civilian populations. Ill health seems to be greater in those who return to civilian life. Sociodemographic factors also seem to be important in ill health in Gulf veterans.


Keywords: military; Gulf veterans; rank

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© 2000 by Journal of Epidemiology and Community Health
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