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September 16, 1998

Illness Among Gulf War VeteransRisk Factors, Realities, and Future Research

Author Affiliations

From the School of Public Health, University of California, Berkeley (Dr Lashof); and the Institute of Medicine, Washington, DC (Dr Cassells). Dr Lashof is a professor emerita and former chairperson of the Presidential Advisory Committee on Gulf War Veterans' Illnesses.

JAMA. 1998;280(11):1010-1011. doi:10.1001/jama.280.11.1010

Although it is now 7 years since the Gulf War ended, research concerning the nature and extent of illnesses reported by returning veterans has yet to define clearly a specific disease entity or etiologic agent to explain these illnesses. Approximately 697000 men and women served in operations Desert Shield and Desert Storm from August 1990 to June 1991. During the war, US troops sustained 148 combat deaths and 145 deaths due to disease or unintentional injuries; 467 individuals were wounded.1 But shortly after returning from the Persian Gulf, some men and women began to experience debilitating illnesses. The most commonly reported symptoms included fatigue, muscle and joint pain, memory loss, and headaches. In 1992, as the number of veterans reporting these symptoms increased and no obvious explanation for their symptoms had been found, the Department of Veterans Affairs established a registry to identify and treat Gulf War veterans' illnesses. In 1994 the Department of Defense established the Comprehensive Clinical Evaluation Program for active-duty service personnel. Three diagnostic categories (International Classification of Diseases, Ninth Revision, Clinical Modification2 )— psychological conditions; musculoskeletal diseases; and symptoms, signs, and ill-defined conditions—accounted for 50% of the diagnoses.3,4 Other primary diagnoses did not concentrate in any organ system. This strongly parallels the experiences of veterans from previous conflicts.5

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