TY - JOUR
T1 - Latency and Exposure-Health Associations in Gulf War Veterans with Early Fatigue Onsets
T2 - A Case-control Study
AU - Lucas, Katherine E.
AU - Rowe, Peter C.
AU - Armenian, Haroutune K.
N1 - Funding Information:
We are grateful to Jackie Kaczmarczyk for study coordination, to Karen DeBusk, RN, for patient management, and to Scott Seggerman of the Defense Manpower Data Center for his assistance with recruiting participants. We also thank the Gulf War veterans for taking part in this study. Finally, we appreciate the funding for this work, which was provided by grant DAMD17-00-1-0072 from the Department of Defense and by the Johns Hopkins General Clinical Research Center, which is supported by National Institutes of Health grant M01 RR000052. Neither the Department of Defense nor the National Institutes of Health participated in the design or conduct of the study; in the collection, analysis, or interpretation of the data; or in the preparation, review, or approval of the manuscript.
PY - 2007/10
Y1 - 2007/10
N2 - Purpose: To see if self-reported exposures were associated with health in early-onset Gulf War illnesses (GWIs) cases and healthy Gulf War veteran controls. Methods: Forty-nine cases and 44 controls completed questionnaires about wartime exposures and symptoms experienced. Odds ratios were calculated using 2×2 tables and logistic regression. The incubation curve of fatigue onsets in cases was drawn to highlight exposure/health associations using Sartwell's method and tested with the Shapiro-Wilk test. The incubation period was defined as the time from arrival in the Persian Gulf to fatigue onset. Results: The incubation curve was right skewed and lognormally distributed (p = 0.48; p > 0.05 indicates lognormality), suggesting an association between a wartime exposure and fatigue. Exposure to oil fire smoke, pesticides, contaminated food or water, dead animals, scud missile attacks, dead bodies, prisoners of war, artillery or small arms fire, and chemical suits was significantly associated with GWIs. Pyridostigmine bromide (PB) was the only continuous exposure significantly associated with GWIs. The odds of having GWIs increased by 1.3% for every PB pill taken (95% confidence interval 1.001-1.02). There were significant trends toward worse health with greater intake of PB. Conclusions: These analyses suggest that wartime exposures, including exposure to PB, are associated with fatigue.
AB - Purpose: To see if self-reported exposures were associated with health in early-onset Gulf War illnesses (GWIs) cases and healthy Gulf War veteran controls. Methods: Forty-nine cases and 44 controls completed questionnaires about wartime exposures and symptoms experienced. Odds ratios were calculated using 2×2 tables and logistic regression. The incubation curve of fatigue onsets in cases was drawn to highlight exposure/health associations using Sartwell's method and tested with the Shapiro-Wilk test. The incubation period was defined as the time from arrival in the Persian Gulf to fatigue onset. Results: The incubation curve was right skewed and lognormally distributed (p = 0.48; p > 0.05 indicates lognormality), suggesting an association between a wartime exposure and fatigue. Exposure to oil fire smoke, pesticides, contaminated food or water, dead animals, scud missile attacks, dead bodies, prisoners of war, artillery or small arms fire, and chemical suits was significantly associated with GWIs. Pyridostigmine bromide (PB) was the only continuous exposure significantly associated with GWIs. The odds of having GWIs increased by 1.3% for every PB pill taken (95% confidence interval 1.001-1.02). There were significant trends toward worse health with greater intake of PB. Conclusions: These analyses suggest that wartime exposures, including exposure to PB, are associated with fatigue.
KW - Environmental Exposure
KW - Fatigue
KW - Military Personnel
KW - Persian Gulf Syndrome
KW - Pyridostigmine Bromide
KW - Veterans
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U2 - 10.1016/j.annepidem.2007.05.001
DO - 10.1016/j.annepidem.2007.05.001
M3 - Article
C2 - 17662618
AN - SCOPUS:34548591034
SN - 1047-2797
VL - 17
SP - 799
EP - 806
JO - Annals of epidemiology
JF - Annals of epidemiology
IS - 10
ER -