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Michael L. Wynn, S. Wendy Johnston, Linda A. McCauley,
Andre Barkhuizen, Daniel Storzbach, Ronald Grewenow, Peter S. Spencer,
Nadia Redmond, Dennis N. Bourdette, and other members of PEHRC
Portland Environmental Hazards Research Center (PEHRC)
We propose a case definition of PGWUI based on results of
detailed clinical assessment of 162 Persian Gulf War veterans. Symptomatic
and asymptomatic subjects were recruited from survey respondents to an
epidemiological survey mailed to a random sample of PGW veterans from
Oregon and Washington. Response rate was 61% (621/920). Subjects were
given a general physical examination, standardized neurological, rheumatological
and neuropsychological evaluations, and extensive laboratory testing.
Of the subjects who completed full clinical evaluation by March 1, 1997,
13% (21/162) were excluded because of (i) an exclusionary diagnosed condition
(11 subjects), (ii) disavowal or resolution of previously reported symptoms
at clinical encounter (9), or (iii) loss to follow-up (1). Of the final
group of 88 symptomatic and 53 asymptomatic veterans, 74% (65/88) had
unexplained findings classified as cognitive/psychological (CP), 47% muscle/joint
(MJ), 44% fatigue (F), 15% gastrointestinal (GI), and 5% dermatologic.
Fifty-one percent (45/88) of symptomatic subjects had complaints in two
or more symptom groups. Of those with only one unexplained symptom (n=43),
58% (25/43), complained of CP difficulties while 26% (11/43) reported
MJ, 9% (4/43) F, and 7% (3/43) GI symptoms. No veteran had unexplained
skin problems as their only defining symptom. General demographic profiles,
detailed general physical/neurological exam and laboratory test results
did not differ between symptomatic and asymptomatic groups. PGWUI is defined
in this group of veterans as the presence of unexplained fatigue, cognitive/psychological
symptoms, and/or muscle/joint pain beginning during or after deployment
to the Persian Gulf, and persisting for at least one month in the three
months preceding examination.
"Keywords:" Questionnaire Symptoms Self-report
This work was supported by a grant from the Department of
Veterans Affairs to the PEHRC, a joint project of the Portland Veterans
Affairs Medical Center and the Center for Research on Occupational and
Environmental Toxicology, Oregon Health Sciences University. |
