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Smith TC, Gray GC, and Knoke JD. Is Systemic Lupus Erythematosis, Amyotrophic Lateral Sclerosis, or Fibromyalgia Associated with Persian Gulf War Service? An Examination of Department of Defense Hospitalization Data. American Journal of Epidemiology 2000; 151: 1053-9.

The authors compared military hospitalizations of active duty Gulf War veterans (GWV) (551,841) to non-deployed veterans (NDV) (1,478,704) who remained on active duty as of July 31, 1991. For systemic lupus erythematosis (SLE), women and blacks had increased risks of hospitalization. GWV were not at increased risk compared to NDV. For amyotrophic lateral sclerosis (ALS), deployment status was not associated with risk of hospitalization. For fibromyalgia (FM), increased risk was associated with female gender, increasing age, pre-war hospitalization, and Army personnel. The risks for GWV and NDV were the same for 3.5 years, following which the GWV had almost twice the risk of hospitalization for FM. This excess risk is believed to be associated with participation in the Comprehensive Clinical Evaluation Program for GWV. For CCEP participants, the risk of hospitalization for FM was 26 times that of non-participants. For all three diagnoses, there were no differences in risk based on either duration of deployment in the Gulf, or potential exposure to low-level dose nerve agent from the release at Khamisiyah. Limitations and strengths of the study are described.

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