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Unwin, C. et al. Health of UK Servicemen Who Served in Persian Gulf War. Lancet (1999) 353: 169-178.

This British study surveyed servicemen and compared those who served in the Gulf War (GWV) to contemporaries who did not deploy to the Gulf and to others who deployed to the Bosnia conflict. There were about 4248 servicemen randomly selected from each of the groups. Response rates were 70%, 62%, and 63% respectively. GWV reported all symptoms and conditions more frequently than the comparison groups. The five most commonly reported symptoms in all three groups were unrefreshing sleep, irritability, headaches, fatigue, and sleeping difficulties. The five most commonly reported conditions in all three groups were back disorders, hay fever, dermatitis, sinus disorders, and migraines. Of all conditions, the one which was most strongly associated with Gulf War service was self-reported chronic fatigue syndrome, although it was uncommon in all three groups. Among servicemen in all three groups, perceptions of poorer health were associated with virtually all potential risk factors or exposures, regardless of deployment status. Belief in exposure to a chemical warfare agent was associated with the lowest health perception. There was also an association of poorer health and receipt of multiple vaccinations, especially among veterans who recalled experiencing side effects from the vaccines. Patterns of symptoms were the same in all three groups, suggesting that there is no specific "Gulf War Syndrome." Limitations: results are based on self-reports in response to a written questionnaire; disorders which require a clinical interview or examination for diagnosis could not be captured; the lack of physical examinations prevents drawing conclusions about physical disorders which might explain the increased frequency of reported symptoms. The authors do plan further studies which will include detailed physical, neurophysiological, and neuropsychological examinations of symptomatic veterans and controls.

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