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Meta-Analysis
. 2018 Feb 13;8(2):e016086.
doi: 10.1136/bmjopen-2017-016086.

Meta-analysis of self-reported health symptoms in 1990-1991 Gulf War and Gulf War-era veterans

Alexis L Maule  1   2 , Patricia A Janulewicz  1 , Kimberly A Sullivan  1 , Maxine H Krengel  1   3 , Megan K Yee  3 , Michael McClean  1 , Roberta F White  1   4
Affiliations
Meta-Analysis

Meta-analysis of self-reported health symptoms in 1990-1991 Gulf War and Gulf War-era veterans

Alexis L Maule et al. BMJ Open. .

Abstract

Objectives: Across diverse groups of Gulf War (GW) veterans, reports of musculoskeletal pain, cognitive dysfunction, unexplained fatigue, chronic diarrhoea, rashes and respiratory problems are common. GW illness is a condition resulting from GW service in veterans who report a combination of these symptoms. This study integrated the GW literature using meta-analytical methods to characterise the most frequently reported symptoms occurring among veterans who deployed to the 1990-1991 GW and to better understand the magnitude of ill health among GW-deployed veterans compared with non-deployed GW-era veterans.

Design: Meta-analysis.

Methods: Literature databases were searched for peer-reviewed studies published from January 1990 to May 2017 reporting health symptom frequencies in GW-deployed veterans and GW-era control veterans. Self-reported health symptom data were extracted from 21 published studies. A binomial-normal meta-analytical model was used to determine pooled prevalence of individual symptoms in GW-deployed veterans and GW-era control veterans and to calculate combined ORs of health symptoms comparing GW-deployed veterans and GW-era control veterans.

Results: GW-deployed veterans had higher odds of reporting all 56 analysed symptoms compared with GW-era controls. Odds of reporting irritability (OR 3.21, 95% CI 2.28 to 4.52), feeling detached (OR 3.59, 95% CI 1.83 to 7.03), muscle weakness (OR 3.19, 95% CI 2.73 to 3.74), diarrhoea (OR 3.24, 95% CI 2.51 to 4.17) and rash (OR 3.18, 95% CI 2.47 to 4.09) were more than three times higher among GW-deployed veterans compared with GW-era controls.

Conclusions: The higher odds of reporting mood-cognition, fatigue, musculoskeletal, gastrointestinal and dermatological symptoms among GW-deployed veterans compared with GW-era controls indicates these symptoms are important when assessing GW veteran health status.

Keywords: Gulf War illness; Gulf War veterans; deployment health; health symptoms; meta-analysis.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Meta-analysis literature search strategy (* syntax indicates that all variations of the word was searched by the databases, eg, symptom* searched for symptoms, symptomatology, etc). OEF/OIF, Operation Enduring Freedom/Operation Iraqi Freedom.
See this image and copyright information in PMC

References

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