Health symptom trajectories and neurotoxicant exposures in Gulf War veterans: the Ft. Devens cohort

Environmental Health

Timothy Heeren¹  Kimberly Sullivan²  Avron Spiro³  Clara G. Zundel⁴  Megan Yee⁴  Maxine H. Krengel⁴  Claudia M. Grasso⁴  Susan P. Proctor⁴ 

[1] Department of Biostatistics, Boston University School of Public Health;Department of Environmental Health, Boston University School of Public Health;Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System;Research Service, VA Boston Healthcare System;

关键词: Gulf War;    Veterans;    Toxic wounds;    Neurotoxicant exposure;    Longitudinal Design;    Health symptoms;   

DOI  :  10.1186/s12940-021-00812-0

来源: DOAJ

【 摘 要 】

Abstract Background Thirty years ago, Gulf War (GW) veterans returned home with numerous health symptoms that have been associated with neurotoxicant exposures experienced during deployment. The health effects from these exposures have been termed toxic wounds. Most GW exposure-outcome studies utilize group analyses and thus individual fluctuations in symptoms may have been masked. This study investigates health symptom trajectories in the same veterans over 25 years. Methods Veterans were categorized into 5 a priori trajectory groups for each health symptom and Chronic Multisymptom Illness (CMI) clinical case status. Multinomial logistic regression models were used to investigate associations between these trajectories and neurotoxicant exposures. Results Results indicate that more than 21 Pyridostigmine Bromide (PB) pill exposure was associated with consistent reporting of fatigue, pain, and cognitive/mood symptoms as well as the development of six additional symptoms over time. Chemical weapons exposure was associated with both consistent reporting and development of neurological symptoms over time. Reported exposure to tent heater exhaust was associated with later development of gastrointestinal and pulmonary symptoms. Veterans reporting exposure to more than 21 PB pills were more than 8 times as likely to consistently meet the criteria for CMI over time. Conclusion This study highlights the importance of the continued documentation of the health impacts experienced by GW veterans’, their resulting chronic health symptoms, and the importance of exposure-outcome relationships in these veterans now 30 years post-deployment.

【 授权许可】

Unknown