IJE Advance Access originally published online on February 28, 2005
International Journal of Epidemiology 2005 34(4):801-808; doi:10.1093/ije/dyi008
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Assessing the potential health impact of the 1991 Gulf War on Saudi Arabian National Guard Soldiers
1 Department of Preventive Medicine and Biometrics, Room A1044, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814-4799, USA
2 Infection Prevention and Control Program, King Abdul Aziz Medical City, King Fahad National Guard Hospital, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
3 Department of Defense Centre for Deployment Health Research, Naval Health Research Centre, PO Box 85122 San Diego, CA 92186-5122, USA
4 Office of the Director, National Centre for Environmental Health, and Agency for Toxic Substances and Disease Registry, Centres for Disease Control and Prevention, Atlanta, GA, USA
5 Department of Epidemiology, College of Public Health, University of Iowa, C2ID General Hospital, 200 Hawkins Drive, Iowa City, IA 52242, USA
* Corresponding author. Department of Preventive Medicine and Biometrics, Room A1044, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, USA 20814-4799. E-mail: ggackstetter{at}usuhs.mil
Background There has been considerable publicity that the 1991 Gulf War may have caused a wide array of health problems in military personnel. Although post-war health outcomes have been studied in US, British, Canadian, Danish, and other deployed troops, this issue has not been previously evaluated in coalition forces native to the Gulf region.
Methods A collaborative team of US and Saudi health researchers was assembled, data sources evaluated, and hospitalizations among Saudi Arabian National Guard (SANG) soldiers between 1991 and 1999 analysed. Multivariate modelling was used to evaluate differences between 8342 soldiers exposed to combat at Al Khafji and a comparison group of 7270 soldiers in the Riyadh area.
Results Among 15 612 SANG soldiers, we identified 148 with at least one hospitalization over the 9 years following the war. The adjusted rate of hospitalization was higher in the combat-exposed group (risk ratio (RR) = 1.80, 95% confidence interval (CI) 1.25–2.59). No unusual patterns of diagnoses were found and, because the overall number of hospitalizations was low, the absolute difference in risk was found to be very small.
Conclusions This is the first reported epidemiological investigation of post-war hospitalizations among coalition forces native to the Gulf region that participated in the 1991 Gulf War. A very small increase in hospitalizations was identified in SANG soldiers exposed to combat at Al Khafji. However, because of data limitations, the clinical relevance of this finding should be interpreted with caution. Future collaborative studies to better understand the health effects of deployment should be encouraged.
Keywords Saudi Arabia, Persian Gulf syndrome, Gulf War syndrome, morbidity, hospitalization, military personnel, military medicine, military deployment, veterans, health, occupational exposure, environmental exposure
Accepted 1 December 2004
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