Are Gulf War veterans experiencing illness due to exposure to smoke from Kuwaiti oil well fires? Examination of Department of Defense hospitalization data

Abstract : Context There has been much public and veteran concern over possible toxic exposures and reported symptoms by Gulf War veterans. Objective To determine if there is an increased risk of postwar morbidity severe enough to warrant hospitalization among those exposed to Kuwaiti oil well fire smoke. Design, Setting, and Participants In this historical cohort study, complete exposure and demographic data were available for 518,87 Gulf War veterans consisting of 87.3% regular active duty and 12.7% Reserve personnel. Main Outcome Measures Using data from all Department of Defense hospitals, Cox modeling was completed for hospitalizations du to any cause, hospitalizations with diagnoses in 15 major categories, and hospitalizations for specific diagnoses thought to be likely manifestations of the exposure. Observation time was calculated from February 2, 1991, until hospitalization, separation from active- duty service, or January 31, 1999, whichever occurred first. Results Exposure to oil well fire smoke particulate matter was determined through the overlay of meteorologic and diffusion modeling data onto troop location data. We constructed 7 exposure groups based on duration and amount of exposure. Among the 25 models, the only model at increased adjusted hospitalization risk was that for diagnoses in the injury and poisoning (RR=1.O5; 95% CI, 1.01- 1.11). Conclusions Having some limitations, these data do not support the hypothesis that Gulf War veterans are suffering an increased risk of postwar morbidity from exposure to Kuwaiti oil well fire smoke.