Federal Nursing Service Award Monitoring the Health of Persian Gulf War Veteran Women

Military Medicine, May 2005 by Pierce, Penny F

The Persian Gulf War imposed unique threats and stressors on our military forces. Mobilization included an unprecedented number of women, with more than 33,000 U.S. military women serving in key combat positions throughout the region. Despite their increasing numbers, little is known about the general health effects of combat exposure on women's long-term health. Objective: The aim of the study was to assess whether the prevalence of health problems remained elevated among women deployed to the Gulf at 6 years after deployment. Methods: This comprehensive self-report survey compared the prevalence of physical health problems among 900 Air Force women deployed to the Gulf and 900 Air Force women deployed elsewhere. Results: Findings indicate that significant health problems among women deployed to the theater have persisted for an extended period and the prevalence remains statistically different from that among women deployed elsewhere during the same period of time. Conclusions: Long-term health surveillance is critical for monitoring the health and well-being of our nation's military members. Ultimately, through this program of research, we hope to be able to determine whether there are preventable risks to women that are associated with specific military duties, deployment, occupational exposures, or combinations of these factors.

Introduction

Although there have been ambitious efforts to study the possible health effects of the Persian Gulf War on returning troops, there has been little attention devoted specifically to the health and well-being of women who served alongside their male counterparts. Many troops prepared for deployment with multiple vaccines and prophylactic medication, lived in crowded and sometimes unsanitary conditions, and suffered exposure to harsh environmental conditions, including contaminants from oil fires, fuels, and other chemicals. Deployment, combat stress, and environmental and occupational exposures may affect women differently than men, and we need scientific information with which we can reliably determine whether there are preventable risks that are associated with military duties, deployment locations, or particular combinations of factors.

Mobilization for the Persian Gulf War included an unprecedented proportion of women from the active duty forces (7%), as well as the Reserve and National Guard (17%). More than 33,000 U.S. military women served in key combat support positions throughout the Persian Gulf region.1 Potential long-term outcomes of physical and emotional stressors common to the combat scenario may pose particular and specific threats to women's health but have received little attention. To date, there have been no other longitudinal studies specifically designed to investigate the physical outcomes for women who participated in full force during the Persian Gulf War.

Studies of the physical and emotional effects of combat exposure on women who served during Operation Desert Storm vary in sampling techniques and data collection methods.2-7 The majority of studies have focused on combat stressors and adjustment among deployed men and women. To date, there have been no other longitudinal studies specifically designed to monitor the health of women after this major deployment. By establishing the prevalence of the health problems of Persian Gulf War veteran women, we draw attention to the need for better predeployment health screening, the need for timely and gender-specific health care in deployed locations, and better surveillance of health problems in the postdeployment period. In addition, we will be better able to determine whether current health problems are related to service in the Gulf region or are attributable to other factors In this regard, there is a need for research on the patterns of illness after deployments, so that preventive measures can be taken in a timely manner in the future.

The opportunity to study the health consequences of Persian Gulf War veteran women in a timely manner meets a critical and longstanding need. Research efforts need to be focused on documenting and monitoring the health effects of occupational and environmental extremes experienced in combat situations and on understanding potential gender-specific effects of certain exposures and circumstances. Use of environmental and occupational categories is consistent with the IOM description, which states, "general environmental exposures of interest include temperature and humidity, sand and dirt, sanitary conditions, fauna, oil well spills and fires, pesticides, petroleum products (especially jet fuel and diesel fuel containing lead additives), mycotoxins, and decontamination solution. Exposures to consider under Occupational environment' are related mainly to general maintenance operations and include battery repair, cleaning/degreasing, electronic/radio repair, generator repair, grinding/sanding, sand blasting, lathing/milling, painting (especially with isocyanate-based paints), refrigeration servicing, vehicle repair, weapons repair, and welding and cutting (p 43). "8