Is the increased reporting of symptomatic ill health in Gulf War veterans related to how one asks the question?

Background: Following the 1991 Gulf War (GW) there was much controversy surrounding service-related health effects. Evidence from the Vietnam experience suggested that self-reported ill health following that conflict might be related to how service during the conflict is framed. The aim of this article is to determine if a GW health effect persisted when the same questions were asked in a "non-GW" context.

Method: Prevalence of physical and psychological health problems were ascertained in a study assessing health screening from a random sample of UK Armed Forces. Record linkage between the screening survey and service history was conducted to obtain information on participation in the GW.

Results: Differences in health outcomes were found between the GW and the non-GW groups. This difference existed for symptomatic measures (OR=1.84, 95% CI, 1.17-2.91) rather than psychological or behavioral measures. No differences were found in psychological measures such as PTSD or behavioral measures such as alcohol consumption. Those deployed to the GW had a poorer self-perception of health (OR=1.47, 95% CI 1.02-2.11).

Conclusions: Even in the absence of framing, a Gulf-related ill health effect was found.