War-related mental health disorders among Iraqis 10 years after the 1991 gulf war: a comparative study of soldiers and civilians living under sustained socio-environmental stress

Prior studies of mental health consequences of the Gulf War [GW] have been confined to Allied forces, limiting the ability to control for important geographically and culturally-related factors. We conducted an epidemiological mental health study among Iraqi soldiers and civilians who are still residing in Iraq. This group has been exposed to sustained socio-environmental stress. A cross-sectional sample of 742 Iraqi GW veterans and 413 civilians responded to a validated mental health survey. The response rate was 96.3%. Mental health disorders, including post traumatic stress disorder [PTSD], were classified using both self-reports and validated scales. War-related exposure was calculated using the sum score of items assessing trauma exposure. Iraqi soldiers reported significantly more depression [Odds Ratio [OR] 4.9; 95% confidence interval [CI] 2.2-11.1] and anxiety [OR 3.9; 95% CI, 1.2-13.3] compared to civilians, adjusting for age, education, and smoking. Soldiers closest to Kuwait during the GW reported significantly more depression compared to soldiers deployed further away from the war epicenter [OR 104.6; 95% CI, 28.0-390.8] and anxiety [OR 4.1; 95% CI, 1.5-11.1]. The highest self-reported trauma exposure occurred in the southwest of Iraq. Iraqi soldiers that took part in the GW are at increased risk suffering from many of the same mental health disorders plaguing Allied soldiers. Soldiers closest to Kuwait were more at risk, suggesting a direct link to war-specific environmental exposures, although self-reported trauma exposure was higher in the southwest of Iraq. The study offers additional insights into the mental health consequences of living under sustained socio-environmental stress, originating from the Iraqi war. The study points out socio-environmental factors worthy of further explorations

Somatic and psychiatric disorders and health care utilization among Iraqi refugees and Yemeni immigrant

Prior studies have reported increased prevalence of mental and somatic health disorders among refugees. However, many of these studies fail to include appropriate comparison groups. Moreover, there is a lack of studies focusing on health care utilization among refugee populations. We examined the distribution of somatic and mental health disorders as well as patterns of health care utilization among 116 Iraqi refugees as compared to 232 non-refugee Arab immigrants. Refugees as compared to non-refugee immigrants exhibit different distributional patterns with regards to several somatic and psychiatric disorders. In addition, specific somatic disorders [e.g., dermatologic and cardiovascular disorders] were found to be associated with greater health care consumption in refugees as compared to regular immigrants with identical diagnoses

Tobacco use among Arab American adults in southeastern Michigan community

Tobacco use is a major public health risk in most of the developing countries of the world. Many immigrant populations carry this behavior to America. In this screening study of 6164 Arab American adults, 1796 identified themselves as either current or former smokers; 946 agreed to complete a tobacco use survey [53% response rate]. The majority were male [80%]; married [77%]; born in the Middle East [97%]; had been in the USA more than five years [67%]; had not finished high school [54%], had annual incomes of less than $10,000.00 [66%], and carried no health insurance [54%]. Significantly more men than women started smoking before 15 years and smoked more cigarettes per day; most women started after aged 20. Early age of initiation was the most powerful predictor of current smoking status [OR = 25.82]. Former smokers were two times more likely to be males and 2.24 times more likely to have been in the United States less than 5 years. Of those currently smoking, 91% wanted to quit and 94% wanted smoking cessation programs. Significant differences were found between current and former smokers and between men and women in this exploratory study. Current smokers were male, in the USA longer, and began smoking before age 15. Men smoked more years and more cigarettes. More rigorous research is needed. Intervention efforts must be focused on smoking prevention or cessation in this and other immigrant populations

Characteristics that influence occupational health and safety knowledge among Arab American workers

The purpose of this study is to examine potential determinants of occupational health and safety knowledge in an Arab-American population. Three hundred unemployed Arab men and women were tested on their knowledge of occupational health and safety by a written test. We evaluated differences in mean raw test scores for age, education, language skill [English only Arabic only, or bilingual], and place of birth, ever having been employed in the U.S. and prior OHS training. Overall scores were quite low [mean = 24% correct]. There were significant differences in mean scores by age, educational level and prior OHS training in men and women. Scores were lower in men who only spoke Arabic, were born in an Arab country and had never worked in the U.S. compared to women whose scores did not seem to be affected by language, birthplace or employment status. Arab Americans job seekers are an understudied immigrant population with low levels of occupational health and safety knowledge. Whereas no knowledge or limited knowledge of English as well as educational level may contribute to lack of OHS knowledge, these are only partially explanatory. More research is needed to more fully understand the determinants of knowledge acquisition, retention, attitudes and skills among Arab Americans

Occupational diseases among hairdressers in Baghdad city

413 barber-shops were visited during the period from Dec. 1991 to Feb. 1992, in which 730 hairdressers worked [340 male, 390 female]. After analysis of the questionnaire, it was found that 60% of them had education less than high school and most of them [56%] were between 20-29 years of age. The pervalence rate of dermatological diseases among hairdressers was 32.6%, about half of which were contact dermatitis [15.3%]. It was also found that 20.3% of hairdressers had varicose veins [24.7% male, 16.4% female], and the prevalence rate increased with the duration of work. It was also found that 28.5% had cervical pain, 33.8% had upper backache, 42.6% had lower backache, 21.4% had wrist pain and 193% had metacarpo-phalangeal joint pain of the thumb. Recommendations were given to the health planner to enforce the regulation of health and safety among hairdressers

study of disability cases due to work injury in Iraq

Two hundred Cases of disability due to work injuries were studied. 81% of the injured workers had disability of less than l5%; 58% of them had services less than one year. The mechanical sector showed the highest percentage [27%] as a place for the injured workers. The main causes for disability were catch-between objects 36.5%, and 70% of such causes were related to machines and tools. The upper extremity, particularly the fingers. the highest percentage [70%] of injuries in which traumatic form amputation formed 48%. There was a significant differences between the time and, the days for the occurence of accidents. The study recommends the importance of occupational training to workers before starting work, to give rest periods in the mid-morrining of the work time, to reduce the working days to five days a week, and to issue a periodic accident statistics

Field survey on health and environment condition of Al-Shaha village, Abo Graib, Baghdad

A field survey on health and environment condition of AL-Shaha village - Abo Graib -Baghdad was carried out 87% of the houses were built from rocks and blocks of cement. All have lavatories but only 40% of them have purified thinking water although it was not sufficient. 43.5% of people in the village were illitrate, 18.7% of them were farm workers. Clinical examination of these people showed that 55.1% were healthy; 87.7% of children below six years were healthy but 98.7% of children were under-fed. Most of the children were vaccinated. Among women 83.1% of them had a natural normal last labour, but 21.8% of these mothers complained of anemia during last pregnancy Recommendations are given

relationship between noise-exposure and absence from work

In a retrospective study, recorded work injuries and absenteeism during the year 1992 were studied among textile workers. 189 workers exposed to high sound level above 95 dB [A] - [EG] and 189 reference workers exposed to less noisy area - below 80 dB [A] - [RG]. The prevalence of injuries were twice in the EG [36.6%] than in the RG [19.6%]. Absenteeism was higher in BC than in the RG. However, there was no significant difference between the two groups for diagnosed medical diseases except for accidents. Recommendation is given

association between blood pressure, pulse rate and noise exposure

A cross-sectional study on the relationship of blood pressure [BP] and pulse rate [PR] to occupational noise exposure was conducted in the Iraqi State Establishment of Cotton Industries. The study included 189 workers from the high noise exposure department [Exposed group: IG] and 89 workers from a low noise exposure departments [Interference group: RG]. The study showed no significant difference in the mean systolic or diastolic BP in all ages and in both sexes. Also the study showed that the reported symptoms were more prevalent in EG than the IG and in both sexes. The study recommends a hearing conservation program

study of the prevalence rate of obvious eye diseases in Baghdad city-Iraq

A cross-sectional study of the prevalence rate of some eye diseases [abnormal appearance] among people living in Baghdad city was conducted. The overall prevalence rate of eye diseases in the study population [a total of 21462 subjects],including the wearing of glasses, was 32.7% of the total population 20.4% wore spectacles 64.5% of the total population had eyes with a dark-colored iris, but only 2.9% had color blindness

Lighting and its effects on health status of female workers in a sewing factory-Iraq

A clinico-epidemiological study was under taken to evaluate the effect of light on the health status of 404 female workers [SG] in a modern sewing factory. 95.8% of the work places occupied by workers showed an illumination level below the lower limit of the Iraqi standard illumination level [ISIL].63.3% of SG were found to have defective visual acuity [DVA]. 38.6% of SG had defective distant vision [DVD] and defective near vision [DNV]. 11.9% of the SG had defective distant vision [DSV] only and 12.9% of them had defective near vision [DNV- only]. No significant difference was found between types of work regarding DDV [P>o.o5] DNV [P<0.001]

prevalence rate of hypertension among a group of industrial population-Iraq

The point prevalence of hypertension [HT] among 1098 male workers with five years of continuous employment was found to be 11.8%, 75% were newly discovered. HT was found to be more prevalent among employees of the general service department. Raised blood pressure was found to be associated significantly with duration of employment using the multiple regression analysis

prevalence of low back pain among workers in an engineering factory-Iraq

The 12 month prevalence rate [PR] of low back pain [LBP] among 1098 male workers working in an engineering factory for more than five years was 16.7% which was significantly prevalent among sedentary workers The PR of LBP was increasing with both advancing age and increasing body weight. A high ESR was found to be associated significantly with LBP. Weight reduction programs are recommended

Suggested reference range of ESR for healthy Iraqi male workers below fifty years of age

A cross-sectional epidemiological survey was conducted on 1098 male employee. who spent more than five-continuous years in AL-Qadissiya State Establishments Factory. Elevated erythrocyte sedimentation [ESR] was found to be associated significantly with increasing age, diabetes and low back pain, but no such relation was found with hypertension and varicose veins. The suggested reference range ESR for healthy male workers below fifty years of age was found to be 0-24 m [West.]/hr

Fluoride absorption among workers of lamps factors

41 workers exposed to fluoride. and 28 non-exposed workers were studied. No significant difference in mean urinary fluoride level [MUFL] was observed between male and female workers, and between Iraqi and Chinese workers. There was significance difference between the pro and post-shift MUFL. A strong correlation was observed between MUFL and duration of exposure, and also between MUFL. and air fluoride level. It is suggested that MUFL might be considered as a good index of fluoride absorption

prevalence of diabetes mellitus among male workers in an engineering factory Iraq

Across-sectional epidemiological survey was conducted on 1098 male employees who spent more than five continuous years in an engineering factory. The point Prevalence [PR] of diabetes mellitus [DM] and impaired glucose tolerance [IGT] among the study group was found to be 2.8% and 11.5%, respectively- The PR of newly discovered subjects in this study was found to be high. DM was found to be more prevalent among workers in surface treatment department [dept.]. Age and body; mas index [BMI] were correlated significantly and independently to 2hr post-load blood glucose level, but duration of employment was not correlated to blood glucose level. Regular follow up of workers and weight reduction program is recommended

prevalence of knee injuries among first class football players in Iraq

A cross-sectional study was done to study the prevalence rate [PR] of knee injuries [KI] over the last six months among 319 first class professional Iraqi football players [study group= SG] from 17 first class football clubs. 125 male individuals were studied as a comparison group [CG] from the college of education. The PR of KI among SG was higher [35.1%] than that in CG [7.2%]. 24.6% of the SG had a torn collateral ligament. An association was found between the occurrence of KI among SG and their age group or duration of playing. The level of education of the players and their age groups were associated inversely with the PR in players with recurrente KI. Defenders and forward players were found to have a high PR of KI among the SG [40.7% and 40.3% respectively]. The study recommends to increase the players knowledge about different types of KI and to improve the medical services for each club

prevalence of varicose veins among male workers in an engineering factory Iraq

A cross-sectional survey was conducted on 1098 male employees who had five or more years of employment in an engineering factory. The prevalence rate [PR] of varicose veins [vv] was 7.2% the highest PR of VV [17.6%] was in the age group 40-49 years and among workers employed for more than 20 years [14.3%]. This condition was also more prevalent among married workers [10.14%] and among office workers [11.0%]. A statistically significant association [P < 0.005] was found between increased body mass index [BMI] and VV. Weight reduction programs were recommended

Epidemiological study on smoking habit among females in Baghdad city-1991

A questionnaire of 4816 females from different areas of Baghdad City on smoking habit showed that the prevalence rate of smoking habit among females [PR-SHAF] was 13.3%. The PR-SHAF increased as age progressed. 0.3L of females started smoking at the age of 9 years, the percentage of female smokers continued to increase till the age of 24 years [29.5%] then declined to reach 6.9% after the age of 40 years. High PR-SHAF were found among widows [45.42] in comparison to divorcedo [42.4%] or married women [14.3%] or singles [5.4%]. The PR-SHAF decreased as the level of education among females increased. House wives showed a high PR of smoking habit [22.7%] followed by clerical women [18.5%] teachers [18%] then students [6.8%]. The most prevalent cause for smoking was the presence of smoking habit in the family [25.3%] and psychological problems [21.9%]. Several causes prevented females from stopping smoking such as inability to stop smoking [20.1%]. feeling she is addict to smoking [19.6%] and the presence of problems [17.4%]. The study recommends to consider the results in the anti-smoking program which is usually designed by the public health planners

Mercury exposure in chloralkali factory-Iraq

A total of 61 workers [50 exposed workers-EW to mercury vapor and 11 non exposed workwes-NEW] were investigated. The mean urinary mercury concentration [MUMC] was significantly different [P<0.005] among workers exposed for different times to air born mercury level [ABML]. Workers with history of exposure to mercury [Hg] for more than ten years showed higher prevalence of toxicity. Recommendation are given to reduce the work hazards