Predicting self-reported exposure to nerve agents by reserve component personnel during the first Persian Gulf War.

Approximately 13% of 654 Reserve Component Gulf War veterans (18% women, 65% ground forces, between 24 and 61 years of age, average 40.2 yr.) surveyed in the Ohio Desert Storm Research Project reported that they had probably been exposed to nerve or mustard gas agents, while another 32% thought such exposures were possible. Reports of exposure were found, through ordinary least squares regression analysis, to be associated with membership in ground forces (Army/Marine Corps) (b = .29), geographical location (b = .17), ethnic minority status (b = .07), education (b = -.10), intrinsic religiosity (b = .10), and also reporting having had physiological reactions to vaccines or pyridostigmine bromide pills (b = .24). Reports were not associated significantly with subjective health before the war, age, or sex.

Comments on the Institute of Medicine's 2002 report on the safety of anthrax vaccine.

In April 2002, the prestigious Institute of Medicine of the National Academy of Sciences issued a final report on the safety and effectiveness of the anthrax vaccine currently in use by the United States military. It concluded that the present vaccine was completely safe and effective, but ignored evidence of several recent research studies from three different nations that have implicated vaccines, often including anthrax vaccine, in the epidemiology of Gulf War illnesses. Omissions and limitations of that report are discussed.

Pyridostigmine bromide and the long-term subjective health status of a sample of over 700 male Reserve Component Gulf War era veterans.

Data from a 1996-1997 survey of approximately 700 Reserve Component male veterans indicate that the consumption of pyridostigmine bromide pills, used as a pretreatment for potential exposure to the nerve agent Soman, was a significant predictor of declines in reported subjective health status after the war, even after controlling for a number of other possible factors. Reported reactions to vaccines and other medications also predicted declines in subjective health. While higher military rank generally predicted better health during and after the war, educational attainment, minority status, number of days in theater, and age generally did not predict changes in subjective health. Although servicemembers were directed to take three pills a day, veterans reported a range of compliance--less than a fourth (24%) followed the medical instructions compared to 61% who took fewer than three pills daily and 6% who took six or more pills a day. Implications for use of pyridostigmine bromide are discussed.

Self-reported changes in subjective health and anthrax vaccination as reported by over 900 Persian Gulf War era veterans.

A 1999 study of United Kingdom servicemembers by Unwin, et al. recently found significant relationships between anthrax and other vaccinations, reactions to those vaccines, and later health problems for male current or former active military Gulf War veterans. Likewise, in 2000 Steele and in 1998 Gilroy found possible adverse effects of vaccinations on Gulf War veterans. However, the role of such vaccinations remains controversial; more recent government reports continue to dispute the existence of any data that might reflect adversely on the role of vaccinations on the health of Gulf War veterans. To address this controversy, the current study assessed similar relationships for over 900 Reserve Component Gulf War Era veterans from Ohio and nearby states. Gulf War veterans were more likely to report poorer health than non-Gulf veterans. Female veterans were more likely to report mild or severe reactions to vaccines than male veterans. Those veterans who received anthrax vaccine reported more reactions to vaccines than those who did not receive anthrax vaccine. Declines in long-term subjective health were associated with receipt of anthrax vaccine by Gulf War veterans but not for those who did not deploy to the Gulf, although few of the latter received anthrax vaccine. Regardless of deployment status, veterans who reported more severe reactions to vaccines were more likely to report declines in subjective health. Female veterans reported poorer health during the Gulf War than did male veterans, but sex was not related to veterans' reports of subjective health at subsequent times. It is recommended that servicemembers who experience severe reactions to anthrax vaccine be medically reevaluated before receiving further anthrax vaccine and that careful follow-ups be conducted of those receiving the vaccine currently, in accordance with Nass's 1999 recommendations. We also recommend that safer alternatives to thimerosal (a mercury sodium salt, 50% mercury) be used to preserve all vaccines.