Study

Design

Population

Outcomes

Results

Adjustments

Comments

Studies of respiratory outcomes specifically associated with modeled oil-well fire exposure

Cowan et al., 2002 (Vol. 4)

Case-control study of exposure to smoke from oil-well fires; DoD registry, Army only

873 with asthma vs 2464 controls

Physician-assigned diagnosis of asthma 3-6 years after war

Self-reported exposure: OR 1.56 (95% CI 1.23-1.97) Cumulative modeled exposure: OR 1.24 (95% CI 1.00-1.55) for intermediate cumulative modeled exposure; OR 1.40 (95% CI 1.11-1.75) for high exposure. Number of days at > 65 µg/m3: OR 1.22 (95% CI 0.99-1.51) for 1-5 days; OR 1.41 (95% CI 1.12-1.77) for 6-30 days

Sex, age, race, military rank, smoking history, self-reported exposure

Effect seen in former smokers and never-smokers, but not current smokers. Key strength: modeled exposure rather than only self-reported exposure. Limitations: self-selected population; no specified criteria for asthma diagnosis and no pulmonary function data; pre-exposure asthma status unknown

Lange et al., 2002 (Vol. 4)

Cross-sectional study of exposure to smoke from oil-well fires; derived from cohort study

1560 Iowa veterans

Asthma symptoms; bronchitis symptoms; structured interviews conducted 5 years after the war

For modeled exposure, adjusted ORs for quartiles of exposure, 0.77-1.26 with no dose-response relationship; for self-reported exposure, asthma ORs 1.77-2.83, bronchitis ORs 2.14-4.78

Sex, age, race, military rank, smoking history, military service, level of preparedness for war

Key strengths: modeled exposure rather than only self-reported exposure, population-based sample. Key limitation: symptom-based case definition of bronchitis and asthma

Smith et al., 2002 (Vol. 4)

DoD hospitalizations 1991-1999; exposure modeling for oil-well fire smoke

405,142 active-duty Gulf War veterans

ICD-9-CM codes for: Asthma Acute bronchitis Chronic bronchitis Emphysema Respiratory conditions due to chemical fumes and vapors Other respiratory

Exposed vs nonexposed:

RR 0.90 (95% CI 0.74-1.10)

RR 1.09 (95% CI 0.62-1.90)

RR 0.78 (95% CI 0.38-1.57)

RR 1.36 (95% CI 0.62-2.98)

RR 0.71 (95% CI 0.23-2.17)

“Influential predictors” of p < 0.15 included in analyses

Objective measure of disease not subject to recall bias; no issues with self-selection; however, only DoD hospitals, only active duty, no information on smoking or other exposures that may be

 

 

 

RR 1.45 (95% CI 0.86-2.46)

 



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