diseases related to respiratory symptoms, most adults with asthma or chronic bronchitis have never been hospitalized for that condition

Study of respiratory outcomes specifically associated with exposure to Khamisiyah nerve agent

Gray et al., 1999b (Vol. 4)

DoD hospitalizations 1991-1995, exposure to nerve agents at Khamisiyah based on 1997 DoD exposure models

Not exposed (n = 224,804), uncertain low-dose exposure (n = 75,717), exposed (n = 48,770)

Respiratory system disease (vs not exposed): Uncertain low dose < 0.013 mg-min/m3 0.013-0.097 mg-min/m3 0.097-0.514 mg-min/m3


Sex, age group, prewar hospitalization, race, service type, marital status, pay grade, occupation

See Smith et al., 2002. Probable substantial exposure misclassification as models were revised, lack of a clear dose-response pattern, little biologic plausibility given that no effect was seen for nervous system diseases

OR 0.92 (95% CI (0.85-0.99)

OR 0.90 (95% CI 0.77-1.04)

OR 0.89 (95% CI 0.79-1.02)

OR 1.26 (95% CI 1.05-1.51)

Bullman et al., 2005 (Update)

Cohort mortality study; follow-up from March 1991 through 2000

100,487 US Army GWVs exposed to chemical warfare agents at Khamisiyah; 224,980 nonexposed army GWVs; exposure determined from the DoD plume model (Rostker, 2000)

Association of exposure to chemical warfare agents and respiratory disease mortality, determined through BIRLS, SSA; COD data from NDI

Exposed vs unexposed RR 1.03 (95% CI 0.62-1.72)

Age, race, sex, rank, unit component

 Limitations: short latency, possible exposure misclassification

NOTE: BIRLS = Beneficiary Identification and Records Locator Subsystem (VA); CI = confidence interval; COD = cause of death; DMDC = Defense Manpower Data Center; FEV1 = forced expiratory volume in the first second of expiration; FVC = forced vital capacity; GWV = Gulf War veteran; HR = adjusted hazard ratio; NDI = National Death Index; NS = not significant; OR = adjusted odds ratio; PFT = pulmonary function test; RR = adjusted risk ratio; SSA = Social Security Administration.

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