Between 1990 and 1997, being deployed to the Gulf War appears to have resulted in a slight increase in all-cause mortality for female veterans compared with female veterans who served in the military during the same time but were not deployed (OR 1.16, 95% CI 0.97-1.38). Deployed female veterans were at increased risk for death from external causes (OR 1.39, 95% CI 1.08-1.80), particularly motor vehicle accidents (OR 1.63, 95% CI 1.09-2.45). The vital status of 621,902 Gulf War veterans (7.0% women) was compared with that of 746,248 era controls (13.3% women) based on databases from the VA and the SSA and assessment of death certificates (Kang and Bullman, 2001).

Summary and Conclusions

Female Gulf War veterans experienced many of the exposures and stressors that male Gulf War veterans experienced while deployed to the Persian Gulf region in 1990-1991, including combat stressors such as seeing dead bodies and being near Scud missile explosions. In addition, female veterans were more likely to be subjected to sexual harassment and sexual assault than were male veterans.

The number of female military personnel who served in the Gulf War theater was much smaller (about 7%) than the number of males and this is reflected in the subsequent studies of the health effects of serving in the Gulf War. For this reason, few studies of Gulf War veterans include women, and most of these are unable to examine the health effects experienced by female veterans separately from male veterans because of small sample sizes. However, the few studies that did provide information on health effects seen in female Gulf War veterans who were deployed compared with female veterans who were in the military during the Gulf War but were not deployed, were reviewed by the Update committee. In general, the findings from the studies suggest that female Gulf War veterans suffer from many of the same health effects as do male Gulf War veterans but a larger proportion of them report more health symptoms, including Gulf War or multisymptom illness, than either male Gulf War veterans or nondeployed female veterans.

Although deployed female veterans report more adverse reproductive outcomes, these outcomes are often based on self-reports and there is no consistency in the type of adverse outcomes reported. For example, although more deployed female veterans reported giving birth to a child with a likely birth defect in 1996, by 2005, female veterans who had been deployed reported fewer miscarriages in the 6 months prior to the survey.

All of the studies of the mental health of female veterans indicate that the prevalence of mental health disorders was greater in deployed women compared to nondeployed women or to deployed men (even after adjustment for combat exposure). As with the deployed male veterans, increased exposure to combat stressors or sexual assault resulted in a greater risk for the development of PTSD. Female veterans were more likely to be the subject of sexual assault than male veterans, but male veterans were more likely to have mental health disorders as a result.

The committee concludes that female veterans who were deployed to the Gulf War have an increased prevalence of adverse health effects, including mental health disorders, compared with their nondeployed counterparts and with deployed male veterans.

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