completed in 1995, veterans were not yet notified of possible chemical agent exposure in Khamisiyah. No difference in self-perception of health status was found between the exposed (n = 1898) and unexposed (n = 3336) groups.

Page and colleagues (2005b) also examined the association between notification of possible exposure at Khamisiyah and self-reported morbidity. In 2000, a subsample of 1056 deployed army veterans was surveyed; of the 600 notified subjects, 438 (73%) responded, and of the 456 nonnotified subjects, 318 (70%) responded. Results indicate no significant difference in activity limitations, bed days, or number of clinic or hospital visits among the groups.

Blanchard and colleagues (2005) assessed the prevalence and severity of chronic multisymptom illness (CMI) in the same cohort of deployed (n = 1061) and nondeployed (1128) veterans as described by Eisen and colleagues (2005). Combat exposure was significantly associated with CMI. The prevalence of CMI in the nondeployed population has remained relatively constant at 4, 7, and 10 years postwar. Among the deployed veterans, CMI prevalence has decreased from 44.7% at 4 years to 28.9% after 10 years (Fukuda et al., 1998; Steele, 2000). Blanchard et al. (2005) also assessed for the presence of CMI based on the possible exposure of deployed veterans to nerve agents as a result of the Khamisiyah demolition. Based on DoD modeling, 236 (22.2%) of the deployed veterans were exposed; 92 (39.0%) had CMI, and 144 (61.0%) did not. See Chapter 4 for more details.

Toomey and colleagues (2007) examined the prevalence of mental health disorders, self-report of symptoms, and quality of life in the same cohort of 1061 Gulf War deployed versus 1128 nondeployed veterans 10 years postconflict as that of Eisen et al. (2005). Deployed veterans self-reported lower levels of life satisfaction and their SF-36 scores were significantly lower than the nondeployed veterans. See Chapter 4 for more details.

Toomey and colleagues (2009) also evaluated neuropsychologic functioning 10 years postconflict in the same population as the study described above (Toomey et al., 2007). The measures assessed were based on those previously found to be different between the deployed and nondeployed groups in earlier studies of the same cohort; examples include measures of general intelligence, attention or executive functioning, motor ability, visuospatial processing, and verbal and visual memory. Further details can be found in Chapter 4.

Kang and colleagues (2009) conducted a 10-year follow-up general health assessment using the population of the National Health Survey of Gulf War Veterans and Their Families (15,000 Gulf War deployed and 15,000 nondeployed). In phase I of the follow-up, VA and Social Security records through December 2002 were used to identify and mail health questionnaires to the 29,607 living participants. Phase II consisted of telephone interviews with 2000 nonresponsive participants and a sample of 1000 participants who had indicated a clinic visit or hospitalization within the previous 12 months in order to obtain permission for medical record retrieval. After phases I and II, 6111 (40%) deployed and 3859 (27%) nondeployed participants responded to the survey; overall response rate was low, only 34%. The administered questionnaire was a modified version of that used in the 1995 survey and included the Psychopathy Check List (PCL), the Patient Health Questionnaire (PHQ), and the SF-122 in addition to other items used to assess general health status. See Chapter 4 for more details.

2

“The 12-Item Short Form Health Survey (SF-12) was developed for the Medical Outcomes Study, a multiyear study of patients with chronic conditions. The instrument was designed to reduce respondent burden while achieving minimum standards of precision for purposes of group comparisons involving multiple health dimensions” (RAND Corporation, 2010).



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