Smith et al., 2002 (Update)

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

405,142 active-duty GWVs who were in theater during the time of Kuwaiti oil-well fires

Hospitalization for diseases of the blood (ICD-9-CM codes 280-289)

No clear association between exposure and blood disease across all exposure levels

Adjusted for “influential covariates,” defined as demographic or deployment variables with p values less than 0.15

Objective measure of disease not subject to recall bias; no issues with self-selection; however, only DoD hospitals, only active duty, no adjustment for potential confounders such as smoking

Smith et al., 2003 (Update)

DoD hospitalization study (1991-2000); analysis of health outcomes and exposure to nerve agents (follow-up of Gray et al., 1999b)

99,614 active-duty military considered exposed vs 318,458 nonexposed, according to revised DoD exposure model

First hospitalization for any blood disorder (ICD-9-CM codes 280-289)

Exposed vs unexposed: RR 0.96 (95% CI 0.89-1.03)


Restricted to DoD hospitals; restricted to hospitalizations for only Gulf War veterans who remained on active duty after the war; no adjustment for confounding exposures

Ishoy et al., 1999b (Update)


686 Danish peacekeepers deployed to gulf in 1990-1997 vs 231 age- and sex-matched armed forces nondeployed controls

Blood hemoglobin, erythrocyte count, hematocrit, mean corpuscular volume, leukocyte count, and platelet count

Hemoglobin (mmol/L): 9.3 (sd = 0.5) vs 9.3 (sd = 0.6); erythrocytes (million/L): 4.8 (sd = 0.3) vs 4.8 (sd = 0.3); hematocrit 0.44 (sd = 0.25) vs 0.44 (sd = 0.26); corp. vol. (10-15 L): 91 (sd = 3.6) vs 91 ((sd = 3.8); leukocytes (109/L): 5.8 (1.7) vs 5.9 (sd = 1.8); platelets (109/L): 205 (sd = 45) vs 211 (sd = 43), p < 0.05


Participation rate 83.6% deployed, 57.8% nondeployed; no adjustment for possible confounding factors

Sim et al., 2003 (Update)

Cross-sectional, mailed questionnaire and clinical

1355 male and 30 female Australian GWVs; 1361 male and 32 female

Hemoglobin, MCV, MCH, lymphocyte count, platelet count

Hemoglobin (g/L), men: 153.4 (sd = 9.5) vs 153.1 (sd = 9.1); women: 131.8 vs 134.3

Service type, rank, age, education, marital status

High participation in deployed veterans (male 81%, female 79%), but low participation in

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