The Health of Former Prisoners of War

Results from the Medical Examination Survey of Former POWs of World War II and the Korean Conflict

A Report for the Medical Follow-up Agency
Institute of Medicine
by

WILLIAM FRANK PAGE

NATIONAL ACADEMY PRESS
Washington, D.C. 1992



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement



Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.

OCR for page R1
The Health of Former Prisoners of War: Results from the Medical Examination Survey of Former POWs of World War II and the Korean Conflict The Health of Former Prisoners of War Results from the Medical Examination Survey of Former POWs of World War II and the Korean ConflictA Report for the Medical Follow-up Agency Institute of Medicine by WILLIAM FRANK PAGE NATIONAL ACADEMY PRESS Washington, D.C. 1992

OCR for page R1
The Health of Former Prisoners of War: Results from the Medical Examination Survey of Former POWs of World War II and the Korean Conflict NATIONAL ACADEMY PRESS 2101 Constitution Ave., N.W. Washington, D.C. 20418 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council (NRC), whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. Ordinarily, the NRC appoints a committee of experts to produce a report, which then undergoes independent review according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. In the case of this report, the Medical Follow-up Agency’s (MFUA) general oversight body, the Committee on Epidemiology and Veterans’ Follow-up Studies, has provided overall guidance; the study, however, was conducted by MFUA staff and the report written by an MFUA staff officer. Although this report has been reviewed in accordance with established NRC procedures, it represents the views of its author and not the deliberations of an expert NRC committee. The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy’s 1863 congressional charter responsibility to be an advisor to the federal government and its own initiative in identifying issues of medical care, research, and education. This project was supported by funds from the Department of Veterans Affairs under contract V101(93)P-1225. Library of Congress 92-62023 ISBN 0-309-04791-9 Additional copies of this report are available from: National Academy Press 2101 Constitution Avenue, NW Washington, DC 20418 B031 Copyright 1992 by the National Academy of Sciences. All rights reserved. Printed in the United States of America The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The image adopted as a logotype by the Institute of Medicine is based on a relief carving from ancient Greece, now held by the Staatlichemuseen in Berlin.

OCR for page R1
The Health of Former Prisoners of War: Results from the Medical Examination Survey of Former POWs of World War II and the Korean Conflict Preface The beginnings of the Medical Follow-up Agency (MFUA) study of former prisoners of war (POWs) can be found in the early 1950's when the Veterans Administration (now the Department of Veterans Affairs) initiated a program of studies of the medical status of POWs compared with non-POW controls. The latest follow-up component of this long-term study was begun in August 1986 under a contract with the National Research Council (NRC) to conduct a medical examination survey of these groups. Ordinarily, the NRC appoints a committee of experts to produce a report, which then undergoes independent review according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. In the case of this report, the MFUA's general oversight body, the Committee on Epidemiology and Veterans' Follow-up Studies—chaired by the late Richard D. Remington—has provided overall guidance; the study, however, was conducted by MFUA staff and the report written by an MFUA staff officer. Although this report has been reviewed in accordance with established NRC procedures, it represents the views of its author and not the deliberations of an expert NRC committee. It is in the nature of long, complicated longitudinal studies such as this one that recent work builds on the foundation of earlier efforts. For that reason, I am especially appreciative of the soundness of earlier work by Cohen, Cooper, Nefzger, Beebe, and Keehn (see the reference list later in this volume). The staff of the MFUA likewise deserve acknowledgment

OCR for page R1
The Health of Former Prisoners of War: Results from the Medical Examination Survey of Former POWs of World War II and the Korean Conflict and a great share of the credit for careful, tireless work in collecting and organizing the data on which this report is based. Special thanks go to Chiquita Benson, Harriet Crawford, and Mary Williams for their assistance. The support of such a long, complex study—indeed, the entire series of studies—by Department of Veterans Affairs (VA) staff is also greatly appreciated. I would be remiss if I did not make special mention of project officer David Thomas and his successor, Robert Meci, as well as numerous VA Central Office staff in the Medical Research program. Space limitations prevent my thanking individually the many VA field personnel who contributed their time and experience on behalf of this study; I am particularly indebted to those VA personnel who met with me during visits to their stations. (A list of site visits can be found in Appendix B.) I would also like to thank Brian Engdahl and Steven Oboler for their helpful comments on an earlier version of this manuscript and Susan Solomon and Ellen Gerrity of the National Institute of Mental Health for their support and sponsorship of the last-minute supplemental psychological data collection. Finally, of course, I am indebted to those former POWs and combat veterans who volunteered to come to a nearby VA medical center to be examined. Not only were the examinations themselves arduous because they were so extensive, but it was no doubt difficult to relive sometimes extraordinarily unpleasant past experiences. To our gratitude for their earlier sacrifices in wartime we must add our thanks for their recent efforts in this study. William Frank Page

OCR for page R1
The Health of Former Prisoners of War: Results from the Medical Examination Survey of Former POWs of World War II and the Korean Conflict Contents     SUMMARY   1 1   BACKGROUND   12 2   DATA COLLECTION PROCEDURES   17 3   FINAL STATUS OF DATA COLLECTION   24 4   GENERAL RESULTS   33 5   EXAMINATION OF BASIC RESEARCH QUESTIONS   43 6   FURTHER ANALYSES OF EXAMINATION DATA   71 7   REVIEW OF DATA QUALITY AND STUDY FINDINGS   85 8   LITERATURE REVIEW AND FURTHER DISCUSSION OF FINDINGS   93 9   FUTURE WORK   126     APPENDIXES   129     A. VA Circulars   131     B. List of Site Visits to VA Medical Facilities (with Map)   149     C. Detailed Diagnostic Data from the Medical Examination   151

OCR for page R1
The Health of Former Prisoners of War: Results from the Medical Examination Survey of Former POWs of World War II and the Korean Conflict This page in the original is blank.