Respiratory health status of Australian veterans of the 1991 Gulf War and the effects of exposure to oil fire smoke and dust storms

Background: Since the 1991 Gulf War concerns have been raised about the effects on veterans' health of exposures to Kuwaiti oil fire smoke and to dust storms. Methods: A cross sectional study compared 1456 Australian Gulf War veterans with a randomly sampled military comparison group ( n = 1588). A postal questionnaire asked about respiratory conditions, exposures, medications, tobacco use, demographic characteristics, and military service details. During a medical assessment, spirometric tests and a physical examination were performed and a respiratory questionnaire was administered. Results: The response rate for the Gulf War veteran group was 80.5% and for the comparison group 56.8%. Australian Gulf War veterans had a higher than expected prevalence of respiratory symptoms and respiratory conditions suggesting asthma ( OR 1.4; 95% CI 1.1 to 1.9) and bronchitis first diagnosed since the Gulf War (OR 1.9; 95% CI 1.2 to 3.1) but did not have poorer lung function or more ventilatory abnormalities than the comparison group. Veterans who reported exposure to oil fire smoke had slightly poorer forced vital capacity ( difference between means - 0.10 l; 95% CI - 0.18 to - 0.03) and those exposed to dust storms had a slightly better peak expiratory flow rate ( difference between means 12.0 l/ min; 95% CI 0.6 to 23.4) than veterans who did not report exposure. Veterans who were in the Gulf at or after the start of the oil fires had more respiratory conditions suggesting asthma ( OR 1.7; 95% CI 1.0 to 2.9) than those who completed their deployment before this time. Conclusions: Increased self-reporting of respiratory symptoms, asthma, and bronchitis by veterans was not reflected in poorer lung function. The findings do not suggest major long term sequelae of exposure to oil fire smoke or dust storms.