2 February 1999

War Can Be A Health Hazard (Maybe)

In this week's British Medical Journal (BMJ), physicians working in the Ministry of Defence's Medical Assessment Programme describe their independent clinical findings on Gulf War veterans coming forward for assessment. These findings confirm other recent work that suggests no single physical or psychological cause is responsible for the illnesses seen in some Gulf War veterans. The authors speculate that this pattern of illness has been described after previous conflicts and may be another example of, what have been described as, "postwar syndromes".

Dr Bill Coker and colleagues assessed 1 000 Gulf War veterans who sought medical treatment between October 1993 and February 1997. They found that 59 per cent of veterans had more than one diagnosed condition; 39 per cent had at least one condition for which no physical or psychological diagnosis could be given and in nearly 9 per cent of patients, no diagnosis could be made.

The conditions that were reported by veterans were characterised by fatigue in 24 per cent and psychiatric conditions in 19 per cent of patients. Musculoskeletal disorders and respiratory conditions were also found to be relatively common (18 per cent and 16 per cent respectively).

The authors conclude that from a clinical standpoint, the variety and multiplicity of symptoms make it unlikely that any single cause will be found to underlie the ill health described in some veterans. However, in light of a recent study, which found that active service has often been associated with illnesses occurring in the post-war period, Coker et al speculate that some of the illnesses experienced by veterans may be explained by the phenomenon of "postwar syndromes".