{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T07:20:43Z","timestamp":1781594443371,"version":"3.54.5"},"reference-count":68,"publisher":"BMJ","issue":"2","funder":[{"name":"US DoD Congressionally Directed Medical Research Program"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,1,18]]},"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Across diverse groups of Gulf War (GW) veterans, reports of musculoskeletal pain, cognitive dysfunction, unexplained fatigue, chronic diarrhoea, rashes and respiratory problems are common. GW illness is a condition resulting from GW service in veterans who report a combination of these symptoms. This study integrated the GW literature using meta-analytical methods to characterise the most frequently reported symptoms occurring among veterans who deployed to the 1990\u20131991 GW and to better understand the magnitude of ill health among GW-deployed veterans compared with non-deployed GW-era veterans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Literature databases were searched for peer-reviewed studies published from January 1990 to May 2017 reporting health symptom frequencies in GW-deployed veterans and GW-era control veterans. Self-reported health symptom data were extracted from 21 published studies. A binomial-normal meta-analytical model was used to determine pooled prevalence of individual symptoms in GW-deployed veterans and GW-era control veterans and to calculate combined ORs of health symptoms comparing GW-deployed veterans and GW-era control veterans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>GW-deployed veterans had higher odds of reporting all 56 analysed symptoms compared with GW-era controls. Odds of reporting irritability (OR 3.21, 95%\u2009CI 2.28 to 4.52), feeling detached (OR 3.59, 95%\u2009CI 1.83 to 7.03), muscle weakness (OR 3.19, 95%\u2009CI 2.73 to 3.74), diarrhoea (OR 3.24, 95%\u2009CI 2.51 to 4.17) and rash (OR 3.18, 95%\u2009CI 2.47 to 4.09) were more than three times higher among GW-deployed veterans compared with GW-era controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The higher odds of reporting mood-cognition, fatigue, musculoskeletal, gastrointestinal and dermatological symptoms among GW-deployed veterans compared with GW-era controls indicates these symptoms are important when assessing GW veteran health status.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-016086","type":"journal-article","created":{"date-parts":[[2018,2,13]],"date-time":"2018-02-13T09:06:39Z","timestamp":1518512799000},"page":"e016086","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":67,"title":["Meta-analysis of self-reported health symptoms in 1990\u20131991 Gulf War and Gulf War-era veterans"],"prefix":"10.1136","volume":"8","author":[{"given":"Alexis L","family":"Maule","sequence":"first","affiliation":[{"name":"Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA"},{"name":"Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia A","family":"Janulewicz","sequence":"additional","affiliation":[{"name":"Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly A","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxine H","family":"Krengel","sequence":"additional","affiliation":[{"name":"Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA"},{"name":"Research Service, VA Boston Health Care System, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan K","family":"Yee","sequence":"additional","affiliation":[{"name":"Research Service, VA Boston Health Care System, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"McClean","sequence":"additional","affiliation":[{"name":"Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta F","family":"White","sequence":"additional","affiliation":[{"name":"Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA"},{"name":"Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,2,13]]},"reference":[{"key":"2025121219364742000_8.2.e016086.1","unstructured":"Research Advisory Committee on Gulf War Veterans\u2019 Illnesses. 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