Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #111744

Aaron I. Schneiderman, PhD, RN¹, Andrew E. Lincoln, ScD, MS², Drew Helmer, MD, MS³, H. Liesel Copeland, PHD⁴, Michelle K. Prisco, MSN¹, Gudrun Lange, PhD³, Han K. Kang, DrPH¹, and Benjamin H. Natelson, MD³. (1) War-Related Illness & Injury Study Center (WRIISC), U.S. Department of Veterans Affairs, 50 Irving Street, NW (MS 11), Washington, DC 20422, 202-745-8000 X6236, aaron.schneiderman@med.va.gov, (2) MedStar Research Institute, 6495 New Hampshire Avenue, Suite 201, Hyattsville, MD 20783, (3) DVA-New Jersey Healthcare System, 385 Tremont Avenue, VAMC #129, East Orange, NJ 07018, (4) Health Education and Behavioral Science, UMDNJ SPH, 200 Second Ave, Piscataway, NJ 08854

Purpose: Military veterans often return from combat having experienced a wide range of physical and psychological exposures, symptoms, and medical conditions. This study describes the combat veterans with deployment-related health concerns and medically unexplained symptoms who were referred to the Department of Veterans Affairs War-Related Illness and Injury Study Centers (WRIISCs).

Methods: Patients referred to the two specialized centers were extensively evaluated. We report the clinical characteristics, environmental exposures, health status, healthcare utilization, and satisfaction of 53 combat veterans who participated in the National Referral Program (NRP) from January 2002 until March 2004.

Results: Participants were primarily male (81%) and served in the Gulf War (79%). Common diagnoses were chronic fatigue syndrome (n=23, 43%), neurotic depression (n=21, 40%), and posttraumatic stress disorder (n=20, 38%). Self-reported exposures related to weaponry, disease prophylaxis, environmental hazards, stress, and poor hygiene. A small increase in mean SF-36V mental component scores (2.8 points, p-value=0.009) and use of rehabilitation therapies (1.6 additional visits, p=0.018) followed the NRP referral.

Implications: The results document the health status of combat veterans who continue to experience deployment-related health problems more than 10 years following combat participation. The WRIISCs represent an expanded effort by VA to address the unexplained symptoms that many combat veterans experience. The small gain in mental function following the consultation suggests the NRP may benefit combat veterans with long and complex medical histories. Given the deployment health concerns of past and current conflicts, the WRIISCs will likely become an increasingly important resource for veterans' post-deployment health.

Learning Objectives:

• Recognize the existence of medically unexplained symptoms associated with modern warfare.
• Discuss the clinical approach utilized by the WRIISCs in assessing unexplained symptoms in military veterans and the program’s performance.
• List the most commonly reported symptoms, diagnoses, and environmental exposures cited by combat veterans of recent wars.

Keywords: Environmental Exposures, Veterans

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.