Neurology Service, Department of Veterans Affairs (VA) Medical Center, Georgetown University School of Medicine, Washington, D.C., USA.
Neuroepidemiology. 2014;42(4):226-34. doi: 10.1159/000360701. Epub 2014 May 25.
Concern has been raised that US veterans of the 1990-1991 Gulf War (GW1) may be at increased risk to develop neurologic disease.
An incident cohort of multiple sclerosis (MS) and other demyelinating disease (ODD) was assembled from the US military comprising the Gulf War era (1990-2007). Cases of MS and ODD meeting standard diagnostic criteria were matched to a database of all active duty personnel from the Department of Defense. Relative risk (RR) estimates for MS and all demyelinating disease based on onset, deployment status, and exposures were calculated.
For GW1, a total of 1,841 incident cases of definite MS and ODD were identified, with 387 among 696,118 deployed and 1,454 among 1,786,215 nondeployed personnel. The RR for MS alone among those deployed compared to those nondeployed was 0.69 (confidence interval, CI: 0.61-0.78), with 0.72 (CI: 0.62-0.83) in men and 0.96 (CI: 0.75-1.22) in women. Deployment was also nonsignificant or protective as an MS risk factor across racial groups, all age groups, and each military service. RRs for MS by service were: Air Force 0.71 (CI: 0.53-0.96), Army 0.80 (CI: 0.67-0.96), Marines 0.96 (CI: 0.63-1.47), and Navy 0.56 (CI: 0.43-0.74).
Military deployment to GW1 was not a risk factor for developing MS.
人们担忧，1990-1991 年海湾战争（GW1）的美国退伍军人可能面临更高的神经疾病发病风险。
本研究从美国军队中组建了多发性硬化症（MS）和其他脱髓鞘疾病（ODD）的病例队列，该队列涵盖海湾战争时期（1990-2007 年）。符合标准诊断标准的 MS 和 ODD 病例与国防部现役人员数据库相匹配。基于发病时间、部署情况和暴露情况，计算 MS 和所有脱髓鞘疾病的相对风险（RR）估计值。
GW1 共确定了 1841 例明确的 MS 和 ODD 病例，其中 696118 名部署人员中有 387 例，1786215 名非部署人员中有 1454 例。与非部署人员相比，部署人员中 MS 的 RR 为 0.69（置信区间，CI：0.61-0.78），男性为 0.72（CI：0.62-0.83），女性为 0.96（CI：0.75-1.22）。在所有种族群体、所有年龄组和每个军种中，部署与 MS 的风险因素无关或具有保护作用。按军种划分的 MS RR 为：空军 0.71（CI：0.53-0.96）、陆军 0.80（CI：0.67-0.96）、海军陆战队 0.96（CI：0.63-1.47）和海军 0.56（CI：0.43-0.74）。
GW1 的军事部署不是患 MS 的危险因素。
