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The Association Between Self-Reported Types of Toxic Exposures and Symptom Severity Among Gulf War Era Veterans

Bibliographic Data

ID9098987
AuthorsMolly S Phan (VA Portland Health Care System, Portland, OR, corresponding author), Kara Winchell (Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR), Elizabeth R Hooker (0000-0002-1198-4127, VA Portland Health Care System), Elizabeth Hooker (Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR), Jennifer Barton (Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR), Jennifer L Barton (0000-0002-6771-3465, Oregon Health & Science University), Mark Helfand (0000-0003-4846-9900, Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR), Shannon Nugent (Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR), Shannon M Nugent (0000-0003-3173-6590, Oregon Health & Science University)
Year2026
Volume64
Issue2S
PagesS149-S154
Publication date2026-01-01
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000002212
PMID41385260
OpenAlexW4417304989
LanguageEN
Citations received1
References cited18

BACKGROUND: Gulf War illness is a chronic multisymptom illness impacting Veterans of the 1990-1991 Persian Gulf War. Toxic exposures are believed to be associated with the condition, but little is known about how multiple types of exposures can impact the disease. The aim of this study is to determine if a positive association exists between the multiplicity of exposure types and symptom severity score. METHODS: A cross-sectional survey design was used in which Persian Gulf Veterans completed a questionnaire with items related to symptom severity and types of self-reported toxic exposures. Linear regression models were used to examine the association between the number of types of toxic exposures and symptom severity scores. We also examined the association between each type of reported exposure and symptom severity score. RESULTS: Veterans with a greater number of self-reported toxic exposures reported higher scores on symptom severity. While no individual exposure type reached a statistically significant association with symptom score, radiation and biological agent exposures showed the strongest association. DISCUSSION: We found a positive association between the number of toxic exposure types and total symptom severity. Veterans who self-reported having Gulf War Illness also reported more types of toxic exposures compared with Veterans who did not report having Gulf War Illness. Radiation and biological agent exposure showed the strongest positive association with symptom scores, yet very few Veterans reported isolated exposure of these types. Our findings suggest that cumulative exposure to multiple types of toxins could be associated with the development and severity of Gulf War Illness symptoms

Association (psychology) · Gulf war · MEDLINE · Occupational safety and health · Poison control · Severity of illness · Vietnam War · Fibromyalgia and Chronic Fatigue Syndrome Research · Posttraumatic Stress Disorder Research · Psychosomatic Disorders and Their Treatments

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Citations per year1
Citation span2026 - 2026 (1)
Highly citedNo

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