Epidemiologic Survey Of Adverse Health Effects In The Population Of Saudi Arabia Associated With The 1991 Gulf War

ISEE-241 Introduction: The Persian Gulf War of 1990 to 1991 had a significant impact on residents of the Kingdom of Saudi Arabia (KSA). The war exposed the population of the Kingdom to direct health stressors including air pollution from oil spills and fires, combat and troop activities, as well as indirect psychological and social stressors related to the conflict. A major component of a program to assess the health effects associated with the Gulf War on the population of the Kingdom was a population-based health survey, titled the Exposure and Health Survey (E&HS). This survey was conducted in 2003 to characterize the consequences for the physical and mental health of the residents of KSA impacted by the events of 1990 to 1991. The survey had three purposes: (1) to provide a general characterization of the health of Saudi citizens after the conflict; (2) to characterize the health consequences attributable to physical and psychological exposures for the population as the basis for estimating past and future medical morbidity and attendant costs due to the 1990 to 1991 Gulf War, and (3) to identify conditions and individuals for the purpose of targeting future medical monitoring towards those affected by the conflict. Methods: The E&HS was a representative sample survey comprising 19,856 participants from the population of the Kingdom of Saudi Arabia. The total survey population was divided approximately equally across three geographically defined exposure groups defined by varying levels of exposure to smoke and military activities and movements and an “unexposed” control group. Persons who had resided in areas directly or indirectly exposed to agents and conditions associated with the conflict and events following the Iraqi invasion of Kuwait, as well as those in the unexposed control population, were interviewed in order to determine the health impact of these events. The E&HS collected information on individual attributes such as physical characteristics, socioeconomic indicators, exposure to harmful agents, and physical and mental health outcomes as well as histories of traumatic experiences and the health status of family members. Results: Relative risk estimates for a number of acute and chronic health conditions are reported, with findings of an increased risk for a number of illnesses and other adverse health outcomes in relation to exposure to both smoke from the fires and troop activities related to the Gulf War conflict. Discussion: The results of the survey provide a useful characterization of current and historical health and wartime experiences among the Saudi population, as well as a picture of the consequences of the Gulf War conflict, 12 years after its end. Estimates of the attributable risk of exposure indicated that a substantial percentage of acute adverse health effects were due to exposure during the war period.