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Bergman, Beverly P.; Mackay, Daniel F.; Pell, Jill P. (2015)
Publisher: BMJ Publishing Group
Languages: English
Types: Article

Classified by OpenAIRE into

mesheuropmc: humanities, health care economics and organizations
Objectives: In 2003, it was reported that motor neurone disease was linked to military service in the 1990–1991 Gulf War. A large study in the US confirmed an association with military service but found no association with specific conflicts or length of service. Non-veteran studies have suggested an association with physical activity, smoking and other risk factors. We used data from the Scottish Veterans Health Study to investigate the association between motor neurone disease and military service in UK veterans.\ud \ud Methods: Retrospective cohort study of 57 000 veterans born 1945–1985, and 173 000 demographically matched civilians, using Cox proportional hazard models to compare the risk of motor neurone disease overall, and by sex, birth cohort, length of service and year of recruitment. We had no data on smoking prevalence.\ud \ud Results: Veterans had an increased risk of motor neurone disease compared with non-veterans (adjusted HR 1.49, 95% CI 1.01 to 2.21, p=0.046). The increase was independent of birth cohort, length or period of service, or year of recruitment. Risk was associated with a history of trauma or road traffic accident in veterans and non-veterans.\ud \ud Conclusions: We confirmed an increased risk of motor neurone disease in military veterans, although the absolute risk is extremely low. We found no evidence that the increased risk was associated with any specific conflict. We could not rule out that smoking (and perhaps other lifestyle factors) may be responsible for our findings. Trauma may play a role in the increased risk but further studies are needed.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. Chancellor A, Slattery J, Fraser H et al. The prognosis of adult-onset motor neuron disease: a prospective study based on the Scottish Motor Neuron Disease Register. J Neurol . 1993;240:339-46.
    • 2. Binns JH, Barlow C, Bloom FE et al. Gulf War Illness and the Health of Gulf War Veterans. DTIC Document . ref. ADA490518, 2008. http://oai.dtic.mil/oai/oai?verb=getRecord&metadataPrefix=html&identifier=ADA490518 last accessed 3 Feb 15.
    • 3. Haley RW. Excess incidence of ALS in young Gulf War veterans. Neurology. 2003;61(6):750-6.
    • 4. Horner RD, Kamins KG, Feussner JR et al. Occurrence of amyotrophic lateral sclerosis among Gulf War veterans. Neurology. 2003;23(6):742-9.
    • 5. “VA Secretary Established ALS as a Presumptive Compensable Illness” [press release]. 2008. http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1583 last accessed 3 Feb 15.
    • 6. Rose MR. Gulf War service is an uncertain trigger for ALS. Neurology. 2003;61(6):730-1.
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    • 8. Weisskopf MG, O'Reilly EJ, McCullough ML et al. Prospective study of military service and mortality from ALS. Neurology. 2005;64(1):32-7.
    • 9. Bergman BP, Mackay DF, Pell JP. Acute Myocardial Infarction in Scottish Military Veterans: A Retrospective Cohort Study of 57,000 Veterans and 173,000 Matched Nonveterans. Am J Epidemiol. 2014;179(12):1434-41.
    • 10. Grambsch PM, Therneau TM. Proportional hazards tests and diagnostics based on weighted residuals. Biometrika. 1994;81:515-26.
    • 11. Johnson RT, Bradley WG, Ritz BR et al. Amyotrophic Lateral Sclerosis in Veterans: Review of the Scientific Literature. Washington DC: National Academies Press; 2006.
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  • Discovered through pilot similarity algorithms. Send us your feedback.

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