1. INTRODUCTION

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The Korean War saw Australia commit its armed Services to the first collective, aggressive United Nations (UN) Force, which involved 20 other member countries. Nearly 18,000 Australian armed forces personnel served in combat from 1950 to 1953, or as part of the UN Command to preserve the independence of the Republic of Korea (South Korea) after the 1953 cease-fire, until the final Australian units were withdrawn in 1956.

The Korean War is notable for several significant battles, a severely hostile climate and a lack of public interest despite a total of over four and a half million casualties from both sides. Despite first initiatives to end the war in 1951, many long months of hazardous static warfare ensued while armistice negotiations dragged on.

As with veterans of other major military conflicts throughout history, Korean War veterans are likely to hold mixed memories of painful losses and life benefits associated with their military experiences. Various studies have shown that the experience of war, and the subsequent transition from military to civilian life, can have legacies that manifest in a variety of physical health and psychological health problems. [1]

Literature on physical health problems in Korean War veterans includes investigations of combat injury and other service-related disabilities, [2, 3] frostbite, [4] Korean haemorrhagic fever, [5, 6] and malaria. [7] Prisoner of War (POW) status, in particular, is associated with tuberculosis and liver cirrhosis, [8] hepatitis B infection, [9] duodenal ulcers, [10] strongyloidiasis [10, 11] and various other disorders of the nervous system and sense organs, and gastrointestinal, genitourinary, circulatory and musculoskeletal systems. [12]

The adverse psychological health effects of combat experience through WWII and in to the 1950’s were frequently measured according to such global terms as combat fatigue, [13] shell shock, [14] battle exhaustion [15] and combat stress reaction. [16] The symptoms of these disorders can be described in contemporary terms under a syndrome known as posttraumatic stress disorder (PTSD), a type of anxiety disorder. [17] Symptoms include emotional numbing, behavioural changes and re-experiencing of similar or related events (such as flashbacks). [17] As post war syndromes have been investigated further it has been found that depression, other anxiety disorders and substance abuse also appear to be elevated in combat-exposed populations. [18]

Until now, no studies have thoroughly investigated the adverse effects of Australia’s involvement in the Korean War on the burden of illness in surviving Australian veterans. This report describes the results of a new study comparing the general physical and psychological health of Australian male Korean War veterans with that of a comparison sample of similarly aged, Australian men who lived in Australia at the time of the Korean War but who did not serve in that conflict. More specifically, the study compares the two populations on measures of general physical functioning, quality of life including level of life satisfaction, hospitalisations, general psychological functioning, anxiety including posttraumatic stress disorder, depression, alcohol disorders and common medical conditions. Further, the study investigates whether Korean War deployment characteristics, such as Service branch, age and level of rank at deployment, duration and era of deployment and combat severity, are associated with current health. Female Korean War veterans comprised 0.3% of the total Australian deployment, and were excluded from the study due to their extremely small numbers and because health patterns in men and women can be quite different.

This study was designed to complement the Korean War veterans’ Mortality [19] and Cancer Incidence [20] Studies and is a cross-sectional study including the entire cohort of surviving Australian male Korean War veterans and a smaller sample of community based, age matched Australian men. Participants were invited to partake via mailed invitation and health data was obtained primarily via self-administered questionnaire.

Prior to the main study commencing, a pilot study was conducted to evaluate various aspects of the main study protocol including participation rates and quality of returned data. The results of the pilot study are presented in Appendix M. The final design of this main study was based on several recommendations arising from the pilot study results.