1. Introduction
Iraq invaded Kuwait on August 2, 1990. In response, Australia provided military forces to the Gulf area in support of United Nations Security Resolutions as part of a larger multinational response. These Australian deployments are defined as operational service for the purposes of the Veteran's Entitlements Act 1986.
Following the Gulf War, defence personnel from several countries that had deployed troops began to report a wide range of health complaints. In response, there has been a sustained effort internationally to investigate the health of Gulf War veterans, with studies having been conducted of Gulf War veterans from the United States of America, Great Britain, Canada and Denmark. While some health problems were found to be more common among these Gulf War veterans, this field of research has had many limitations. These limitations have included health outcome data based mainly on self-report, self-referred populations in registry studies, problems in objectively measuring exposures and difficulties contacting study participants with resultant low response rates, particularly for control groups. Prior to this study, there has been no systematic study of the health of Australian Gulf War veterans.
Most of the published health studies have been of Army Gulf War veterans from the UK and USA. They have therefore tended to focus on health outcomes and exposures of Army veterans, rather than those of veterans in the Navy or Air Force. As over 90% of the Australian Gulf War veterans were in the Navy, the exposures and experiences of Australian Gulf War veterans were likely to be different from those of their international counterparts from the UK and USA. Therefore, the results of published overseas studies may not be relevant or generalisable to Australian Gulf War veterans.
There has been increasing interest among the Australian Gulf War veteran community in a study of Australian Gulf War veterans. In light of this, the limitations of overseas studies and the different service experience of the Australian Defence Force in the Gulf, it was decided to undertake a study to investigate in a comprehensive way the health of Australia's Gulf War veterans. Through an open tender process, research groups were invited in December 1999 to submit proposals to undertake this study. The Department of Epidemiology & Preventive Medicine at Monash University, in collaboration with Health Services Australia, was selected by the Department of Veterans' Affairs to conduct an independent study of the health of Australian Gulf War veterans on behalf of the Commonwealth Departments of Veterans' Affairs and Defence. The study was funded by the Department of Veterans' Affairs. In addition, a Scientific Advisory Committee was established to oversee the conduct of the study and a Consultative Forum was set up to represent the veteran community and in turn feed back information about the study to its constituent members.
This report outlines the background to the study, aims and objectives, methods used to assess health outcomes and relevant exposures, results of the study, discussion, conclusions and recommendations. It also contains an Executive Summary.