Gulf War Era Cohort Study
The Gulf War Era Cohort Study (GWECS) is the largest and longest-running study of Veterans who served during the 1990-1991 Gulf War. The GWECS began in 1995 when VA researchers invited 15,000 Gulf War Veterans and 15,000 Gulf War Era Veterans (Veterans who served during the 1990-1991 Gulf War but did not deploy) to participate in a health survey to collect information on various symptoms and illnesses they were experiencing. VA researchers re-contacted the same cohort of Veterans in 2005, 2012, and 2024 to collect updated health information and to examine the health of 1990-1991 Gulf War Veterans compared to Gulf War Era Veterans over time.
Past surveys have helped VA to better understand Gulf War illness, chronic diseases, health effects of environmental exposures, and other health conditions associated with deployment to the 1990-1991 Gulf War. VA has used the results from this study to inform health care and benefits policy for 1990-1991 Gulf War Veterans. A list of peer-reviewed publications resulting from this important research can be found below.
Goals
Beginning in September 2024, VA’s Health Outcomes Military Exposures Epidemiology Program invited all living Gulf War and Gulf War Era Veterans who were asked to participate in the previous surveys to participate in a fourth round of survey data collection. This survey data collection, which is now complete, provided VA with updated information about the health of this cohort, now over 30 years after the 1990-1991 Gulf War, to help VA better understand the long-term health effects of service in the 1990-1991 Gulf War.
Participants
This study design requires following the same individuals over time. We contact the same 30,000 Veterans with each survey round. The study group includes Veterans who served in different branches of service, representing active, Reserve, and National Guard members. Researchers have made a special effort to ensure women are appropriately represented (women constitute 20% of the study sample). We do accept volunteers for this study but have encouraged those contacted to participate.
Methods
In the fourth round of data collection, participants were asked to complete a survey on paper, online, or over the telephone, depending on the Veteran’s preference. The survey included questions on diagnosed medical conditions, mental health conditions, cancer diagnoses, COVID-19 infection, Gulf War illness, women’s health, sleep disorders, general health perceptions, health care utilization, ability to perform daily functions, and health behaviors. This fourth round of data collection is complete and analyses are ongoing.
Investigators
Erin Dursa, Ph.D., M.P.H.
Aaron Schneiderman, Ph.D., M.P.H., R.N.
Publications
Dursa EK, Cao G, Culpepper WJ, Schneiderman A. Comparison of Health Outcomes Over Time Among Women 1990-1991 Gulf War Veterans, Women 1990-1991 Gulf Era Veterans, and Women in the U.S. General Population. Womens Health Issues. 2023.
Dursa E, Cao G, Porter B, Culpepper W, Schneiderman A. The health of Gulf War and Gulf Era Veterans over time: U.S. Department of Veterans Affairs’ Gulf War Longitudinal Study. J Occup Environ Med 2021; 63:889-894.
Barth SK, Innes KE, Dursa EK, Bossarte RM. The association of pre-war medical conditions to Gulf War Illness. Life Sci. 2021.
Dursa EK, Barth SK, Porter BW, Schneiderman AI. Health Status of Female and Male Gulf War and Gulf Era Veterans: A Population-Based Study. Womens Health Issues 2019; Suppl 1: S39-46.
Dursa E, Barth S, Porter B, Schneiderman A. Gulf War illness in the 1991 Gulf War and Gulf Era Veteran population: An application of the Centers for Disease Control and Prevention and Kansas case definitions to historical data. J Mil Veterans Health 2018; 26: 43-50.
Porter B, Long K, Rull RP, Dursa EK, Millennium Cohort Study Team. Health Status of Gulf War and Era Veterans Serving in the US Military in 2000. J Occup Environ Med. 2018; 60: e261-e267.
Dursa EK, Barth SK, Schneiderman AI, Bossarte RM. Physical and mental health status of Gulf War and Gulf era Veterans: Results from a large population-based epidemiological study. J Occup Environ Med 2016; 58: 41-46.
Dursa EK, Barth SK, Schneiderman AI, Bossarte RM. Physical and mental health status of Gulf War and Gulf era Veterans: Results from a large population-based epidemiological study. [Reply to letter of Coughlin S]. J Occup Environ Med 2016; 58: e187.
Dursa, EK, Schneiderman A, Hammer H, and Kolenikov S. Nonresponse Bias Measurement and Adjustment in the Follow-up Study of a National Cohort of Gulf War and Gulf War Era Veterans (Wave 3). Proceedings of the American Statistical Association, Survey Research Methods Section. Alexandria, VA: American Statistical Association 2015: 3996–4010.
Li B, Mahan CM, Kang HK, Eisen SA, Engel CC. Longitudinal health study of U.S. 1991 Gulf War Veterans: Changes in health status at 10-year follow-up. Am J Epidemiol 2011.
Coughlin SS, Kang HK, Mahan CM. Alcohol use and selected health conditions of 1991 Gulf War Veterans: Survey results, 2003-2005. Prev Chronic Dis 2011;8(3).
Coughlin SS, Kang HK, Mahan CM. Selected health conditions among overweight, obese, and non-obese Veterans of the 1991 Gulf War: Results from a survey conducted in 2003-2005. The Open Epidemiology Journal 2011; 4:133-139.
Kang HK, Li B, Mahan CM, Eisen SA, Engel CC. Health of U.S. Veterans of 1991 Gulf War: A follow-up survey in 10 years. J Occup Environ Med 2009;51:401-410.
Wallin MT, Wilken J, Alfaro MH, Rogers C, Mahan CM, Chapman JC, Fratto T, Sullivan C, Kang HK, Kane R. Neuropsychologic assessment of a population-based sample of Gulf War Veterans. Cog Behav Neurol 2009;22:155-166.
Toomey R, Kang HK, Karlinsky J, Baker DG, Vasterling JJ, Alpern R, Reda DJ, Henderson WG, Murphy FM, Eisen SA. Mental health of U.S. Gulf War Veterans 10 years after the war. British J Psychiatry 2007;190:385-393.
Eisen SA, Karlinsky J, Jackson LW, Blanchard M, Kang HK, Murphy FM, Alpern R, Reda DJ, Toomey R, Battistone MJ, Parks BJ, Klimas N, Pak HS, Hunter J, Lyons MJ, Henderson WG. Spouses of Persian Gulf War I Veterans: Medical evaluation of a U.S. cohort. Mil Med 2006; 171:613-618.
Blanchard MS, Eisen SA, Alpern R, Karlinsky J, Toomey R, Reda DJ, Murphy FM, Jackson LW, Kang HK.Chronic multisymptom illness complex in Gulf War I Veterans 10 years later. Am J Epidemiol 2006;163:66-75.
Kang HK, Dalager NA, Mahan CM, Ishii E. The role of sexual assault on the risk of PTSD among Gulf War Veterans. Ann Epidemiol 2005;15:191-195.
Mahan CM, Page WF, Bullman TA, Kang HK. Health effects in Army Gulf War Veterans possibly exposed to chemical munitions destruction at Khamisiyah, Iraq: Part I. Morbidity associated with potential exposure. Mil Med 2005;170:935-944.
Page WF, Mahan CM, Kang HK, Bullman TA. Health effects in Army Gulf War Veterans possibly exposed to chemical munitions destruction at Khamisiyah, Iraq: Part II. Morbidity associated with notification of potential exposure. Mil Med 2005;170:945-951.
Eisen SA, Kang HK, Murphy FM, Blanchard MS, Reda DJ, Henderson WG, Toomey R, Jackson LW, Alpern R, Parks BJ, Klimas N, Hall C, Pak HS, Hunter J, Karlinsky J, Battistone MJ, Lyons MJ. Gulf War Veterans’ health: Medical evaluation of a U.S. cohort. Ann Intern Med 2005;142:881-890.
Karlinsky JB, Blanchard M, Alpern R, Eisen SA, Kang H, Murphy FM, Reda DJ. Late prevalence of respiratory symptoms and pulmonary function abnormalities in Gulf War I Veterans. Arch Intern Med 2004;164:2488–2491.
Mahan CM, Kang HK, Dalager NA, Heller JM. Anthrax vaccination and self-reported symptoms, functional status, and medical conditions in the National Health Survey of Gulf War Era Veterans and Their Families. Ann Epidemiol 2004;14:81–88.
Kang HK, Natelson BH, Mahan CM, Lee KY, Murphy FM. Post-traumatic stress disorder and chronic fatigue syndrome-like illness among Gulf War Veterans: A population based survey of 30,000 Veterans. Am J Epidemiol 2003;157:141–148.
Young HA, Simmens SJ, Kang HK, Mahan CM, Levine PH. Factor analysis of fatiguing syndrome in Gulf War era Veterans: Implications for etiology and pathogenesis. J Occup Environ Med 2003;45:1268–1273.
Kang HK, Mahan CM, Lee KY, Murphy FM, Simmens SJ, Young HA, Levine PH. Evidence for a deployment-related Gulf War syndrome by factor analysis. Arch Environ Health 2002;57:61-68.
Kang HK, Magee C, Mahan C, Lee K, Murphy F, Jackson L, Matanoski G. Pregnancy outcomes among U.S. Gulf War Veterans: A population-based survey of 30,000 Veterans. Ann Epidemiol 2001;11:504–511.
Kang HK, Mahan CM, Lee KY, Magee CA, Murphy FM. Illnesses among United States Veterans of the Gulf War: A population-based survey of 30,000 Veterans. J Occup Environ Med 2000;42:491–501.
