Abstract: Military Deployment and Risk For Multiple Sclerosis In The First Gulf War (The 27th Annual Meeting of the CMSC and the 5th Cooperative Meeting of the CMSC-ACTRIMS)

Saturday, June 1, 2013

Mitchell T Wallin, MD, MPH , Washington, DC VAMC, MS Center of Excellence, Washington, DC

Clare Mahan, PhD , Post-Deployment Health Epidemiology Program, Office of Public Health, Department of Veterans Affairs, Washington, DC

Heidi Maloni, PhD , Washington, DC VAMC, MS Center of Excellence, Washington, DC

William J Culpepper II, PhD, MA , MS Center of Excellence, Baltimore VAMC, Baltimore, MD

Parisa Coffman, BA , Washington, DC VAMC, MS Center of Excellence, Washington, DC

John F Kurtzke, MD , Neurology, Georgetown University, Washington, DC

Background:

Concern has been raised that US veterans of the 1990-1991 Gulf War (GW) may be at increased risk to develop neurologic disease. The association of neurologic disease and GW1 service may be related to a variety of potentially hazardous environmental exposures that were present in the war theater. Our group has recently assembled a GW era multiple sclerosis (MS) cohort showing high MS incidence rates for men and women of multiple races. It is not known if deployed GW veterans have an increased risk for developing MS.

Objectives:

To evaluate the risk of developing MS in deployed vs. non-deployed veterans of the First Gulf War.

Methods:

Medical records and data from the Department of Defense (DoD) and Department of Veterans Affairs (VA) for cases of MS who served in the military between 1990, the start of the Gulf War era, and 2007 and who were service-connected by the VA were reviewed. Validated MS cases meeting the McDonald criteria from this GW Era MS cohort who had served in the First Gulf War (1990-1991) were matched to the GW1 database of all active duty troops from the DoD according to deployment status to the Theater of Operations. Relative risk estimates with 95% confidence intervals (CI) for MS based on deployment status were calculated within standard demographic groups.

Results:

Among the 696,118 troops deployed in GW1, 387 incident MS cases were found. A total of 1,457 incident MS cases were identified in 1,786,215 non-deployed personnel. The relative risk (RR) for MS among those deployed compared to those non-deployed was 0.68 (CI: 0.61-0.76) with 0.72 (CI: 0.63-0.81) in men and 0.92 (CI: 0.73-1.15) in women. Deployment was non-significant or protective as an MS risk factor across major racial groups: whites RR 0.62 (CI: 0.54-0.71), blacks RR 0.83 (CI: 0.68-1.02), and other races RR 1.65 (95% CI: 0.70-3.91); across all age groups; and across each Service: Army RR 0.80 (CI: 0.68-0.94), Navy RR 0.57 (CI: 0.45-0.74), Marines RR 0.99 (CI: 0.67-1.47), and Air Force RR 0.66 (CI: 0.50-0.87).

Conclusions:

Military deployment to the Theater of Operations in the First Gulf War was not a risk factor for developing MS. Further study of environmental factors that influence recent morbidity trends in MS are needed.

P24 Military Deployment and Risk For Multiple Sclerosis In The First Gulf War