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James V. Writer, MPH; Robert F. DeFraites, MD, MPH; John F. Brundage, MD, MPH

JAMA. 1996;275(2):118-121.

Abstract
Objective.
—To determine cause-specific mortality rates among US troops stationed in the Persian Gulf region and compare them with those of US troops serving elsewhere during Operations Desert Shield and Desert Storm.

Design.
—Retrospective cohort.

Population.
—US men and women on active duty from August 1, 1990, through July 31, 1991.

Main Outcome Measures.
—Deaths occurring among all active-duty US military persons during the 1-year study period. Age-adjusted mortality rates among US troops stationed in the Persian Gulf region were compared with rates projected from mortality rates among troops on active duty elsewhere.

Results.
—A total of 1769 active-duty persons died during the study period, 372 in the Persian Gulf region and 1397 elsewhere. Of the 372 deaths in the Persian Gulf region, 147 (39.5%) occurred as a direct result of combat during the war, 194 (52.2%) resulted from injuries not incurred in battle, and 30 (8%) resulted from illness. Twenty-three of the deaths due to illness were considered unexpected or cardiovascular deaths. Based on age-adjusted mortality rates observed among US troops on active duty outside the Persian Gulf region, 165 deaths from unintentional injury and 32 deaths from illness (20 of which were unexpected or cardiovascular) would have been anticipated among Persian Gulf troops.

Conclusion.
—Except for deaths from unintentional injury, US troops in the Persian Gulf region did not experience significantly higher mortality rates than US troops serving elsewhere. There were no clusters of unexplained deaths. The number and circumstances of nonbattle deaths among Persian Gulf troops were typical for the US military population.

(JAMA. 1996;275:118-121)

Author Affiliations
From the Division of Preventive Medicine, Walter Reed Army Institute of Research, Washington, DC (Mr Writer and Dr DeFraites), and the Epidemiology and Disease Surveillance Directorate, US Army Center for Health Promotion and Preventive Medicine, Aberdeen Proving Ground, Md (Dr Brundage).

Footnotes
The views expressed herein are those of the authors and do not necessarily reflect the official policy or position of the Department of the Army, the Department of Defense, or the US government.

Reprint requests to Division of Preventive Medicine, Walter Reed Army Institute of Research, Washington, DC 20307-5100 (Mr Writer).

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