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Gulf War I Registry Gulf War I Registry ExaminationsExaminations
The Atlanta VAMC ExperienceThe Atlanta VAMC ExperienceSuzanne Cullins, M.D.Suzanne Cullins, M.D.
Gulf War Registry ExamsGulf War Registry Exams
•• Compensation and Pension/Special Compensation and Pension/Special Exams Unit SectionExams Unit Section
•• C & P examsC & P exams•• Agent Orange Registry examsAgent Orange Registry exams•• Gulf War Registry examsGulf War Registry exams•• Military Separation examsMilitary Separation exams•• Other examsOther exams
Gulf War Registry ExamsGulf War Registry Exams
•• Section ChiefSection Chief•• ExaminersExaminers——MDMD’’s, NPs, NP’’s, Fellows, s, Fellows,
ResidentsResidents•• Administrative staffAdministrative staff
Gulf War I EraGulf War I Era
•• Desert Shield and Desert StormDesert Shield and Desert Storm•• U.S. deployed 697,000 military U.S. deployed 697,000 military
personnelpersonnel•• Kuwait TheaterKuwait Theater•• Public Law 102Public Law 102--585585——Gulf War RegistryGulf War Registry
Gulf War I VeteranGulf War I Veteran’’s Demographicss DemographicsMaleMaleFemaleFemale
939377
Age (mean) in 1991 (years)Age (mean) in 1991 (years) 2727
CaucasianCaucasianAfrican AmericanAfrican AmericanHispanicHispanicOtherOther
707023235522
EnlistedEnlistedOfficerOfficer
90901010
ArmyArmyNavyNavyMarinesMarinesAir ForceAir Force
5050232315151212
Active dutyActive dutyReserves or National GuardReserves or National Guard
83831717
Gulf War I Registry ExamsGulf War I Registry Exams
•• Per EAS registry, 3272 unique registry Per EAS registry, 3272 unique registry exams completed in Atlanta VAMC from exams completed in Atlanta VAMC from 01/01/1990 to 12/31/200801/01/1990 to 12/31/2008
•• Represents 3098 unique veteransRepresents 3098 unique veterans——2692 males and 406 females2692 males and 406 females
•• For 2009, 19 exams for Gulf War I For 2009, 19 exams for Gulf War I veterans completed to dateveterans completed to date
Gulf War I Registry Exams 1990-2008
0
20000
40000
60000
80000
100000
120000
140000
Atlanta VA Wide
Atlanta Gulf War I Registry Exams 1990-1999
0
100
200
300
400
500
600
700
800
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999
Atlanta Gulf War I Registry Exams 2000-2008
0
50
100
150
200
250
300
350
400
2000 2001 2002 2003 2004 2005 2006 2007 2008
0
200
400
600
800
1000
1200
1400
1600
1800
2000
Decade 1 Decade 2
Atlanta Gulf War I Registry Exams for Two Decades
0
500
1000
1500
2000
2500
3000
3500
One Exam Two Exams Three Exams
Atlanta Gulf War I Registry Exams 1990-2008
Two Gulf War I Registry Exams
0
20
40
60
80
100
120
1990-1995 1996-2001 2002-2005 2006-2008
Three Gulf War I Registry Exams
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
1990-1995 1996-2001 2002-2005 2006-2008
Gulf War I Registry Exams Gulf War I Registry Exams ExposuresExposures•• Smoke from oil firesSmoke from oil fires•• Diesel fumesDiesel fumes•• Exposure to burning Exposure to burning
trash/fecestrash/feces•• Drank or consumed Drank or consumed
food contaminated food contaminated with smoke, oil or with smoke, oil or other chemicalsother chemicals
•• Unknown chemicalsUnknown chemicals•• Bathed in Bathed in
contaminated watercontaminated water•• Drank contaminated Drank contaminated
waterwater
PTSD
Rash
Arthralgia
Fatigue
Headache
HTN
Migraines
Back pain
Sleep dist
Dyspepsia
Diarrhea
Hair loss
Dyspnea
Tremor
Depression
Common Symptoms/Complaints in Male Veterans
Migraines
Back pain
HTN
Fatigue
Rash
Headaches
Arthralgia
Tremor
FMS
Hair loss
Bloating
Common Symptoms/Complaints in Female Veterans
Gulf War I Registry ExamsGulf War I Registry Exams
•• PTSDPTSD•• Panic disorderPanic disorder•• DiverticulitisDiverticulitis•• Migraine headachesMigraine headaches•• Diabetes mellitusDiabetes mellitus•• Sleep apneaSleep apnea
Gulf War I Registry ExamsGulf War I Registry Exams
•• Coronary atherosclerotic heart diseaseCoronary atherosclerotic heart disease•• Depressive disorderDepressive disorder•• Benign prostate hypertrophyBenign prostate hypertrophy•• Hiatal herniaHiatal hernia•• Bipolar disorderBipolar disorder•• DJD of multiple jointsDJD of multiple joints
Gulf War I Registry ExamsGulf War I Registry Exams
•• Complete Compensation and Pension Complete Compensation and Pension claim if not already doneclaim if not already done
•• Primary care follow up at the VAMC or Primary care follow up at the VAMC or with private providerwith private provider
•• As health condition changes, followAs health condition changes, follow--up up with another registry examinationwith another registry examination
Gulf War I Veterans and C & P Gulf War I Veterans and C & P examinationsexaminations
•• Exam specific requests seen in veteran Exam specific requests seen in veteran who served in Gulf Warwho served in Gulf War
•• Gulf War exam requests with symptom Gulf War exam requests with symptom related complaintsrelated complaints
Gulf War I Veterans and C & P Gulf War I Veterans and C & P ExaminationsExaminations•• CoughCough•• DyspneaDyspnea•• FatigueFatigue•• ArthralgiasArthralgias•• RashRash•• Chest painChest pain•• GastroenteritisGastroenteritis•• MSMS
•• HeadachesHeadaches•• Rhinitis/SinusitisRhinitis/Sinusitis•• Back painBack pain•• Sleep disorderSleep disorder•• FMSFMS•• CFSCFS•• Memory LossMemory Loss•• DepressionDepression
Gulf War I Veterans and C & P Gulf War I Veterans and C & P ExaminationsExaminations•• Greater outreach and encouragement to Greater outreach and encouragement to
complete Gulf War registry complete Gulf War registry examinationsexaminations
•• Encouragement to complete C & P Encouragement to complete C & P claimsclaims
•• Awareness that the VAMC is available Awareness that the VAMC is available and ready to assist with healthcare and ready to assist with healthcare needsneeds
ReferencesReferences
•• EAS Registry reports and data, EAS Registry reports and data, retrieved 02/09/2009retrieved 02/09/2009
•• Atlanta VAMC Gulf War Registry exam Atlanta VAMC Gulf War Registry exam data, retrieved 02/09/2009data, retrieved 02/09/2009
•• IOM, Gulf War and Health, Volume IIOM, Gulf War and Health, Volume I•• IOM, Gulf War and Health, Volume IVIOM, Gulf War and Health, Volume IV•• www.va.govwww.va.gov
