) % ( e c n e l a v e r P 25 20 15 10 5 0 GWV NGWV BMC Public Health 2004, 4:27 http://www.biomedcentral.com/1471-2458/4/27 uscMuleon-staklealentdalb&ehcaovninoeucratilvdeistiosrsOduetehresdrissoyrmdeprtsomsNOS NervoussystemdisordersInfection Fatigue M Digestive,SsRkteoinsmpaailrclaehtrog&rDiEyeinensddttiieososorcitrraidninteiaoerln,sdniiCnsuoatgrrriedtdineoioernsvraaalslachnuedlaamlrthdeitsaobrodleicrsdisorders ChestpaGinesn/itotig-uhrtinneasrysNs(inygoshttteesmlwseedwaisAthoslerl/edreeregxrciscelaesssosstiifhvieeedrs)twhaenatsinkgin/A"fcecvAieduretson"-tiamlminjuunryedisease Cancer Self-reported ill health category cPFaritgeevugarolernie1cseaomf osenlgf-GreWpoVrt)ed ill health categories by deployment to the Gulf war (ordered by frequency of reported ill health Prevalence of self-reported ill health categories by deployment to the Gulf war (ordered by frequency of reported ill health categories among GWV) nations and psychiatric assessments of every veteran would have been time consuming and prohibitively expensive. Furthermore, studies looking at 'hard' clinical diagnoses or more objective outcomes, such as cancer [25] or hospitalisation rates [26], have shown no important differences between GWV and comparison groups. Researchers have concentrated instead on differences in 'softer' endpoints [1-3], which are similar to those reported here. Conclusions This study is consistent with other research showing a sig- nificant excess of morbidity among GWV. It also confirms the lack of specificity in post-Gulf war illness. These find- ings were replicated despite the fact that reproduction and child health were the focus of the study (rather than the veterans' general health), and questions relating to the veterans' own health were open-ended. Research groups have linked post-Gulf War ill health to a number of self- reported exposures but these analyses are limited by a lack of independent individual-level exposure data [1,27,28]. It has been suggested that changes in perception resulting from the disruption of war rather than specific exposures might be responsible [3], and there have been calls to move away from this narrow focus [29]. In the Gulf, dis- ruption included change of climate, living conditions, diet, sleeping patterns, physical activity and separation from family, as well as the threat of chemical and biolog- ical weapons [27]. Despite such conjecture, explaining the increased ill health of GWV remains a controversial sub- ject and there is no real consensus of opinion. In order for more rigorous aetiological studies of post-conflict illness to be undertaken in the future, there is a need to improve routine health surveillance and record-keeping both pre- and post- deployment [30]. This surveillance should also translate into more effective prevention and treatment programs in order to reduce the burden of post-war ill- ness. Further research on the mechanisms underlying the Page 8 of 10 (page number not for citation purposes)