The physical and mental health of Australian Vietnam veterans 3 decades after the war and its relation to military service, combat, and post-traumatic stress disorder.

ANZAC Research Institute, Repatriation General Hospital Concord, New South Wales, Australia.
American journal of epidemiology (Impact Factor: 4.98). 07/2009; 170(3):318-30. DOI: 10.1093/aje/kwp146
Source: PubMed

ABSTRACT The long-term health consequences of war service remain unclear, despite burgeoning scientific interest. A longitudinal cohort study of a random sample of Australian Vietnam veterans was designed to assess veterans' postwar physical and mental health 36 years after the war (2005-2006) and to examine its relation to Army service, combat, and post-traumatic stress disorder (PTSD) assessed 14 years previously (1990-1993). Prevalences in veterans (n = 450) were compared with those in the Australian general population. Veterans' Army service and data from the first assessments were evaluated using multivariate logistic regression prediction modeling. Veterans' general health and some health risk factors were poorer and medical consultation rates were higher than Australian population expectations. Of 67 long-term conditions, the prevalences of 47 were higher and the prevalences of 4 were lower when compared with population expectations. Half of all veterans took some form of medication for mental well-being. The prevalence of psychiatric diagnoses exceeded Australian population expectations. Military and war service characteristics and age were the most frequent predictors of physical health endpoints, while PTSD was most strongly associated with psychiatric diagnoses. Draftees had better physical health than regular enlistees but no better mental health. Army service and war-related PTSD are associated with risk of illness in later life among Australian Vietnam veterans.

  • International journal of preventive medicine 06/2014; 5(6):703-9.
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    ABSTRACT: To inform risk assessment and regulatory decision-making, the relationship between 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and prostate cancer requires clarification. This article systematically and critically reviews the epidemiologic evidence on the association between exposure to TCDD or Agent Orange, a TCDD-contaminated herbicide used during the Vietnam War, and prostate cancer risk. Articles evaluated include 11 studies of three cohorts, four case-control or cross-sectional studies, and three case-only studies of military veterans with information on estimated Agent Orange or TCDD exposure; 13 studies of seven cohorts, one case-control study, and eight proportionate morbidity or mortality studies of Vietnam veterans without information on Agent Orange exposure; 11 cohort studies of workers with occupational exposure to TCDD; and two studies of one community cohort with environmental exposure to TCDD. The most informative studies, including those of Vietnam veterans involved in Agent Orange spraying or other handling, herbicide manufacturing or spraying workers with occupational TCDD exposure, and community members exposed to TCDD through an industrial accident, consistently reported no significant increase in prostate cancer incidence or mortality. Only some potentially confounded studies of Vietnam veterans compared with the general population, studies with unreliable estimates of Agent Orange exposure, and analyses of selected subgroups of Vietnam veterans reported positive associations. Overall, epidemiologic research offers no consistent or convincing evidence of a causal relationship between exposure to Agent Orange or TCDD and prostate cancer. More accurate exposure assessment is needed in large epidemiologic studies to rule out a causal association more conclusively.
    European Journal of Epidemiology 07/2014; · 5.15 Impact Factor
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    ABSTRACT: Objectives. We sought to better understand the association between early life exposure to war and trauma and older adult health status in a developing setting. Methods. We analyzed data of 405 Vietnamese men and women in 1 northern Vietnam commune who entered early adulthood during the Vietnam War and who are now entering late adulthood (i.e., ages 55 years and older in 2010). Results. The toll of war's trauma in the aging northern Vietnamese population was perceptible in the association between exposure to war trauma and various measures of physical health, including negative self-reported health and somatic symptoms. Killing another person and being exposed to toxic substances in warfare was especially detrimental to health in older adulthood. War traumas were likely implicated more strongly as determinants of late adulthood health in men than in women. The weak association between trauma exposure and reported depressive symptoms raised questions about measuring mental health. Conclusions. Military service and war trauma were important determinants of older adult health beyond the US context, given the widespread waging of war and concentration of recent armed conflicts within developing societies. (Am J Public Health. Published online ahead of print June 12, 2014: e1-e10. doi:10.2105/AJPH.2014.301925).
    American Journal of Public Health 06/2014; · 4.23 Impact Factor


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