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Women and war: The toll of deployment on physical health

August 15, 2008

ANN ARBOR, Mich.---More than 80 percent of a sample of Air Force women deployed in Iraq and other areas around the world report suffering from persistent fatigue, fever, hair loss and difficulty concentrating, according to a University of Michigan study.

The pattern of health problems reported by 1,114 women surveyed in 2006 and 2007 is similar to many symptoms of Gulf War Syndrome, the controversial condition reported by veterans of the 1991 Persian Gulf War.

"It is possible that some unknown environmental factor is the cause of current health problems and of Gulf War Syndrome," said U-M researcher Penny Pierce.

"But it is also possible that these symptoms result from the stress of military deployment, especially prolonged and multiple deployments."

Pierce and U-M colleagues conducted a similar study of women veterans in 1992 following that war to assess the impact of deployment and combat exposure on physical and mental health.

An associate professor at the U-M School of Nursing and a faculty associate at the U-M Institute for Social Research (ISR), Pierce is also a colonel in the Air Force Reserve Program. With ISR psychologist Lisa Lewandowski-Romps, she presented the findings from the study Aug. 14 in Boston at the annual meeting of the American Psychological Association.

"Women now comprise approximately 15 percent of our nation's armed forces," Pierce said. "And since the Persian Gulf War, combat roles for women have expanded substantially. This study is an attempt to understand the impact of deployment and war-related stressors on the health of military women."

The Air Force women surveyed by telephone and through mailed questionnaires were drawn from a stratified, random sample and deployed at least once since March 2003 during Operation Iraqi Freedom. Half of those sampled served in the theater of war and half served elsewhere; half had children under the age of 18 still living at home; half were active duty, a quarter in the Reserves and another quarter in the National Guard. The median age of participants was 36 years, and 45 percent were married. About 36 percent had a dependent child at the time they were sent overseas. About 70 percent were white.

Asked if they experienced any of a list of symptoms persistently in the past year, 89 percent of those surveyed reported suffering from fatigue, 85 percent from difficulty concentrating, 83 percent from fever, and 83 percent from hair loss. In addition, 35 percent reported suffering from muscle pain and stiffness, 29 percent from irritability, 26 percent from loss of energy and 25 percent from headaches.

In general, Pierce and Lewandowski found that those in the reserve and guard reported more physical symptoms than active duty personnel. Enlisted women reported more health problems than officers did.

In most cases, women serving in the theater of war were more likely to report physical health problems than were than those serving elsewhere. But in many cases, the differences were small, suggesting to Pierce that deployment-related stressors such as family separation and disruption of social support systems may play a critical role in developing stress-related physical problems.

In an earlier analysis of data from the study, presented at last year's American Psychological Association conference, Pierce and Lewandowski-Romps found that about 20 percent of the women surveyed reported at least one major symptom of post-traumatic stress disorder (PTDS).

"Deployment itself is a major stressor," she said. "The whole person is deployed---body, mind, and spirit. We don't know the precise biological mechanism, but it is generally accepted now---perhaps more so than it was in the early 1990s when Gulf War Syndrome was first reported---that persistent levels of heightened stress take a major toll on physical health.

"By identifying problems early, I hope our findings will guide policy-makers and health care professions to design interventions to support service members and their families."

University of Michigan

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