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American Journal of Epidemiology Vol. 135, No. 3: 312-323
Copyright © 1992 by The Johns Hopkins University School of Hygiene and Public Health

research-article

Self-reported Health Status of Vietnam Veterans in Relation to Perceived Exposure to Herbicides and Combat

Pierre Decouflé1,, Patricia Holmgreen1, Coleen A. Boyie1 and Nancy E. Stroup2

1 Center for Environmental Health and Injury Control, Centers for Disease Control Atlanta, GA
2Epidemiology Program Office, Centers for Disease Control Atlanta, GA

Reprint requests to Dr. Pierre Decoufle, Center for Environmental Health and Injury Control, Centers for Db-ease Control (F-37), 1600 Clifton Road, Atlanta, GA 30333

The authors examined how the setf-reported hearth of 7,924 US Army Vietnam veterans in 1985–1986 related to the men's perceived exposure to herbicides and combat in Vietnam. The results showed strong, positive associations between the extent of reported herbicide exposure (classified as a four-level ordinal index) and all 21 health outcomes studied, with clear "dose-response" relations in most instances. In contrast, only chloracne and psychological symptoms, including a symptom pattern consistent with posttraumatic stress disorder, were found to be strongly related to the amount of reported combat exposure (classified as a four-level ordinal index). The multiple herbicide/outcome associations seem implausible because of their nonspecific-ity and because of collateral biologic evidence suggesting the absence of widespread exposure to dtoxin-containing herbicides among US Army combat units. These associations may have resulted from long-term stress reactions that produced somatjzation, hypochondriasis, and increased utilization of medical care among some Vietnam veterans. The available data suggest, however, that the association between reported combat exposure and psychological symptoms consistent with posttraumatic stress disorder may be causal. Am J Epidemiol 1992;135:312–23.

combat disorders; herbicides; hypochondriasis; somatization disorders; stress; veterans; Vietnam


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