BMJ -- Press Releases

Releases Saturday 13 December 2003
No 7428 Volume 327

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(1) Are Gulf war veterans getting better?
(2) Security duties damage soldiers' mental health
(3) Natural plant oil does not improve eczema
(4) Children and pensioners endure heavy burden of caring

(1) Are Gulf war veterans getting better?

(Gulf war illness ? better, worse, or just the same?)
http://bmj.com/cgi/content/full/327/7428/1370

(Incidence of cancer among UK Gulf war veterans)
http://bmj.com/cgi/content/full/327/7428/1373

(Editorial: The health consequences of the first Gulf war)
http://bmj.com/cgi/content/full/327/7428/1357

Gulf war veterans still have considerably poorer health than
other military personnel, but the health gap has narrowed
slightly, finds a study in this week's BMJ. A second study
shows no increased risk of cancer among Gulf war
veterans.

The first study compared the health of members of the UK
armed forces who served in the 1991 Gulf war with
non-deployed military personnel over a four-year period.
Gulf war veterans experienced a modest reduction in
fatigue and psychological distress, but a slight worsening of
physical functioning.

Gulf war veterans continue to experience symptoms that
are considerably worse than other military personnel, say
the authors. However, Gulf war veterans are not
deteriorating and do not have a higher incidence of new
illness, they conclude.

The second study compared cancer rates in 51,721 UK
Gulf war veterans and 50,775 non-deployed service
personnel in the 11 years since the end of the war.

Incidence of and deaths from cancer in Gulf war veterans
was almost identical to that seen in veterans who were not
deployed, even after smoking and alcohol consumption,
which are known to influence cancer risk, were taken into
account.

Furthermore, the risk of cancer was no higher in Gulf war
veterans who reported multiple vaccinations or exposure to
pesticides or depleted uranium during deployment.

Although this study should provide some reassurance of a
lack of association between deployment to the Gulf and
increased risk of cancer, the long latent period for cancer
means that these groups should continue to be monitored,
conclude the authors.

Contacts:
Study 1: Matthew Hotopf, Gulf War Illness
Research Unit, Department of Psychological Medicine,
Guy's, King's and St Thomas's School of Medicine,
London, UK
Email: m.hotopf{at}iop.kcl.ac.uk

Study 2: Gary MacFarlane, Professor of Epidemiology,
School of Epidemiology and Health Sciences, University of
Manchester, UK
Email: G.Macfarlane{at}man.ac.uk

(2) Security duties damage soldiers' mental health

(Security duties in Northern Ireland and the mental health of
soldiers: prospective study)
http://bmj.com/cgi/content/full/327/7428/1382

Security duties in Northern Ireland may be damaging to
soldiers' mental health, say researchers in this week's BMJ.

A sample of 150 servicemen from all ranks of an infantry
battalion were surveyed two weeks before deployment to
Northern Ireland and again two weeks before the end of a
six month tour between 1993 and 1994. Their mental
health was scored using recognised scales.

Soldiers reported high levels of psychological illness, and
were three times more likely to suffer physical and
psychological symptoms after their tour in Northern
Ireland. Symptoms of anxiety and social isolation increased
significantly, but ratings for depression did not change.

Although research had emphasised the detrimental effects
of fighting war, tours to maintain security may also be
damaging to soldiers' mental health, say the authors. On
tour, soldiers live in cramped conditions and experience
long periods of inactivity interspersed with sporadic
episodes of exposure to potentially dangerous situations.

Future research should explore what aspects of a soldier's
existence contribute to changes in psychological illness if
remedial steps are to be taken to maximise a soldier's
professional potential, they conclude.

Contacts:
Jane Ogden, Reader in Health Psychology,
Department of General Practice, Guy's, King's and St
Thomas's School of Medicine, London, UK
Email: Jane.Ogden{at}kcl.ac.uk
or Geoff Lawrenson, General
Practitioner, Colchester Garrison, Colchester, Essex, UK

(3) Natural plant oil does not improve eczema

(Efficacy and tolerability of borage oil in adults and children
with atopic eczema: randomised, double blind, placebo
controlled, parallel group trial)
http://bmj.com/cgi/content/full/327/7428/1385

Editorial: Evening primrose oil for atopic dermatitis
http://bmj.com/cgi/content/full/327/7428/1358

Borage oil (sold as starflower oil in chemists and health
food shops) does not improve symptoms of eczema,
despite some studies suggesting a dose related benefit,
finds a study in this week's BMJ.

Purified borage oil contains a minimum of 23% gamma
linolenic acid (GLA), an essential fatty acid that is needed
for normal skin function. Evening primrose oil also contains
GLA, but in lower concentrations.

Researchers identified 151 patients with atopic eczema.
Every day for 12 weeks they received either high dose
borage oil (containing 920 mg of GLA) or placebo in
matching capsules. Symptoms were scored using
recognised scales.

The symptoms and signs improved to a similar degree in
both groups, with a marginally greater improvement in the
placebo group. The authors suggest that GLA is unlikely to
offer any useful benefit in treatment of atopic eczema.

This study, along with the recent decision of the UK
Medicines Control Agency to withdraw the product licence
for evening primrose oil, suggests that GLA
supplementation for atopic dermatitis has had its day,
writes a skin specialist in an accompanying editorial.

Contact:
John Berth-Jones, Consultant Dermatologist,
Department of Dermatology, George Elliot Hospital,
Nuneaton, UK
Email: johnberthjones{at}aol.com

(4) Children and pensioners endure heavy burden of caring

(Health of young and elderly informal carers: analysis of UK
census data)
http://bmj.com/cgi/content/full/327/7428/1388

More children and pensioners act as informal carers for
family or friends with chronic illness than previously
thought, and many of these are not in good health
themselves, according to a study in this week's BMJ.

Researchers analysed the 2001 UK census data, which for
the first time, asked the entire population about caring
responsibilities. About 5.9 million people provided informal
care for another person. Of these, 114,000 were children
aged between 5 and 15 and more than one million were
people aged 65 and over.

Nearly 9,000 children and 381,000 people aged 65 and
over provided at least 50 hours of care a week. Many of
these children and pensioners were not in good health
themselves.

Even the oldest age group (more than 85 years) included
44,000 carers, more than half of whom were providing at
least 50 hours of care a week.

Many would consider this an unacceptably heavy burden
for children and pensioners, say the authors. Further
research is needed to show the impact that this burden of
care has on the lives and future wellbeing of young and
elderly people.

Contact:
Tim Doran, Clinical Lecturer in Public Health
Medicine, Department of Public Health, University of
Liverpool, UK
Email: timdoran{at}liverpool.ac.uk

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