alexa Brief Report on the Effect of Environment on Prevalence of Auto Immune Diseases in Veterans | OMICS International
ISSN: 2167-7921
Journal of Arthritis
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Brief Report on the Effect of Environment on Prevalence of Auto Immune Diseases in Veterans

Ketan Desai*
VA Medical Center, Wilkes Barre, Pa, USA
Corresponding Author : Ketan Desai
VA Medical Center, Wilkes Barre, Pa, USA
Tel: 1 202-273-5781
E-mail: [email protected]
Received: December 09, 2015; Accepted: January 05, 2016; Published: January 15, 2016
Citation: Desai K (2016) Brief Report on the Effect of Environment on Prevalence of Auto Immune Diseases in Veterans. J Arthritis 5:184. doi:10.4172/2167-7921.1000184
Copyright: © 2016 Desai K. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Abstract

The role of environment has been widely speculated to play a role in the pathogenesis of auto-immune diseases such as Lupus, Rheumatoid Arthritis, Psoriasis, etc. However, no definitive linkage has been found so far. In order to explore this possible association, a retrospective study was undertaken in veterans who had fought in various wars ranging from WWII to Gulf War and the prevalence of auto-immune diseases ascertained. This was compared to the prevalence in civilian populations. Except for auto-immune thyroiditis, no difference was found in veterans who had been exposed to different environments and between them and civilians in the US. A larger study will be needed to explore this lack of association.

Keywords
Lupus; Rheumatoid arthritis; Psoriasis; Auto-immune thyroiditis; Auto immune diseases
Introduction
It is estimated that the prevalence of auto-immune disease is 3.2% in the general population [1]. Autoimmune diseases are multi-factorial in nature, with genetics, environmental, and other as yet undetermined determinants playing a role. In order to assess the role of environment, a retrospective study was done on US Veterans at the VA Medical Center in Wilkes Barre. The rationale was that US servicemen and women have had exposure to diverse socio-economic environments across the globe, ranging from well developed countries to developing ones. They also have exposure to diverse ecosystems, ranging from deserts to mountains to tropical jungles. Thus, they are a good group to analyze the effect of the environment on the prevalence of autoimmune diseases and compare it to US population as a whole.
Methods
A retrospective chart analysis was done in patients at the VA Medical Center at Wilkes Barre, Pennsylvania. The prevalence of autoimmune diseases in Veterans who fought in WWII (Europe and Asia Pacific), Korean War, Vietnam Conflict, and the Persian Gulf War was compared to the prevalence of these diseases in the US population. The prevalence was also compared by gender and, for the WWII Vets, between those who served in Europe versus those who served in Asia Pacific. The diseases studied included psoriasis, psoriatic arthritis, inflammatory bowel disease, rheumatoid arthritis, lupus, myositis, auto-immune thyroiditis, vasculitis, ankylosing spondylitis, pemphigus, bullous dermatitis, systemic sclerosis, autoimmune hepatitis, Sjogren’s Syndrome, reactive arthritis, polymyalgia rheumatic, and sarcoidosis.
Results
There were 37,373 patients in the database, of whom 441 had autoimmune diseases, a prevalence of 1.177%, which is about half that seen in the general population. The most common auto-immune disease was rheumatoid arthritis. The highest prevalence was in female veterans who fought in the Korean War, at 1.3%. The lowest was in the Persian Gulf War, at 0.03% in males and 0.06% in females, perhaps reflecting the demographic age group of these patients. It ranged from 0.2% - 0.6% in the other groups. This prevalence is less than that seen in the civilian population where the prevalence is around 0.5 - 1% [2]. The prevalence of all other auto-immune diseases was similarly lower than in the US population as a whole. Females had a higher prevalence than males. There was no difference in prevalence of any auto-immune disease between veterans of different wars except for auto-immune thyroiditis, which was higher in those who served in the Persian Gulf War. While no cases were found in any other war, the prevalence was 0.4% in men and 0.6% in women who served in the Persian Gulf War (Table 1).
Discussion and Conclusion
In this brief retrospective study, no clear environmental influence was seen in veterans with auto-immune diseases. This encompassed various theatres of war, including different climate, topography and socio-economic exposures. Unfortunately, there was not enough detail in patient charts to ascertain and analyze dietary habits or religious affiliation. Nevertheless, in this study, the prevalence of auto-immune diseases in this veteran population was found to be lower than that seen in the US population suggesting that if anything, the military environment is protective against auto-immune diseases. A larger study would be needed to explore this observation further.
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Review summary

  1. Alvin
    Posted on Aug 22 2016 at 12:13 pm
    The article presents a brief idea on the role of environment in pathogenesis of auto-immune diseases. Authors found no clear environmental influences with auto-immune diseases and suggested need to explore the observation further. The document is a significant addition to the scientific literature in this field.

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