(Beyond Pesticides, November 18, 2008) At least one in four of the 697,000 U.S. veterans of the 1991 Gulf War suffer from Gulf War illness, a condition caused by exposure to toxic chemicals, including pesticides and a drug administered to protect troops against nerve gas, and no effective treatments have yet been found, a federal panel of scientific experts and veterans concludes in a landmark report released November 17, 2008.
The Congressionally-mandated Research Advisory Committee on Gulf War Veterans’ Illnesses presented the report to Secretary of Veterans Affairs James Peake at Veterans Administration (VA) headquarters in Washington, DC. Scientific staff support to the Committee is provided by the Boston University School of Public Health (BUSPH).
“The extensive body of scientific research now available consistently indicates that Gulf War illness is real, that it is the result of neurotoxic exposures during Gulf War deployment, and that few veterans have recovered or substantially improved with time,” the report says. The 450-page report brings together for the first time the full range of scientific research and government investigations on Gulf War illness and officially resolves many questions about the condition.
The report found that Gulf War illness fundamentally differs from stress-related syndromes described after other wars. “Studies consistently indicate that Gulf War illness is not the result of combat or other stressors, and that Gulf War veterans have lower rates of posttraumatic stress disorder than veterans of other wars,” the Committee wrote.
Gulf War illness is typically characterized by a combination of memory and concentration problems, persistent headaches, unexplained fatigue and widespread pain, and may also include chronic digestive problems, respiratory symptoms and skin rashes.
“Veterans of the first Gulf War have been plagued by ill health since their return 17 years ago. Although the evidence for this health phenomenon is overwhelming, veterans repeatedly find that their complaints are met with cynicism and a ‘blame the victim’ mentality that attributes their health problems to mental illness or non-physical factors,” said committee scientific director Roberta White, PhD, associate dean for research at Boston University’s School of Public Health. She said the Committee’s findings “clearly substantiate veterans’ beliefs that their health problems are related to exposures experienced in the Gulf theatre. It provides a state-of-the-art review of knowledge about Gulf War veterans’ health concerns that can guide clinicians and researchers, and offers a scientific rationale for the new Administration to further our understanding of these health problems — most importantly, by funding treatment trials to develop effective treatments of the veterans’ symptoms.”
The Committee evaluated evidence related to a broad spectrum of Gulf War-related exposures. Its review included hundreds of studies of Gulf War veterans, extensive research in other human populations, studies on toxic exposures in animal models, and government investigations related to events and exposures in the Gulf War.
The Department of Defense reports that U.S. personnel serving in the Gulf War used or had available for use, at least 64 pesticides and related products, containing 37 active ingredients. Of these, 15 were identified as “pesticides of potential concern” based on what was known about the use and toxic effects of these compounds. The pesticide products include organophosphates (azamethiphos, dichlorvos, chlorpyrifos, diazonon and malation), carbamates (propoxur, bendiocarb, methomyl), pyrethroids (d-phenothrin, permethrin), organochlorine (lindane), and the insect repellant DEET.
According to the report, the most commonly used personal repellants were DEET, which was primarily to be used on the skin, and permethrin, which was to be sprayed onto uniforms. Some personnel are known to have acquired personal use pesticides in addition to those supplied by the military, including the commercial product OFF, citronella products, and flea collars. Military environmental pesticide control measures included surface spraying and environmental fogging using the organophosphates chlorpyrifos, diazinon, and malathion, in varying concentrations, as well as the carbamates propoxur and bendiocarb. The organochlorine lindane powder was used by military police and other personnel for delousing in the processing of the more than 87,000 enemy prisoners captured in the war. Lindane was also issued to troops for their personal use, primarily to Army personnel.
The new report says that scientific evidence “leaves no question that Gulf War illness is a real condition,” and it cites dozens of research studies that have identified “objective biological measures” that distinguish veterans with the illness from healthy controls. Those measures relate to structure and functioning of the brain, functioning of the autonomic nervous system, neuroendocrine and immune alterations, and variability in enzymes that protect the body from neurotoxic chemicals.
The Committee found that an association between Gulf War illness and several other exposures could not be ruled out. These included low-level exposures to nerve agents, extended exposure to smoke from oil well fires, receipt of large numbers of vaccines, and combinations of neurotoxic exposures.
The report concludes, “A renewed federal research commitment is needed ”¦ to achieve the critical objectives of improving the health of Gulf War veterans and preventing similar problems in future deployments. This is a national obligation, made especially urgent by the many years that Gulf War veterans have waited for answers and assistance.”
Many studies have linked pesticides to Gulf War Syndrome since the conclusion of the war, including a 2008 study published in the Proceedings of the National Academy of Sciences. Study author Beatrice Golomb, MD, PhD, associate professor of medicine at the University of California, San Diego School of Medicine, warns of the potential risk to civilians exposed to pesticides. “Health issues among Gulf War veterans have been a concern for nearly two decades. Now, enough studies have been conducted, and results shared, to be able to say with considerable confidence that there is a link between chemical exposure and chronic, multi-symptom health problems,” said Dr. Golomb.