Monday, April 13, 2009

Gulf War Syndrome Gets Real

Gulf War Syndrome Gets Real

BU experts evaluate the science for landmark federal report
| From Explorations | By Caleb Daniloff
SPH’s Roberta White says symptoms of Gulf War syndrome, such as fatigue, skin lesions, and gastrointestinal upset, are not the result of stress alone. Photo by Frank Curran
Gulf War veterans suffering a host of neurological problems have scored a victory in their struggle to legitimize their medical claims – thanks in part to public health experts at BU, whose research effectively debunks years of government denials.

A congressionally mandated panel, made up of leading scientists, medical experts, and military veterans, charged with shaping federal health research related to the 1991 Middle East conflict has concluded that Gulf War syndrome is a real medical condition and that it afflicts at least one in four of the 697,000 U.S. veterans who fought in Iraq, Kuwait, and Saudi Arabia. The landmark report, presented in November by the BU-based Research Advisory Committee on Gulf War Veterans’ Illnesses to Secretary of Veterans Affairs James Peake, calls on Congress to appropriate $60 million for treatment of Gulf War vets.

“Veterans of the first Gulf War have been plagued by symptoms of ill health, including fatigue, problems with thinking, skin lesions, and gastrointestinal upset, since their return seventeen years ago,” says Roberta White, the committee’s scientific director and a professor and chair of the School of Public Health department of environmental health. “Despite their persistence and severity, these symptoms have often led to no diagnosis in a substantial portion of the war’s veterans.”

The 450-page report brings together for the first time the full range of scientific research and government investigations on Gulf War illness. The report found that the condition fundamentally differs from stress-related syndromes seen after other wars and states that scientific evidence “leaves no question that Gulf War illness is a real condition.”

The report lays the blame for several health problems on the troops’ exposure to toxins, primarily in two contexts where the exposure was caused by the U.S. military itself. In anticipation of a chemical attack, the drug pyridostigmine bromide was given to hundreds of thousands of troops. And living and dining areas, tents, and uniforms were sprayed with pesticides to battle desert insects.

The report also suggests that the U.S. demolition of an Iraqi munitions dump may have exposed 100,000 troops to nerve gas stored at the facility. Gulf War veterans have shown significantly higher rates of amyotrophic lateral sclerosis, a neurodegenerative condition also known as Lou Gehrig’s disease, than veterans of other wars. And troops that were stationed downwind from the demolition site have died from brain cancer at twice the rate of other Gulf War veterans.

For almost two decades, the government and the military have downplayed veterans’ complaints, often referring to them as another form of post-traumatic stress disorder. For its report, the research committee evaluated hundreds of studies of Gulf War veterans, extensive research in other human populations, studies on toxic exposures in animals, and government investigations related to exposures in the Gulf War.

“The illness is probably controversial because it’s symptom-based, and most veterans don’t have a common medical diagnosis that fits all of their symptoms,” White says. “It may also be controversial because people feel that it’s obvious that war is stressful and therefore stress must be causing the health symptoms, even though this has never been proven. In fact, it’s been discounted in quite a few studies.”

White has been studying Gulf War illnesses since 1993 and served as research director of one of the three initial VA-funded centers on Gulf War illness. Since the early 1990s the U.S. Department of Defense and the Department of Veterans Affairs, among other federal entities, have funded SPH studies of Gulf War veterans and the effects of exposure to low-level sarin, pesticides, and pyridostigmine bromide.

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