Panel Refutes 'Gulf War Syndrome'
Report by Institute of Medicine Is a Blow to Veterans Seeking Compensation
By Todd Zwillich
WebMD Medical News
Source:
http://www.webmd.com/content/article/127/116643
Reviewed By Brunilda Nazario, MD
on Tuesday, September 12, 2006
Sept. 12, 2006 -- A government advisory panel on Tuesday said it could find no
evidence of a 'Gulf War syndrome' afflicting U.S. soldiers who served in Iraq
and Kuwait in the early 1990s, though it did affirm that combat veterans do
suffer increased rates of many individual ailments.
The conclusion was a blow to veterans who maintain that exposures to pesticides,
weapons residues, or other chemicals caused a set of symptoms unique to their
service in Operation Desert Storm. The symptoms included fatiguefatigue, memory
loss, severe headaches, and respiratory and skin ailments, which interfered with
normal daily activities.
Those symptoms and others have penetrated the American lexicon as 'Gulf War
syndrome.' But experts convened by the Institute of Medicine (IOM) said that
their review of 850 studies shows it doesn't exist.
While studies show that Gulf War veterans are at higher risk than nondeployed
soldiers for a variety of illnesses, "the results of that research indicate that
… there is not a unique symptom complex (or syndrome) in deployed Gulf War
veterans," the report stated.
Seeking Compensation
Congress and the Veterans Administration rely in part on IOM to determine
compensation levels for various illnesses. The VA has resisted calls to classify
Gulf War symptoms as a service-connected syndrome. Tuesday's conclusions appear
to make it less likely that soldiers will be able to prove to the government's
satisfaction that their symptoms are a result of service in Iraq and therefore
deserving of full compensation.
"It makes it much harder to make that case," Shannon Middleton, assistant
director of health policy at the American Legion, tells WebMD.
The Pentagon began ordering soldiers to undergo health evaluations before
deployment in the 1990s after complaints about a Gulf War syndrome first
surfaced. But earlier studies usually lacked control groups or measures of
soldiers' health before the war -- factors researchers consider vital to
understanding the cause of disease.
High Rate of Complaints
Thirty percent of Gulf War veterans complain of some form of "multisymptom"
illness, often including fatigue, depression, anxiety, pain, or gastrointestinal
problems. About half as many nondeployed veterans complain of those symptoms,
according to the report.
Complaints of respiratory and cardiovascular symptoms, while more frequent in
combat veterans, were not generally borne out by heart and lung function tests.
"They're not different from the symptoms deployed people have. They just report
them at a higher rate," Lynn R. Goldman, MD, who chaired the panel that issued
the report, tells WebMD.
"There is not particular constellation of symptoms that's unique to Gulf War
vets," says Goldman, a professor at the Bloomberg School of Public Health at
Johns Hopkins University in Baltimore, Md.
The report did validate the higher rates of depression, anxiety, posttraumatic
stress, and substance abuse often seen in combat veterans and those with
prolonged service in battle theatres.
Sick or Not Sick?
Still, the results angered some Gulf War activists. Joyce Riley, spokeswoman for
the American Gulf War Veterans Association, called the report "one more blow"
for soldiers returned from the war.
That group and others maintain that as many as 150,000 Gulf War veterans suffer
from disabling symptoms unique to their service in Iraq and Kuwait but that full
compensation remains out of reach.
Riley called the debate over a definition of Gulf War syndrome "meaningless."
"Are they sick, or are they not sick," says Riley, a former Air Force captain
who served in the Gulf War.
Some studies have found increased rates of birth defects in children of
soldiers, though results are inconsistent. Of defects that have been observed,
urinary tract abnormalities are the most consistent, the report said.
The report also cited studies linking Gulf War service to a few diseases,
including the rare but fatal nerve disorder ALSALS, also known as Lou Gehrig's
disease. Some troops also showed evidence of confusion, memory loss, and
headaches, which is consistent with symptoms of exposure to sarin, a nerve agent
used in chemical weapons that were destroyed by U.S. forces during the war, the
findings stated.
Experts urged the department to perform follow-up studies on possible ALS, birth
defects, some cancers, and a suspected higher rate of motor vehicle deaths in
Gulf War veterans.
"There definitely are some signals there that need to be tracked over time,"
Goldman says.
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SOURCES: Gulf War and Health, Volume 4: Health Effects of Serving in the Gulf
War, Institute of Medicine, Sept. 12, 2006. Shannon Middleton, assistant
director of health policy, American Legion. Lynn R. Goldman, professor, Johns
Hopkins University; chair, IOM panel. Joyce Riley, spokeswoman, American Gulf
War Veterans Association.