Gulf War Illness Linked To Toxic Chemicals

Gulf War illness, the multi-symptom condition resulting from service in the 1990-1991 Gulf War, is the most prominent health issue affecting Gulf War veterans.

At least one fourth of 697,000 U.S. veterans who served in the 1990-1991 Gulf War are affected by the chronic symptomatic illness known as Gulf War illness (GWI). Clear determination of the causes of GWI has been hindered by many factors, including limitations in how epidemiologic studies have assessed the impact of the complex deployment environment on veterans’ health.

In a November 2008 report called, Gulf War Illness and the Health of Gulf War Veterans: Scientific Findings and Recommendations the Research Advisory Committee on Gulf War Veterans’ Illnesses, listed their results of extensive study and research.

The Congressionally mandated Research Advisory Committee on Gulf War Veterans’ Illnesses reviewed the extensive evidence available, including important findings from scientific research and government investigations not considered by earlier panels, to determine what is known about the health consequences of military service in the Gulf War. This evidence identifies the foremost causes of Gulf War illness, describes biological characteristics of this condition, and provides direction for future research urgently needed to improve the health of Gulf War veterans.

Evidence strongly and consistently indicates that two Gulf War neurotoxic exposures are causally associated with Gulf War illness: 1) use of pyridostigmine bromide (PB) pills, given to protect troops from effects of nerve agents, and 2) pesticide use during deployment. Evidence includes the consistent association of Gulf War illness with PB and pesticides across studies of Gulf War veterans, identified dose-response effects, and research findings in other populations and in animal models.

Widespread use of PB as a protective measure in the event of nerve gas exposure was unique to the 1990-1991 Gulf War. Pyridostigmine bromide is one of only two exposures consistently identified by Gulf War epidemiologic studies to be significantly associated with Gulf War illness. About half of Gulf War personnel are believed to have taken PB tablets during deployment, with greatest use among ground troops and those in forward locations.

Several studies have identified dose-response effects, indicating that veterans who took PB for longer periods of time have higher illness rates than veterans who took less PB. In addition, clinical studies have identified significant associations between PB use during the Gulf War and neurocognitive and neuroendocrine alterations identified many years after the war. Taken together, these diverse types and sources of evidence provide a consistent and persuasive case that use of PB during the Gulf War is causally associated with Gulf War illness.

The widespread use of multiple types of pesticides and insect repellants in the Gulf War theater is credited with keeping rates of pest-borne diseases low. Pesticide use, assessed in different ways, is one of only two exposures consistently identified by Gulf War epidemiologic studies to be significantly associated with Gulf War illness. Multisymptom illness profiles similar to Gulf War illness have also been associated with low-level pesticide exposures in other human populations.

In addition, Gulf War studies have identified dose-response effects, indicating that greater pesticide use is more strongly associated with Gulf War illness than more limited use. Pesticide use during the Gulf War has also been associated with neurocognitive deficits and neuroendocrine alterations in Gulf War veterans in clinical studies conducted many years after the war. Taken together, all available sources of evidence combine to support a consistent and compelling case that pesticide use during the Gulf War is causally associated with Gulf War illness.

There were also several other Gulf War exposures, that included low-level exposure to nerve agents, close proximity to oil well fires, receipt of multiple vaccines, and effects of combinations of Gulf War exposures. There is some evidence supporting a possible association between these exposures and Gulf War illness, but that evidence is inconsistent or limited in important ways.