Report to Congress: Gulf War syndrome is real

Los Angeles Times

Contradicting nearly two decades of government denials, a congressionally mandated scientific panel has concluded that Gulf War syndrome is real and still afflicts nearly a quarter of the 700,000 U.S. troops who served in the 1991 conflict.
The report cited two chemical exposures consistently associated with the disorder: the drug pyridostigmine bromide, given to troops to protect against nerve gas, and pesticides that were widely used -- and often overused -- to protect against sand flies and other pests.
"The extensive body of scientific research now available consistently indicates that Gulf War illness is real, that it is a result of neurotoxic exposures during Gulf War deployment, and that few veterans have recovered or substantially improved with time," according to the report presented today to Secretary of Veterans Affairs James Peake.
The report vindicates hundreds of thousands of U.S. and allied veterans who have been reporting a variety of neurological problems -- even as the government maintained that their symptoms were largely due to stress or other unknown causes.
"Recognition of the full extent of the illnesses suffered by these veterans of the conflict and the obligation owed them is long overdue," said Marshal of the Royal Air Force Lord David Craig, chief of the British defense staff during the war. "They are victims of the war as much as anyone struck by a bullet or shell."
The panel, made up of scientists and veterans, called on Congress to appropriate $60 million per year to conduct research into finding a cure for the disorder.
"The tragedy here is that there are currently no treatments," said the panel's chair, James H. Binns, a former principal deputy assistant secretary of defense and a Vietnam veteran.
The reports of a Gulf War syndrome have percolated ever since the end of the war. Many veterans reported memory and concentration problems, persistent headaches, unexplained fatigue and widespread pain. Some also reported chronic digestive problems, respiratory symptoms and skin rashes.
The new report is the product of the Research Advisory Committee on Gulf War Veterans' Illnesses, which was chartered by Congress in 1998 because many members felt that veterans were not receiving adequate care. Its 15 members, about two-thirds scientists and the rest veterans, were not appointed until January 2002.
Critics charged that the VA was reluctant to spend the research and treatment funds that such a committee might recommend.
Several reports had already been issued by the prestigious Institute of Medicine, an arm of the National Academy of Sciences, concluding that there was little evidence to support existence of the syndrome.
Today's report, however, concludes that those studies were inappropriately constrained by the VA.
The bulk of the evidence about the neurotoxic effects of the chemicals to which the soldiers were exposed comes from animal research, but the VA ordered the institute to consider only the much more limited human studies, skewing the results, the panel said.
"Everyone quotes the Institute of Medicine documents as meaning nothing's going on here," said Roberta F. White, associate dean of research at the Boston University School of Health and the panel's scientific director. "Some people feel that the IOM reports have been permission to ignore these guys. . . . 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."
The panel urged VA to instruct the Institute of Medicine to redo its reports and take into consideration all the available animal research.
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.
The major causes of the disorder appear to be self-inflicted. Pyridostigmine bromide was given to hundreds of thousands of troops in the fear that the Iraqis would unleash chemical warfare against them.
The pesticides cited in the report were sprayed not only around living and dining areas, but also on tents and uniforms, White said.
Another, although probably lesser cause, was the U.S. demolition of Iraqi munitions near Khamisiyah, which may have exposed about 100,000 troops to nerve gases stored at the facility, according to the panel.
It cited a 2007 study by White that showed that the exposure could have caused lasting brain changes in troops and that the extent of the changes correlated with the degree of exposure.
The panel also noted that veterans have significantly higher rates of amyotrophic lateral sclerosis than other veterans and that troops who were downwind from Khamisiyah have died from brain cancer at twice the rate of other veterans.
Binns emphasized that the report was not written to yield recriminations about past actions.
"The importance . . . lies in what is done with it in the future," he said. "It's a blueprint for the new administration."
Engel and Maugh are Times staff writers
mary.engel@latimes.com
thomas.maugh@latimes.com

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