According to a report produced by a congressionally mandated investigation more than 1 in 4 US veterans of the first Gulf War suffers from a multi-symptom illness commonly referred to as Gulf War syndrome or Gulf War illness.
Prior to the report's release on Monday a change in position had slowly been taking place within the US government and military regarding Gulf War syndrome, but for much of the 17 years since the war in 1991 it had been dismissed and affected veterans given little medical or financial help.
Almost 700,000 US troops were deployed to the Gulf during Operation Desert Storm so if the figures in the report are correct that translates to at least 175,000 veterans left sick and unable to live any kind of normal life. A startling number and more continue to come forward.
The report, compiled by The Research Advisory Committee on Gulf War Veterans Illnesses, a committee of prominent scientists and veterans, states that: "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."
Dismissing the often used argument that Gulf War syndrome is purely a result of the stress of combat and that veterans are suffering from post-traumatic stress disorder (PTSD) the report says: "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."
Gulf War illness is typically characterized by symptoms including unexplained fatigue, widespread pain, problems with memory and concentration, and persistent headaches. Sufferers may also experience chronic digestive problems, respiratory symptoms, skin rashes, and a acute sensitivity to chemicals encountered inevery day life. Many scientists, veterans, and their doctors have noted the close similarity of veteran's illnesses to other multi-symptom conditions such as chronic fatigue syndrome (ME/CFS), fibromyalgia, and multiple chemical sensitivity (MCS).
Professor Malcolm Hooper of the University of Sunderland, UK, discusses how these conditions are linked, both in terms of symptoms and biological abnormalities, in his extensive article 'Guts, Brains and Gulf Veterans'. Professor Hooper also points out that the contribution multiple vaccinations made to the onset of Gulf War illness might have something to teach us about vaccines and the development of autism in children.
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.
It says that it is the first investigation to use all available evidence to come to a reliable conclusion on the illnesses suffered by veterans. Criticizing particularly, earlier investigations which had failed to include the results animal studies looking at the effects of toxic exposures.
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 gave special mention to two Gulf War exposures consistently found by studies to be causally associated with Gulf War illness: (1) the drug pyridostigmine bromide (PB), given to troops to protect against nerve gas, and (2) pesticides that were widely used, and often overused, during the Gulf War.
Earlier in the year committee member Dr. Beatrice Galomb revealed that some people are at particularly risk from such chemicals due to genetic variations which impair enzyme function. When exposed these people run a much higher risk for developing symptoms and disease.
Golomb cited pyridostigmine bromide as being the most likely single trigger for the symptoms experienced by veterans.
"Convergent evidence now strongly links a class of chemicals - acetyl cholinesterase inhibitors [of which PB is a major example] - to illness in Gulf War veterans," Dr Golomb said.
According to Cox Newspapers interviewed veterans reported that trucks would come through their camps at 3 a.m. and spray clouds of pesticides to ward off swarms on sand flies. They also said that fly strips that smelled toxic hung everywhere, especially near food. The soldiers felt that the exposure to pesticides on a daily basis was far larger than would be experienced in everyday life.
Several soldiers interviewed by the newspaper group said "they were ordered to dunk their uniforms in the pesticide DEET and to spray pesticide routinely on exposed skin and in their boots to ward off scorpions," while others wore pet flea collars around their ankles.
The new report also said 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.
In addition to the symptoms associated with Gulf War syndrome, the Committee said, Gulf War veterans have significantly higher rates of amyotrophic lateral sclerosis (ALS) than other veterans. ALS is a form of motor neurone disease associated with degeneration of the nerves which control the muscles. ALS sufferers experience a weakening of muscles, gradually lose the ability to coordinate movements and may eventually become paralyzed. ALS can prove to be fatal if muscles controlling respiration are affected.
Finally the report notes that troops who were downwind from the Khamisiyah (an Iraqi munitions dump) demolitions have died from brain cancer at twice the rate of other Gulf War veterans.
The Committee's report recognises that: "Veterans of the 1990-1991 Gulf War had the distinction of serving their country in a military operation that was a tremendous success, achieved in short order. But many had the misfortune of developing lasting health consequences that were poorly understood and, for too long, denied or trivialized."
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."