Effect Measure

Gulf War illness: getting real

A congressionally mandated independent panel of scientists has just issued a report verifying what many of us have know since the early 1990s. Gulf War Syndrome (GWS) is real:

Gulf War syndrome is real and afflicts about 25 percent of the 700,000 U.S. troops who served in the 1991 conflict, a U.S. report said Monday.

Two chemical exposures consistently associated with the disorder — one to a drug given to soldiers to protect against nerve gas and the other said to protect against desert pests — were cited as causes in the congressionally mandated report presented to Veterans Affairs Secretary James Peake, the Los Angeles Times reported.

“The extensive body of scientific research now available consistently indicates that Gulf War illness is real, that it is a result of neuro-toxic exposures during Gulf War deployment, and that few veterans have recovered or substantially improved with time,” the report said. (UPI)

I was among the first epidemiologists to grapple with the problem of studying GWS. Some of my colleagues were jealous. One problem environmental epidemiologists have is acquiring good exposure information and records of events that may have taken place years prior to our coming on the scene. The assumption was that military records would be among the best and most useful. That problem, at least, would not bedevil the epidemiology. Unfortunately that was far from the truth. Military records were a shambles, what was left often stored in huge warehouses in cardboard cartons in paper form. The whole bag of crap that was the Gulf War of 1991 was djinned up in a few months and nobody planned for it. The Quartermaster Corps didn’t even have accurate records as to how many anti-nerve gas pills (pyridostigmine bromide) were shipped to the war zone, much less how many pills a soldier took. There was no guidance or foresight. Soldiers told us that many believed that if one pill was good, five pills were better, and they popped them when alarms went off. Most of the nerve gas alarms were false alarms, however. Some soldiers didn’t take any, under any circumstance. Then there were the oil well fires, resulting in uniforms soaked in the black oil mist that darkened the sky. Or the insect repellent lavishly applied, or the pesticides used in the tents, or the oil spread on the sand and tent floor as a dust suppressant, or the exposure of some troops decommissioning Iraqi nerve gas canisters, or the leishmaniasis, or the heat or any of a score of other possibly toxic exposures. The question in my mind was not whether some of the vets we saw were sick from the experience but the wonder why they weren’t all sick. As it turns out, this latest estimate suggests a quarter of them did get sick, and remain so.

Sorting all of this out, in the absence of good records, has taken time, persistence and ingenuity. The latest panel reviewed some 1800 scientific documents bearing on the matter (including some I authored with colleagues). We knew, and stated early on, that the problem was not just another manifestation of battlefield stress and were among the first to show fairly conclusively that stress was not a plausible explanation. That didn’t stop the Department of Defense or the Department of Veterans Affairs from invoking it at every opportunity. Neither DoD nor DVA have honored their social contract with soldiers and have been persistent and often cruel deniers of the reality of the illness they inflicted on these men and women by their lack of planning and lack of care.

I haven’t done Gulf War Syndrome scientific studies for some years, although I remain on a scientific advisory committee that deals with the latest research. Meanwhile there has been little research on treatment and research for either treatment or the mechanisms of harm have been scaled back drastically. As always, the carnage of the most recent war has eclipsed the damaged soldiers of the previous war. They are now forgotten soldiers.

I confess I find it hard not to be bitter when I observe that those most in favor of this war are often the first to forget the last one.


  1. #1 Brad
    November 19, 2008

    Kipling had it pretty much right:

    For it’s Tommy this, an’ Tommy that, an’ “Chuck him out, the brute!”
    But it’s “Saviour of ‘is country” when the guns begin to shoot;

    Then it’s back to “Chuck him out” again afterward.

  2. #2 cooler
    November 19, 2008

    The cause of GWI was always obvious. It was caused by an infection mycoplasma incognitus discovered the Armed Forces Institite of Pathology. This is what Garth and Nancy Nicolson found in their blood, no wonder they were so sick!

    “Lo laid all his cards on the table. He had detected an organism similar to a bacteria, called a mycoplasma, in cells taken from AIDS patients. He could not find the organism in cells of healthy individuals. When he injected the organism into four silvered leaf monkeys, three quickly developed low-grade fevers. All four lost weight. All four died within seven to nine months of infection. When they were autopsied, there was Lo’s mycoplasma in their brains, livers and spleens.

    Lo also reported finding the mycoplasma in the damaged tissue of six HIV-negative human beings who had died from unspecified causes after suffering from suspiciously AIDS-like symptoms.”
    Is HIV guilty? Miami herald 1990

  3. #3 JK
    November 19, 2008

    I’m sorry to see that your implicit claim those who have tried to understand the role of social psychology and stress as patsies of the Pentagon who think that suffering of veterans is not ‘real’.

  4. #4 cooler
    November 19, 2008

    Stress can’t explain vets going blind, bloody diarrhea and abnormal brain scans. Nice try though.

  5. #5 Julie Stahlhut
    November 19, 2008

    Stress and the social milieu of war are certainly not your friend, but these vets were being exposed to a lot of things besides the sound of gunfire and the sight of casualties. I’m sure the WWI soldiers who got attacked with mustard gas were under a lot of psychological stress, but they were still being poisoned in addition to everything else.

  6. #6 revere
    November 19, 2008

    JK: Combat in this war lasted 4 days and the rate of PTSD is far below that of other wars. More importantly, we took account of the stress factor in some of our studies. Early on it was very clear it was not the explanation yet the Pentagon and VA continued to trot it out at every opportunity. This was not a dig at the importance of stress in general, just in this instance.

  7. #7 Kyle
    November 19, 2008

    This is really interesting and very sad. The things that we used to try to keep our soldiers safe actually ended up harming them in the end. It really makes you think about the cleaners, medicine, etc that you use everyday.

  8. #8 MK
    November 19, 2008

    “it is a result of neuro-toxic exposures during Gulf War deployment”

    I personally feel this was your onl strong point. This is the onl scientific reason you tried to use to explain the so called “Gulf War Illness”. This information is being backed up with no actual scientific data, therefore it is hard to grasp and believe. Stress and chaos is not enough to cause someone an illness. This post was you trying to convince us with nonsense that the Gulf War illness is real. If you want to prove the conditions of these soldiers and have people back you up, more date and information would help.

  9. #9 revere
    November 19, 2008

    MK: I don’t need to convince you and wasn’t trying to. The post was about a comprehensive report from an independent scientific panel that examined almost 2000 scientific documents on the matter. I wasn’t reviewing the evidence but noting the evidence had been reviewed and the obvious conclusion reached. There is a lot of data. If you are interested you will have no trouble finding it. If you aren’t interested, forget it. That seems to be the style with the whole subject, unfortunately.

  10. #10 WotWot
    November 20, 2008

    What? A ‘Functional Somatic Syndrome’, declared by certain world leading experts to undeniably be a psycho-social pathology, actually turns out to be a biological disorder?

    Well bless my little cotton socks. Whoodathunkit?

    I mean, this is unprecedented. Right?

  11. #11 Lab Lemming
    November 21, 2008

    just out of curiosity, how does the current best scientific understanding rank exposure to depleted uranium munitions in its list of most likely causes of GWS?

  12. #12 maryn
    November 21, 2008

    As a journalist I am supposed to be dispassionate, but: This is amazing news. In 1992, Nick Tate and I, then at the Boston Herald, wrote the first of a series of stories that eventually stretched over 15 months, about mysterious illnesses in veterans in western Massachusetts. (The initial stories were about reservists, who, having returned to their civilian lives, were less afraid to come forward than active-duty military.) The stories caught the attention of Rep. Joe Kennedy, who convened the first Congressional hearings on what came to be known as Gulf War Syndrome. It has always bothered me that the symptoms we reported in those stories did not accord with either psychogenic illness or PTSD (though some of the vets probably had PTSD as well). It’s heartening to have an answer at last.

  13. #13 Michael Z. Williamson
    November 24, 2008

    I’m curious, because I’ve seen previous studies that stated the illness rate among Gulf vets was LOWER than baseline. OF course, that doesn’t mean that those who got sick aren’t legitimately sick with something, but 25%? I know that’s impossible. I’ve served with/know/friends with hundreds of Gulf War vets–heck, there were several hundred on my recent deployment. No one is talking or referencing “their friend sick since the Gulf War.” And 25% is statistically high enough I should both know someone AND hear about it. In the military, I hear NOTHING about it. 175,000 of my brothers and sisters are sick? Sorry, they’re not. There’s a HUGE mistake somewhere in this study.