Gulf War illness: getting real

by revere, cross-posted at Effect Measure

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.