GULF WAR SYNDROME is real. That's the conclusion of a report from the congressionally mandated Research Advisory Committee on Gulf War Veterans' Illnesses, which for the first time declares a causal link between exposure to toxic chemicals and the neurological symptoms of the vets who served in the 1990–91 conflict.
The report also states that the symptoms were not caused by wartime stress, which is a factor emphasized by the Institute of Medicine (IOM) in numerous studies it has done on Gulf War illnesses.
The advisory committee cites two primary causes for the illnesses: overuse of the drug pyridostigmine bromide (PB) and exposure to a variety of pesticides.
PB was administered as a first level of protection to troops who might be exposed to certain nerve agents. It counters the effects of nerve agents such as soman by reversibly binding to and temporarily inactivating acetylcholinesterase, the enzyme typically targeted by the agents.
Heavy use of pesticides was common during the war to deal, for example, with flies and fleas, which were a major problem for troops. Soldiers frequently applied carbamates, pyrethroids, and organophosphate compounds to their skin or uniforms, the report notes.
"The report provides a blueprint for the new Administration to focus resources on improving the health of Gulf War veterans," said Committee Chairman James H. Binns at the presentation of the report on Nov. 17.
Among its recommendations, the committee seeks additional funds for research on Gulf War illnesses and asks the Department of Veterans Affairs to instruct IOM to redo its completed studies because they have been "skewed and limited."
Lynn R. Goldman, a professor at Johns Hopkins Bloomberg School of Public Health, chaired two of the IOM Gulf War panels and served on another. She "firmly denies that the IOM studies were skewed or restricted." Although she agrees with some of the conclusions in this study, she says, the claim of causality is hard to establish. The committee apparently used a different standard for causality than did IOM, she adds.