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One in Four Vets Suffers Gulf War Illness

Medical breakthroughs: BU experts own the science for landmark report

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Medical stories transcend all boundaries, because all of us — rich or poor, old or young, Mayflower descendant or recent arrival — hope for good health and need care sooner or later. This week, we revisit some intriguing medical reports from the past school year; the insights and breakthroughs they reveal could well shape our lives going forward.

Effectively debunking years of government denials, Gulf War veterans suffering a host of neurological problems scored a huge victory last fall in their struggle to legitimize their medical claims — thanks in part to public health experts at BU.

Comprising leading scientists, medical experts, and military veterans, a congressionally mandated panel charged with shaping federal health research related to the 1991 Middle East conflict has concluded that Gulf War syndrome is a real medical condition and that it afflicts at least one in four of the 697,000 U.S. veterans who fought in Iraq, Kuwait, and Saudi Arabia. The landmark report, presented in November 2008 by the Research Advisory Committee on Gulf War Veterans’ Illnesses to Secretary of Veterans Affairs James Peake, calls on Congress to appropriate $60 million for treatment of Gulf War vets.

“Veterans of the first Gulf War have been plagued by symptoms of ill health, including fatigue, problems with thinking, skin lesions, and gastrointestinal upset, since their return 17 years ago,” says Roberta White, the committee’s scientific director and chair of the department of environmental health at BU’s School of Public Health. “Despite their persistence and severity, these symptoms have often led to no diagnosis in a substantial portion of the war’s veterans.”

The 450-page report, which was prepared under the leadership of Lea Steele, the committee’s former scientific director, and released under White, brings together for the first time the full range of scientific research and government investigations on Gulf War illness. The report found that the condition fundamentally differs from stress-related syndromes seen after other wars and states that scientific evidence “leaves no question that Gulf War illness is a real condition.”

The report lays the blame for several health problems on the troops’ exposure to toxins, primarily in two self-inflicted contexts. In anticipation of a chemical attack, the drug pyridostigmine bromide was given to hundreds of thousands of troops. And to battle desert insects, living and dining areas, as well as tents and uniforms, were sprayed with pesticides.

The report also suggests that the U.S. demolition of an Iraqi munitions dump may have exposed 100,000 troops to nerve gas stored at the facility. Gulf War veterans have shown significantly higher rates of amyotrophic lateral sclerosis, a neurodegenerative disease also known as Lou Gehrig’s disease, than veterans of other wars. And troops that were stationed downwind from the demolitions have died from brain cancer at twice the rate of other Gulf War veterans.

For almost two decades, the government and the military have downplayed veterans’ complaints, often referring to it as another form of post-traumatic stress disorder (PTSD). For its report, the research committee evaluated hundreds of studies of Gulf War veterans, extensive research in other human populations, studies on toxic exposures in animals, and government investigations related to exposures in the Gulf War.

“The illness is probably controversial because it’s symptom-based and most veterans don’t have a common medical diagnosis that fits all of their symptoms,” White says. “It may also be controversial because people feel that it’s obvious that war is stressful and therefore stress must be causing the health symptoms, even though this has never been proven. In fact, it’s been discounted in quite a few studies.”

White has been studying Gulf War illnesses since 1993 and served as research director of one of the three initial VA-funded centers on Gulf War illness. Since the early 1990s the U.S. Department of Defense and Department of Veterans Affairs, among other federal entities, have funded SPH studies of Gulf War veterans and the effects of exposure to low-level sarin, pesticides, and pyridostigmine bromide.

The Research Advisory Committee on Gulf War Veterans’ Illnesses has been based at BU since last year.

Caleb Daniloff can be reached cdanilof@bu.edu.

This story originally ran December 3, 2008.

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