Three Decades after the Gulf War, Veterans Still Battle Health Issues
Three Decades after the Gulf War, Veterans Still Battle Health Issues
New report by SPH researcher highlights ongoing debilitating fatigue, pain, and more
More than 30 years after the 1991 Gulf War, veterans of the war continue to experience a number of debilitating symptoms, collectively known as Gulf War illness (GWI).
About 200,000 veterans—roughly one-third of troops deployed during the Gulf War—are suffering from largely invisible symptoms, ranging from chronic pain and fatigue to respiratory and gastrointestinal issues, memory problems, and chronic headaches. Multiple studies have linked these persistent symptoms to military service during the Gulf War, and current evidence indicates that these health issues were caused by exposure to toxic chemicals, including sarin nerve gas, pesticides, and pyridostigmine bromide pills, meant to protect soldiers from nerve gas during deployment. This type of chemically induced illness has been termed a “toxic wound.”
Kimberly Sullivan (MED’99), a School of Public Health research associate professor of environmental health, is a leading expert on this research on GWI and for nearly 10 years was the principal investigator and director of the former Gulf War Illness Consortium (GWIC), a multi-institutional initiative based at SPH and funded by the Department of Defense’s Gulf War Illness Research Program (GWIRP), which aimed to identify GWI biomarkers to improve diagnosis and develop targeted treatments for ailing Gulf War veterans.
A new study led by Sullivan provides an in-depth assessment of the GWIC’s core clinical work, which focused on understanding the brain and immune functions of veterans with GWI.
The study, published in the journal Brain Sciences, found that veterans with GWI continue to show higher rates of chronic health issues such as memory problems, chronic pain, debilitating fatigue, and gastrointestinal problems. The study also showed evidence that many GW veterans are experiencing an earlier onset of age-related chronic diseases such as hypertension. Sullivan and colleagues also found that the extended use of pesticides on the skin and sustaining a mild traumatic brain injury during the war greatly increased the risk of having GWI. The researchers found no association between war experiences associated with intense stress or trauma and the risk of developing GWI.
“These results clearly show that GWI was not a result of stressors such as combat exposure, but rather are due to toxic wounds from exposures during the war that affect the brain and appear to be additive,” Sullivan says. “We believe these types of combined exposures, or ‘multiple-hits’ to the brain, as well as potential genetic susceptibility, may be why some veterans developed chronic GWI symptoms after these exposures, while others did not.”
For the study, the researchers collected and analyzed data on the health of 269 Gulf War veterans, through clinical evaluations, immune and immunogenetic blood tests, neuropsychological testing, and brain imaging at Boston University, the Miami Department of Veterans Affairs Medical Center, and Baylor College of Medicine between 2015 and 2020. The team also conducted a series of standardized health assessments, including pain, fatigue, sleep and mood outcomes, and performed neuroimmune blood testing.
In addition to these health issues, when compared to healthy GW controls, veterans with GWI scored worse on general health, sleep quality, sinus conditions, depression, and post-traumatic stress disorder (PTSD). For example, 42 percent of GW cases reported respiratory or sinus issues, compared to 7 percent of controls; 70 percent of cases reported body pain, versus 4 percent of controls; 83 percent had trouble finding words when speaking, versus 35 percent of controls; 23 percent of cases experienced chronic fatigue syndrome, versus 2 percent of controls; and 31 percent of cases experienced irritable bowel syndrome versus 7 percent of controls. Either currently or during their lifetime, 44 percent of GWI cases struggled with major depression versus 24 percent of controls. In an important finding, veterans who reported extended use of pesticides on their skin during deployment were three times more likely to have GWI and those who reported sustaining a mild head injury during the war were seven times more likely to have GWI.
Despite these signs of poor health, veterans with GWI reported normal health indicators on standard physical evaluation and clinical diagnostic tests for the study, which the researchers say could contribute to why GWI was unrecognized and undiagnosed by veterans’ physicians for so many years.
These results underscore the need for continued research on GWI to identify biomarkers and develop objective health measures for diagnosis, Sullivan says, rather than rely only on the current method of self-reporting of symptoms.
“Without objective biomarkers and diagnostic tests, it has made it much harder for Gulf War veterans to have official recognition of the disease and its causes, and has left many veterans struggling to get VA benefits for these self-reported symptoms,” she says. “Over 80 percent of Gulf War veteran claims for GWI are still being denied, and veterans feel that they have not been taken seriously about their illness.”
Through their research, Sullivan says, the team can now predict which veterans meet GWI criteria with about 71 to 90 percent accuracy, based on blood, genetic, and brain imaging marker testing from GWIC samples.
“We are working to revise the case definitions to include some of these simple diagnostic markers,” she says. “We hope that this will help to validate their illness and to get our veterans the help that they need. It’s our responsibility to take care of our veterans who went to war and came back sick.”
Since 2019, Sullivan has advanced the work of the GWIC through the Boston Biorepository, Recruitment, and Integrative Network (BBRAIN), a four-site recruitment and 10-site data-mining project that serves as a repository and critical resource for GWI researchers. Funded by the GWIRP, the $3.2 million project houses previous (including GWIC) and newly collected biological specimens and clinical survey and brain imaging data from 500 veterans with GWI and 267 healthy control veterans.
A recent study published in the journal Life Sciences details the work of BBRAIN thus far. Sullivan says the team is working to improve the accuracy of their diagnostic markers with the addition of the larger BBRAIN samples and data.
“We have learned from the GWIC study that combined exposures to toxic pesticides and even mild brain injuries are important to lasting health symptoms in our veterans,” she says. “More focused survey questions regarding these types of exposures are now included in the BBRAIN survey so that we can better identify the cause of the illness and to avoid these types of toxic wounds in future deployments. We hope to finalize study recruitment in the next year to be able to more fully answer these questions and to provide our veterans with simple diagnostic tests for their illness.”
If you are interested in participating in the BBRAIN study, call project coordinator Dylan Keating at 617-358-2230 or email at email@example.com.
Please allow this comment to raise attention, not only to Gulf War Illness (GWI) research but to Dr. Sullivan and her career endeavor to prioritize the health of the 1990/91 Gulf War Veterans (GWV). Dr. Sullivan, you are a stalwart researcher, if I may speak for the 200,000+ Veterans that endure the debilitating effects from our toxic wounds; “we value you deeply, thank you for dedicating your life work to us!” Moreover, allow me to suggest to any 1990/91 GWV, that deployed to Desert Shield/Desert Storm; that is concerned about their post-deployment health, to seriously consider participating in clinical research. You may learn more about what is going-on in your body and, equally important, to take this knowledge to your Patient Aligned Care Team (PACT) at the Veterans Health Administration (VHA), in order to develop effective healthcare plans.
I am a Desert Shield/Storm vet, and I’ve not been feeling so great over the past 15 or so years. I have participated in a bunch of studies with these doctors, and we are moving the ball forward (yes, we vets and researchers). Thank you Dr. Sullivan and team!
I think I am suffering from this. My va. Dr. Does not know anything about it and doesn’t want to know anything about it I need someone to help me. The va won’t. I want to know if I have this.
I am in the same boat ,had my first heart attack 25 years ago along with many health problems without any help from VA on gwi.
Agreed, same here
I am a Desert Shield/Storm vet too and i have felt most of these symptoms for nearly 30 years since returning from the Middle-East. I cannot tell you how many times that my complaints have been dismissed by both VA doctors as well as my PCP. The civilian docs act as If they are oblivious to GWI, and they probably are. The kicker is that they don’t care to learn more even when presented with articles relating to the subject. Very disheartening and frustrating to say the least. Thank you Dr. Sullivan. I wish you the very best in your endeavors.
I’m a gulf war vet. I took the Bromide pills. They had adverse effects on me. I was also guarding a ammo depot before it was blown up. We were under the mushroom cloud of chemicals. I was also exposed to oil clouds. We walked right through them. I’ve had these symptoms for thirty years! I’m a prime candidate for your studies. Please let me know if I can help.
I’m so glad that a came across this document. Very glad to hear there is someone like you Dr Sullivan that has researched this. I have been dealing with all of these issues for about 30 years. I was exposed to the MANY oil wells on fire and a SCUD missile exploding less than a kilometer from me. It is so easy for our government to claim war and send thousands of troops to fight, but then when “issues” arise, the federal government just shuns them off. With technology today, we could get a very easy data base of these conditions of all the troops and make a simple correlation. Again thank you Dr Sullivan, what next?
I’m a gulf war vet. I’ve lost a lot of fellow vet that serve with me to soon. My faith in God is what getting through this. I beat alcoholism & so many close cause to deaf due my service. I suffer from major sleep disorder , mood disorder , memory impairment & chronic pain. I like to be apart of any research.
The research is very much appreciated. However, the VA seems to be all over the place with acknowledging symptoms and illnesses. They often deny claims, regardless of evidence shown. They farm out comp and pen exams to QTC. This company ( in my experience) is nothing more than a rubber stamp. I have had multiple appointments, that had me travel 50 plus miles, and never layed hands on me. Recent news shows the VA is looking to strip veterans of their compensation. OSA, to name one. IF you were fortunate enough to receive a rating, you may now find yourself out in the cold. I myself have been denied, despite having multiple conditions to which OSA is medically linked to as a secondary condition.
I am a gulf war vet and was diagnosed with scleroderma in 2020. The symptoms started in 2019 with chronic pain, skin tightening,gastrointestinal issues which included diarrhea and substantial weight loss, insomnia and fatigue. A lot of the same symptoms described in the MUCMI conditions. Just wondering if there’s a connection.