By Sandra Basu
WASHINGTON – Exposures to pesticides and pyridostigmine bromide are causally associated with Gulf War illness, according to a new report which also said evidence continues to demonstrate that Gulf War illness is not the result of psychological stressors during the war.
“Gulf War illness is a serious physical disease, affecting at least 175,000 veterans of the 1990-1991 Gulf War that resulted from hazardous exposures in the Gulf War theater,” stated the recent report by the Research Advisory Committee (RAC) on Gulf War Illnesses.
The committee, established by Congress with members representing veterans, scientists, clinicians and the general public, emphasized that its recent findings bolster conclusions made in a previous report in 2008.
“Studies published since 2008 continue to support the conclusion that Gulf War illness is causally related to chemical exposures in the combat theater,” said Roberta F. White, PhD, the group’s scientific director.
The report acknowledged that progress has been made in improving scientific understanding of Gulf War illness since 2008 but said much work remains to be done, explaining, “The Committee recommends a robust federal research effort to monitor and improve the health of Gulf War veterans, with the identification of treatments for Gulf War illness the highest priority.”
Studies published since 2008 continue to document “poorer general health status and greater disability among Gulf War veterans than in contemporary veterans who did not deploy to the Gulf,” according to the RAC.
The committee pointed out that the studies they reviewed “show that Gulf War veterans most exposed to the release of nerve gas by the destruction of the Khamisiyah Iraqi arms depot have significantly elevated rates of death due to brain cancer. Veterans who were exposed to the highest level of contaminants from oil well fires also have increased rates of brain cancer deaths.”
The report also asserted that, despite an extensive number of studies conducted in Gulf War veterans in the 23 years since Desert Storm, “medical surveillance in this population remains seriously inadequate.
“Very little other research has yet been conducted to determine rates at which Gulf War veterans have been affected by other medical conditions of possible concern, including neurological diseases such as multiple sclerosis or Parkinson’s disease, other cancers, sleep disorders, adverse pregnancy outcomes or rates of birth defects in veterans’ children.”
The committee wrote that “this lack of scientific evidence undermines the ability of the Secretary of Veterans Affairs to make informed determinations concerning conditions for which veterans should be service-connected for purposes of disability compensation.”
Recommendations in the report include:
- An evidence-based, expert consensus-driven case definition for Gulf War illness should be developed. “The recent IoM [Institute of Medicine] panel on case definitions of Gulf War illness also commented that a data-based case definition of the disorder could be derived;”
- VA should adopt the name Gulf War illness for the symptomatic condition associated with military service in the 1990-1991 Gulf War, a recommendation also supported by the 2014 IoM report;
- A study on the prevalence of “multiple sclerosis, Parkinson’s disease, and brain cancers, as well as central nervous system abnormalities that are difficult to precisely diagnose in Gulf War and recent Iraq/Afghanistan war veterans was required by Congress in 2008 (Public Law 110-389, 2008, Section 804) and should be carried out.”;
- VA’s longitudinal survey should be used to assess rates of medical conditions, including neurological and behavioral disorders and birth defects, in children of Gulf War era veterans; and
- Animal models of Gulf War illness should be used for rapid screening of potential therapeutics.
Backdrop of Controversy
The new report comes against a backdrop of controversy about how the VA has approached Gulf War Illness.
In 2012, the committee said it had “no confidence in the ability or demonstrated intention of VA staff to formulate and execute an effective VA Gulf War illness research program,” charging that VA staff made changes to a Gulf War Illness strategic plan resulting in an unacceptable final version.
Further controversy erupted last year when VA announced that changes would be made to the group’s membership roster and charter “to align it with similar VA charters in accordance with the Federal Advisory Committee Act and the requirements of Public Law 105-368, § 104.” RAC members said that the changes were retaliatory in nature and would be detrimental.
Earlier this year,Rep. Mike Coffman, (R-CO) introduced the Gulf War Health Research Reform Act. If passed, the bill would give the committee independence from the VA and would allow the RAC to “exert independent control of the budget allocations, staffing levels and expenditures, personnel decisions and processes, procurements, and other administrative and management functions of the committee.”