Panel Concludes Chemicals Caused Gulf War Illnesses

Gulf War Syndrome Caused by Chemical Exposures
UPdate spring 2005

Its been thirteen years since thousands of American, Canadian and British veterans who served in the Gulf War developed mysterious, disabling illnesses which continue to this day. For years, governments claimed the illnesses were stress related, and had no physical basis. Now, in a radical break from past official positions, the US presidential advisory committee charged with studying Gulf War illnesses has concluded that many Gulf War veterans suffer from neurological damage caused by exposure to toxic chemicals.

“Although its not proven, the preponderance of the evidence supports a new explanation - brain cell damage, nervous system damage caused by chemical exposures,” states Dr. Robert Haley, a researcher and member of the Research Advisory Committee on Gulf War Veterans’ Illnesses (RAC- GWVI.)

Almost 30% of the veterans from the Gulf War are still disabled by chronic symptoms affecting many body systems. The symptoms include severe headaches, memory problems, confusion, dizziness, blurred vision and tremors. Gulf War vets have developed ALS, or Lou Gehrigs disease, at twice the rate of vets who did not serve in the Gulf War. Some veterans returned seemingly well, yet developed severe illnesses months or years later. The lag time between cause and effect makes understanding these illnesses more difficult.

The committee’s report, Scientific Progress in Understanding Gulf War Veterans’ Illnesses, was released in November, 2004. Based on research carried out in recent years, the committee has pinpointed three sources of exposure as the most likely sources of illness: sarin, which is a nerve gas, pyridostigmine bromide (PB), an “investigational” drug which is itself a nerve gas and was given to troops in small doses with the objective of protecting them against nerve gas, and multiple pesticides including DEET, the repellant used on skin, and permethrin, the repellant used on uniforms.  These chemicals are all acetyl cholinesterase inhibitors, which means they effect nervous system functioning. This category of chemicals can cause a range of symptoms including cognitive impairment, effects on muscles and coordination, pain, fatigue and diarrhea. Earlier reports did not consider the possible role of acetyl cholinesterase inhibitors in veterans’ illnesses.

New research disproves a number of earlier scientific understandings. Fifteen animal studies since 2000 show animals suffer ongoing neurological and immunological effects after low-level exposures to sarin. This evidence undermines a long held belief that long term adverse effects do not occur if there are no immediate symptoms on exposure to low levels of nerve agents.  

PB (pyridostigmine bromide) pills were used by more than half of all personnel in the Gulf war, although  amounts varied widely. Animal studies indicate that PB’s toxic effects can be enhanced when combined with other Gulf War-related exposures. Other studies show higher rates of Gulf War illnesses in veterans who took PB than in those who did not.  

Pesticides are pinpointed as another key contributor to Gulf War Illness. The US Department of Defense reports that 41,000 troops were overexposed to pesticides in the Gulf War. Government reports indicate that more than 37 pesticide ingredients were used; on skin, clothing, in tents and sprayed in camp.  Studies consistently link higher illness rates to greater exposure to  pesticides.

The impact of exposure to a variety of neurotoxic substances at the same time is another significant issue. Dozens of animal studies in recent years have shown that combined exposure to the same chemicals to which solders were exposed during Gulf War service can act synergistically, resulting in toxic effects far greater than the added effects of each individual exposure.

Why some veterans developed chronic problems after the war and others did not may be explained by the fact that individuals differ in their ability to inactivate neurotoxins, the RAC explained. Studies have found that Gulf War veterans who became chronically ill have lower levels of the enzyme PONI, which serves to neutralize nerve agents and pesticides. 

The Advisory Committee report notes that other Gulf War exposures may also have contributed to Gulf War illnesses. They plan to make future reports which will look at the impact of oil well fires, depleted uranium and vaccines. 

Why has it taken so long to reach the conclusion that Gulf War illnesses are caused by low level chemical exposures? Haley, a research scientist, describes the US government’s past denial of Gulf War syndrome as a “10 year misadventure.” He explains that US authorities expected to find many cases of post-traumatic stress disorder (PTSD), and designed tests to screen for this. Although follow up studies in the US and the UK found that only 3% of veterans had PTSD, the myth that Gulf War Syndrome was really a psychological illness persisted, and research funding continued in this direction.

Researchers pursuing different theories were forced to find funding from private sources. Billionaire Ross Perrot provided funds that helped unlock the puzzle. 
“What we should have done was what we do for every new disease: establish a case definition,” Haley says. This would include finding out what unusual symptoms people are reporting, then looking for those symptoms in larger groups to see if they are widespread, associated with particular histories, or if they occur in characteristic clusters. It was critical to ask the right questions, he explained. 

Haley’s research, funded by Perrot, did that.  “When we talked to the veterans, certain symptoms really stood out,’ Haley says. He constructed a questionnaire to find out if two separate groups of veterans had similar symptoms. “If you ask people, do you have aches and pains, people will say yes. But if you ask, do you have severe joint pains that keep you awake and last all day and for months, healthy people don’t. Gulf veterans do,” Haley notes.
Because Gulf War Syndrome has not been recognized by government authorities, most disabled Gulf War veterans in Canada, the US and UK have received almost no treatment for their illnesses. Now that some of the physiological bases for the disease have been identified, the RAC report emphasizes the urgent need to find treatments to improve the health of these veterans.  Improving veterans health must be next research priority, the committee states.  
Most veterans have been denied disability pensions. The winter issue of Salute, published by Veterans Affairs Canada stated, “At present, Veterans Affairs Canada cannot award a disability pension for Gulf War Syndrome because it is not an illness that is recognized by the international medical and scientific community.” The new RAC report should set the stage for a revision of this position. 

Given the political will, Gulf War illnesses could lead to important advances in  scientific understanding, both of the disease and treatment for it.There is a large, identified group of people with similar documented chemical exposures, and there is a control group (vets who did not serve in the Gulf War) for comparison. Gulf War Syndrome does not fall into an accepted disease pattern.  However, it does match up with emerging patterns of illness recognized by those who study multiple chemical sensitivity, sick building syndrome and chronic fatigue syndrome. All of these diseases involve chronic, multi-organ symptoms and decreased tolerance to minute exposures of many unrelated chemical and food groups. As with Gulf War illnesses, incidences of these illnesses have often been attributed to stress. At Camp Hill Medical Centre in Halifax, 600 workers, 30% of the workforce, became ill with a similar myriad of symptoms.  The government review of the problem concluded that these illnesses were caused by stress related to hospital amalgamation, although later Compensation Board hearings found that many workers became ill from chemical exposures.

Research relating to Gulf War illnesses has the potential to help to unlock some of the mysteries of these illnesses, undertake and assess pilot treatment projects, and increase scientific understanding of the toxic effects of low level chemical exposures, alone or in combination.