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Panel Refutes 'Gulf War Syndrome'
Report by Institute of Medicine Is a Blow to Veterans Seeking Compensation
By Todd Zwillich
WebMD Medical News
Reviewed By Brunilda Nazario, MD
on Tuesday, September 12, 2006
Sept. 12, 2006 -- A government advisory panel on Tuesday said it could find no evidence of a 'Gulf War syndrome' afflicting U.S. soldiers who served in Iraq and Kuwait in the early 1990s, though it did affirm that combat veterans do suffer increased rates of many individual ailments.
The conclusion was a blow to veterans who maintain that exposures to pesticides, weapons residues, or other chemicals caused a set of symptoms unique to their service in Operation Desert Storm. The symptoms included fatiguefatigue, memory loss, severe headaches, and respiratory and skin ailments, which interfered with normal daily activities.
Those symptoms and others have penetrated the American lexicon as 'Gulf War syndrome.' But experts convened by the Institute of Medicine (IOM) said that their review of 850 studies shows it doesn't exist.
While studies show that Gulf War veterans are at higher risk than nondeployed soldiers for a variety of illnesses, "the results of that research indicate that … there is not a unique symptom complex (or syndrome) in deployed Gulf War veterans," the report stated.
Congress and the Veterans Administration rely in part on IOM to determine compensation levels for various illnesses. The VA has resisted calls to classify Gulf War symptoms as a service-connected syndrome. Tuesday's conclusions appear to make it less likely that soldiers will be able to prove to the government's satisfaction that their symptoms are a result of service in Iraq and therefore deserving of full compensation.
"It makes it much harder to make that case," Shannon Middleton, assistant director of health policy at the American Legion, tells WebMD.
The Pentagon began ordering soldiers to undergo health evaluations before deployment in the 1990s after complaints about a Gulf War syndrome first surfaced. But earlier studies usually lacked control groups or measures of soldiers' health before the war -- factors researchers consider vital to understanding the cause of disease.
High Rate of Complaints
Thirty percent of Gulf War veterans complain of some form of "multisymptom" illness, often including fatigue, depression, anxiety, pain, or gastrointestinal problems. About half as many nondeployed veterans complain of those symptoms, according to the report.
Complaints of respiratory and cardiovascular symptoms, while more frequent in combat veterans, were not generally borne out by heart and lung function tests.
"They're not different from the symptoms deployed people have. They just report them at a higher rate," Lynn R. Goldman, MD, who chaired the panel that issued the report, tells WebMD.
"There is not particular constellation of symptoms that's unique to Gulf War vets," says Goldman, a professor at the Bloomberg School of Public Health at Johns Hopkins University in Baltimore, Md.
The report did validate the higher rates of depression, anxiety, posttraumatic stress, and substance abuse often seen in combat veterans and those with prolonged service in battle theatres.
Sick or Not Sick?
Still, the results angered some Gulf War activists. Joyce Riley, spokeswoman for the American Gulf War Veterans Association, called the report "one more blow" for soldiers returned from the war.
That group and others maintain that as many as 150,000 Gulf War veterans suffer from disabling symptoms unique to their service in Iraq and Kuwait but that full compensation remains out of reach.
Riley called the debate over a definition of Gulf War syndrome "meaningless."
"Are they sick, or are they not sick," says Riley, a former Air Force captain who served in the Gulf War.
Some studies have found increased rates of birth defects in children of soldiers, though results are inconsistent. Of defects that have been observed, urinary tract abnormalities are the most consistent, the report said.
The report also cited studies linking Gulf War service to a few diseases, including the rare but fatal nerve disorder ALSALS, also known as Lou Gehrig's disease. Some troops also showed evidence of confusion, memory loss, and headaches, which is consistent with symptoms of exposure to sarin, a nerve agent used in chemical weapons that were destroyed by U.S. forces during the war, the findings stated.
Experts urged the department to perform follow-up studies on possible ALS, birth defects, some cancers, and a suspected higher rate of motor vehicle deaths in Gulf War veterans.
"There definitely are some signals there that need to be tracked over time," Goldman says.
SOURCES: Gulf War and Health, Volume 4: Health Effects of Serving in the Gulf War, Institute of Medicine, Sept. 12, 2006. Shannon Middleton, assistant director of health policy, American Legion. Lynn R. Goldman, professor, Johns Hopkins University; chair, IOM panel. Joyce Riley, spokeswoman, American Gulf War Veterans Association.