http://www.navytimes.com/news/2007/05/military_sarin_gulfwar_070525w/
Study: Sarin at
root of Gulf War syndrome
By Kelly Kennedy - Staff writer
Posted : Friday May 25, 2007 11:57:15 EDT
As benefits administrators, officials and politicians argue the worthiness of
studies on Gulf War syndrome, researchers say they have no doubts that they’ve
found the root of the problem.
Sarin gas.
And they have advice for as many as 300,000 troops exposed to small doses of
sarin in 1991: Don’t use bug spray, don’t smoke and don’t drink alcohol.
“Don’t do anything that would aggravate a normal, healthy body,” said Mohamed
Abou-Donia, a neurobiology scientist at Duke University who conducted two
studies for the Army.
Research released in early May showed that 13 soldiers exposed to small amounts
of sarin gas in the 1991 Gulf War had 5 percent less white brain matter —
connective tissue — than soldiers who had not been exposed. A complementary
report showed that 140 soldiers who were exposed had the fine motor skills of
someone 20 years older — what researchers called a “direct correlation” to
exposure.
The data was the work of Roberta White, chairwoman of the Department of
Environmental Health at Boston University School of Public Health.
Her study was noteworthy because it was funded by the Veterans Affairs and
Defense departments, and used Pentagon data to triangulate the locations of
troops who were in the path of a huge sarin plume unleashed when U.S. forces
destroyed an Iraqi chemical weapons dump in Khamisiyah in March 1991. The study
also used new technology to look at troops’ brains.
Of the 700,000 service members who served in Desert Storm, 100,000 have reported
mysterious symptoms. Until recently, each study commissioned by the VA and
Pentagon concluded the problems were caused by stress and had no physical cause.
“We’ve been asking for this for so long,” said Denise Nichols, a Gulf War
veteran who spends much of her time fighting for more information. “It’s not
surprising to me. It’s what I would expect.”
Nichols, like the other veterans, has heart palpitations, a cough, nose bleeds,
joint aches, spine pain, twitching in her legs and leg pain. She also reacts to
strong chemical smells with coughing so heavy she can’t breathe, she said.
The issue surged to the fore in a Senate hearing Wednesday as Sen. Patty Murray,
D-Wash., asked if the VA would send out letters to veterans who may have been
affected, as they did to 100,000 troops at higher risk of brain cancer because
of sarin exposure.
Murray called the study a “great example” of how recent research can provide
guidelines for care. It seems easy enough: If a soldier complains of Gulf War
syndrome, why not check him out with an MRI?
She called the study’s findings “overwhelming,” but noted that the VA’s
response, once again, was merely: “We’re going to study this.
“They were told, ‘It’s all in your head, you’re making it up.’ Now there is a
study that provides a direct link. They deserve to know the answer,” Murray
said.
Sen. Bernie Sanders, I-Vt., called the research “profound.”
“We started out by denying there was any problem,” he said. “It shows that many
soldiers may have suffered brain damage.”
Dr. Gerald Cross, acting principal deputy undersecretary for health at the
Veterans Health Administration, agreed with Murray that troops deserve answers.
But Cross said Sanders’ description of the findings “is different from how I
read it.” Cross called the findings of White’s research a “slight anatomical
variation.”
The debate over this issue goes back 16 years to when U.S. forces blew up the
chemical munitions dump in Khamsiyah and released a plume of sarin gas to which
thousands of U.S. troops were exposed — something the Pentagon denied until
1997.
As more research was done, and as veterans systematically sought details through
the Freedom of Information Act, scientists showed Desert Storm vets exposed to
sarin were at higher risk for brain cancer. And the veterans eventually showed
the Pentagon knew that as many as 300,000 service members had breathed in small
doses of the toxic fumes.
Paul Sullivan, of Veterans for Common Sense, said he filed FOIA requests in
1994, and then helped ensure research was made public that showed veterans were
not making up their illnesses.
Eventually, 10 years after the Gulf War, the Research Advisory Committee on Gulf
War Veterans' Illnesses was created by Congress. It held meetings to determine
what needed to be done, to review research, and to fund further research outside
the VA and Defense Department, Sullivan said.
“That’s why, in the last few years, you’ve seen all the sarin, depleted uranium
and pyridostigmine bromide research,” Sullivan said. “It’s a bittersweet victory
because people waited so long.”
To date, he said, no one has contradicted that research. As such, Sullivan said
he thinks every Gulf War veteran should automatically be presumed to have been
exposed to sarin.
In 1999, working on behalf of the Rand Corp., Beatrice Golomb, professor of
internal medicine at the University of California, San Diego School of Medicine,
reviewed every study she could find on the issue. She said it was the first time
anyone had pulled all that research together.
Golomb said she found a link between symptoms of Gulf War veterans and their
exposure to sarin, pyridostigmine bromide (PB) and bug repellent, all of which
overstimulate muscles by inhibiting acetylcholinesterase, a chemical that
signals muscles to stop moving. The tongue, being a big muscle, eventually cuts
off a person’s ability to breathe if it is overstimulated.
In the case of the bug repellent, the ill effects are aimed at the bug, not the
person wearing the repellent.
In large enough amounts, PB is harmful, but in small doses it acts to prevent
nerve agents from overstimulating muscles, and the effects of PB itself are
temporary and reversible.
Exposure to sarin alone would be problematic enough. But for Gulf War veterans,
exposure to sarin as well as PB and/or bug repellent may have been what ushered
in Gulf War syndrome.
Abou-Donia’s research showed the combination of nerve agents, PB, bug spray and
stress could cause any of those chemicals — as well as any lurking viruses — to
cross the blood-brain barrier, causing other problems. He said he has no doubt
there are other long-term effects of low doses of sarin on other body systems,
citing chronic fatigue, muscle weakness and fibromyalgia as symptoms.
White’s work came in the wake of animal research that showed persistent central
nervous system effects and acetylcholinesterase inhibition following exposure to
sarin at levels too low to produce clinically observable symptoms.
The use of PB among troops, and PB’s potential role in Gulf War syndrome in
combination with other substances, also has been scrutinized.
PB slows the effects of nerve agents, giving troops more time to self-administer
antidotes. Research has shown PB offers troops a better chance of survival
against the nerve agent soman, rather than sarin, because soman works much
quicker than sarin.
Golomb’s research showed that just before the Gulf War, the U.S. government knew
Iraqi leader Saddam Hussein had sarin in his arsenal, but had no evidence he
possessed soman.
As such, she said “there was no benefit” to giving troops PB to increase their
survival odds in the event of a sarin attack as long as they had access to the
antidote, she said.
Yet according to the Pentagon, about 250,000 troops were given PB during the
Gulf War.
Golomb said the U.S. military changed its PB policy because of the report she
did for Rand and is not dispensing it to troops in the current war in Iraq.
John Rash, who did research on PB for the Pentagon in the late 1970s and early
1980s, was charged with ensuring people could react with their antidotes quickly
enough to prevent nerve gas poisoning.
Rash’s research looked at the long-term effects of PB in combination with sarin
and soman on rats. At first, he said, the filaments separating muscle cells
“turned to soup.” But within days, the membranes reappeared and the rats seemed
to have recovered.
“That’s what made the Army particularly like our study,” he said.
But he said he didn’t look at how the drug would affect any other body system.
And, he said, he knew the combination of stress and drugs could cause the agents
to cross the blood-brain barrier.
Rash said his study was never published because the U.S. military didn’t
necessarily want to publicize the results during the Cold War era. But he said
it will come out within the next two years.
A human study in 1997 showed subtle deficits in short-term memory and attention,
a slight elevation of hospitalization for circulatory diseases, and a twofold
increase in brain cancer deaths more than four years after exposure.
To Abou-Donia, the connection became clear after terrorists hit a Tokyo subway
with sarin in 1995. Hospital workers who were never in the subway but who worked
with sickened passengers came down with the same symptoms reported by Gulf War
vets.
“At last they can have peace of mind because they know what it was, most
likely,” he said.
But, he said, there isn’t much that can be done now — although he cautioned Gulf
War vets not to use insecticide.
“It’s kind of too late to do much of anything,” he said. “But the body has many
redundant systems. Usually, if the damage is small, other neurons will take
over. As time goes by, people will adapt.”
A list of units exposed to sarin in the 1991 Gulf War is online.