Gulf War Syndrome

The term Gulf War syndrome or Gulf War illness refers to a number of symptoms reported by American veterans who served in the 1991 Persian Gulf War, including chronic fatigue, headaches, dizziness, memory problems, gastrointestinal problems, and skin problems. Several studies have shown that selfreported health conditions are higher among veterans deployed to the Persian Gulf than to veterans serving elsewhere, but establishing higher rates of clinically defined diseases has proven elusive. The wide range of symptoms reported, the fact that many of the symptoms could have multiple causes, the lack of objective verification for some of the symptoms, and the wide range of potential causes of the symptoms have made research into Gulf War syndrome difficult.

Military personnel serving in the Gulf War were potentially exposed to numerous health hazards, including dust and sand particles, smoke from oil well fires, insecticides, vaccinations, depleted uranium, and psychological and physiological stress. However, linking exposures with specific health conditions in individuals has proven difficult for several reasons, the most important of which is that data quantifying the exposure of particular individuals to specific health threats are not available. Most estimates of exposure are based on self-report, which is subject to recall and other types of bias. Another difficulty is that only limited medical information is available for the veterans before and after deployment, making it impossible to establish a baseline for health status that would serve as a standard of comparison for health status after deployment.

Numerous studies have been conducted investigating the health of Gulf War veterans and evaluating the effects of the hazards they were exposed to. In 1998, the Institute of Medicine (IOM) began a series of congressionally mandated reports to evaluate and summarize the available scientific and medical literature regarding these issues. Volume 4 of the IOM reports, Health Effects of Serving in the Gulf War, summarizes all scientific and medical peer-reviewed literature available in 2006 that addresses the health status of veterans deployed in the Persian Gulf. This report found no evidence for the existence of a unique ‘Gulf War syndrome,’ although it did find that Gulf War veterans were at increased risk for anxiety disorders, depression, and substance abuse problems, and found evidence for a possible elevated risk of amyotrophic lateral sclerosis (ALS). No evidence was found for increased cancer rates among Gulf War veterans, although there was some suggestion that brain cancer rates might be higher, and the IOM recommended follow-up studies to examine this connection further. The IOM report found that selfreported multisymptom illnesses were higher for Gulf War veterans both from the United States and from other countries that sent troops to the Persian Gulf. Gulf War veterans were more likely to be injured or die in a traffic accident in the first few years following their return but not in later years. Rates of hospitalization were similar among deployed and nondeployed veterans, and there was no evidence of an increase in [Page 448]cardiovascular disease or peripheral neuropathy. Evidence on respiratory illness was inconsistent, although some studies found a link between exposure to smoke from oil well fires and asthma. Evidence of the presence of birth defects in children of Gulf War veterans was also inconsistent.

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