Gulf War Illness and the Health of Gulf War Veterans Scientific ...

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MCS MDA MDPH 2ME MEG MF59 MHPG MOD MOPP MPTP MRI MRS mRNA MS NAA/Cr NADH NAPPs NAPs NAS NATO NBC NCO NHRC NIH NK cells NMH NOx NTE O 3 ODS OEF OIF OP OPIDN OR ORD OSAGWI p PA PAC multiple chemical sensitivity malondialdehyde Michigan Department of Public Health ethylene glycolmonomethyl ether, a solvent magnetoencephalography a vaccine adjuvant that contains squalene 3-methoxy-4-hydroxyphenylglycol Ministry of Defence, U.K. Mission Oriented Protective Posture, protective garments worn at different levels of chemical threat 1-methyl 4-phenyl 1,2,3,6-tetrahydropyridine magnetic resonance imagining magnetic resonance spectroscopy messenger ribonucleic acid multiple sclerosis N-acetyl-aspartate/creatine ratio nicotinamide adenine dinucleotide nerve agent pyridostigmine pretreatment sets nerve agent pretreatment sets The National Academy of Sciences North Atlantic Treaty Organization nuclear, biological, and chemical noncommissioned officer Naval Health Research Center, U.S. Navy National Institutes of Health natural killer cells neurally mediated hypotension oxides of nitrogen neuropathy target esterase ozone Operation Desert Storm Operation Enduring Freedom Operation Iraqi Freedom organophosphate organophosphate induced delayed neuropathy odds ratio, a measure of association between a risk factor and health outcome Office of Research and Development, U.S. Department of Veterans Affairs Office of the Special Assistant to the Deputy Secretary of Defense for Gulf War Illnesses p value, a test of statistical significance protective antigen, immunogenic component of the anthrax vaccine Presidential Advisory Committee on Gulf War Veterans’ Illnesses 452 • Gulf War Illness and the Health of Gulf War Veterans
PAHs 2-PAM PB PBMC PCR PET PGVCB PL PM10 PON1 Prev diff PSOB PTSD Q R RAC-GWVI RAND RCT REM RFA RFP ROS RR SCID SCUD SF36 SF36 PCS sign. SIU SO 2 SOx SPECT SR SRI SSG SSgt subQ TCPs Th1 polycyclic aromatic hydrocarbons 2-pralidoxine chloride, used as an antidote following nerve agent exposure pyridostigmine bromide peripheral blood mononuclear cells polymerase chain reaction positron emission tomography Persian Gulf Veterans Coordinating Board public law particulate matter, 10 microns or smaller paraoxonase prevalence difference Presidential Special Oversight Board for Department of Defense Investigations of Chemical and Biological Incidents post traumatic stress disorder glutamine, an amino acid arginine, an amino acid Research Advisory Committee on Gulf War Veterans’ Illnesses RAND National Defense Research Institute randomized, controlled trial rapid eye movement, a stage in the sleep cycle Request for Applications Request for Proposals reactive oxygen species risk ratio, a measure of association between a risk factor and health outcome Structured Clinical Interview for DSM-III-R Subsonic Cruise Unarmed Decoy Medical Outcomes Study Short Form Survey Physical component score of the Medical Outcomes Study Short Form Survey statistically significant Special Investigation Unit on Gulf War Illnesses, U.S. Senate sulfur dioxide oxides of sulfur single photon emission tomography self-reported Stanford Research Institute Staff Sergeant (U.S. Army) Staff Sergeant (U.S. Air Force) subcutaneous tricresyl phosphates T-helper cells associated with cell-mediated immunity and phagocyte-dependent inflammation Abbreviations and Acronyms • 453
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Gulf War Illness and the Health of
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Research Advisory Committee on Gulf
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Research Advisory Committee on Gulf
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Table of Contents 2| What Caused Gu
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Table of Contents Appendices Append
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Gulf War illness is associated with
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described throughout the report, sc
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Other Health Issues Affecting Gulf
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evidence that exposure to oil fire
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epellants, sarin, and stress, at do
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specialized SPECT scan analyses. In
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amounts of PON1 differ, sometimes d
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The Committee identified major prob
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18 • Gulf War Illness and the Hea
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health problems have been the subje
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psychological stress of war to the
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e studied as a “multisymptom illn
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Table 1. Prevalence of Multisymptom
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Table 2. Symptom Domains Affecting
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likely to report a number of other
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indicate that Gulf War illness did
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Table 3. Effects of Confounding by
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Gulf War Illness Prognosis and the
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improvement on veterans’ SF36 PCS
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was provided for Committee review i
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Research studies have not supported
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deployment. This excess could be of
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have asked veterans to report if th
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A number of theories have been put
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children born to male Gulf War vete
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The long-anticipated results of thi
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affect Gulf War veterans at excess
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Recommendations Despite the brief d
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Operation Desert Storm: Summary of
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The Committee used a standardized a
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The word “stress” is used in a
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War and the subsequent development
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Taken together, human and animal st
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The lack of association between com
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Table 4. Prevalence of Post Traumat
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Other studies have reported both hi
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Recommendation Evidence from multip
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winds helped to rapidly dissipate t
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Overall, results from environmental
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after ignition of the oil wells. Ac
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to the risk of developing Gulf War
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Recommendations Based on available
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About 320 tons of DU was used durin
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adiological and chemical effects. 1
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Table 1. Health Effects of Depleted
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Table 2. Brain and Behavioral Effec
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Table 3. Genotoxic, Mutagenic, and
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problems reported by Canadian Gulf
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example, prolactin levels were sign
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Recommendations Preliminary evidenc
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Table 1. Vaccines Routinely Given t
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shots in theater, in January and Fe
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effects from receiving multiple vac
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Accounting Office (GAO, now the Gov
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Table 4. Studies Identifying Rates
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Table 5. Studies Assessing Longer-t
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an arthralgia-related multisymptom
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The squalene controversy has been m
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vaccine formulation, and concluded
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Although squalene has been the prim
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observation period, with improved s
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differed from those administered pr
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current use is the same as that of
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Cholinergic and Related Neurotoxica
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Pyridostigmine bromide (PB) use in
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Table 2. Pesticides and Insect Repe
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Although comprehensive information
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Committee broadly reviewed informat
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more significant symptoms and signs
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agent as a result. But based on rou
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Questions about Khamisiyah models a
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Figure 2. Iraqi Chemical Weapons Fa
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use of chemical agents during the G
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even at higher doses. Additional ef
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sweating. Symptoms are reported by
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vulnerability to adverse effects of
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Civilian use DEET formulations typi
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disease and exposure to pesticides
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The IOM committee also found that e
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Table 4. Studies Evaluating Persist
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very high, only rats with the high
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In 1979, investigators from Harvard
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central nervous system effects, in
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Table 5. Effects of Combined Gulf W
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Table 6. Animal Studies Evaluating
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and up to 60 days in different stud
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clinical research unit, subjects we
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At 16 weeks, brain acetylcholine le
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veterans with PB, pesticides, and v
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The Committee has reviewed results
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exposures. Although subject to conf
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and healthcare utilization are simi
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Recommendations During the 1990-199
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endemic to the region and/or those
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positive antibody titers to this vi
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The most informative research of th
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Table 3. Post-War Assessment of Inf
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this activation may have resulted f
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Anthrax causes an acute and serious
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Recommendations Because of unanswer
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that, during the months that oil fi
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neurological and cardiovascular eff
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fires and tent heaters. During the
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control blowing sand, which may hav
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eport indicated that of the approxi
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Other Potential Hazards Encountered
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Recommendations A number of exposur
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evidence of an association was stro
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of reasons, including the well-reco
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findings to the Gulf War experience
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Table 2. Gulf War Illness in Relati
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Overview of the Evidence Linking Gu
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War illness and low-level nerve age
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228 • Effects of Gulf War Experie
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Biological and Clinical Characteris
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Brain and Central Nervous System Al
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Table 2. Published EEG and Brain Im
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The Committee also reviewed prelimi
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Table 4. Neurocognitive Evaluation
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Table 5. Neurocognitive Evaluation
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As previously described, VA investi
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Table 4. Published Studies of Auton
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Many of the research limitations de
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Table 7. Studies Assessing Sensory
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In several recently-reported studie
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Five of the six Gulf War projects i
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Overall, differences between studie
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BChE projects, was that mean BChE a
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Table 7. Immune Evaluation of Gulf
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specifically at T cell responses to
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symptomatic Gulf War veterans were
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Table 10. Clinical Findings in Symp
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Genetic findings in symptomatic Gul
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In attempting to understand the bio
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Multisymptom illness associated wit
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widespread pain, cognitive difficul
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Gulf War Illness in Relation to Mul
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Table 1. Prevalence of Fatigue and
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ate of FM among family members of F
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eported that MCS patients have sign
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Research findings in multisymptom c
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e common to both CFS and Gulf War i
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Most notably, a burgeoning number o
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Recommendations Research studies ha
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Historical Funding and Management o
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Since 2002, VA has sponsored a stea
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Table 2. Examples of Psychiatric an
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treating Gulf War illness, on long-
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connection with the Gulf War. They
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from the portfolio of studies ident
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available, potentially promising tr
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ecent data that characterize VA hea
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The WRIISCs were established both t
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Congressional actions have brought
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310 • Research Priorities and Rec
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Research to identify specific patho
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Other Research Areas of Importance
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316 •
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Ms. Angela Newbold, Mr. Kevin Smith
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September 19-21, 2005 (Washington,
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September 15-16, 2008 (Washington,
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21. Abu-Qare AW, Abou-Donia MB. Det
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73. Assefi NP, Sherman KJ, Jacobsen
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126. Benmoyal-Segal L, Vander T, Sh
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181. Brown VJ. Battle scars: global
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238. Cheng Y-S. Chemical compositio
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295. Crofford LJ, Rowbotham MC, Mea
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349. Dockery DW, Behbehani J, Fay M
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404. Engel CC, Hyams KC, Scott K. M
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460. Friedman A, Kaufer D, Shemer J
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512. Grabenstein JD. Drug interacti
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567. Haley RW, Maddrey AM, Gershenf
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620. Holmes DT, Tariot PN, Cox C. P
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676. Institute of Medicine. Health
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732. Joy RM, Walby WF, Stark LG, Al
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786. Kellner M, Baker DG, Yehuda R.
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836. Krengel M, Sullivan K. Neurops
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890. Lestaevel P, Houpert P, Bussy
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945. Mach M, Grubbs RD, Price WA, N
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999. McDiarmid MA, Squibb K, Engelh
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1052. Miranda ML. Spatial analysis
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1107. Nemmar A, Hoet PH, Vanquicken
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1161. Ottenweller JE. Paraoxonase A
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1215. Pittman PR, Kim-Ahn G, Pifat
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1273. Research Working Group of Mil
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1329. Russell IJ. Abnormal T cell s
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1382. Seidel MF, Weinreich GF, Stra
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1433. Smith TC, Gray GC, Weir JC, H
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1486. Stevens D, Scott EA, Bowditch
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1539. Tian H, Song X, Bressler J, P
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1586. U.S. Army Environmental Hygie
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and Risk Characterization of U.S. D
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1679. U.S. General Accounting Offic
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1730. Vojdani A. Scientific reality
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1786. Wijeratne C, Hickie I, Davenp
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| Appendices
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396 • Results from Studies of Gul
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Page 410 and 411:
Page 412 and 413: 402 • Results from Studies of Gul
Page 448 and 449: 438 • Research Advisory Committee
Page 450 and 451: other information sources it finds
Page 452 and 453: 442 • Research Advisory Committee
Page 454 and 455: Joel C. Graves, DMin Rev. Graves is
Page 456 and 457: 446 • Gulf War Illness and the He
Page 458 and 459: 448 • Gulf War Illness and the He
Page 460 and 461: corr correlation CPAP Continuous Po
Page 464: Th2 TNF TSPs U.K. U.N. UNSCOM USACH
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