NATIONAL ACADEMY PRESS
2101 Constitution Avenue, N.W. Washington, DC 20418
NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under the Academy’s 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.
This project has been funded entirely with federal funds from the Department of Veterans Affairs, under Contract No. V101(93)P-1637. The views presented are those of the Institute of Medicine Committee on a National Center on War-Related Illnesses and Postdeployment Health Issues and are not necessarily those of the funding organization.
International Standard Book Number 0-309-06630-1
Additional copies of this report are available from the
National Academy Press,
2101 Constitution Avenue, N.W., Box 285, Washington, DC 20055. Call (800) 624-6242 or (202) 334-3313 in the Washington metropolitan area), or visit the NAP on-line bookstore at www.nap.edu.
For more information about the Institute of Medicine, visit the IOM home page at www.iom.edu.
Copyright 1999 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The image adopted as a logotype by the Institute of Medicine is based on a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.
COMMITTEE ON A NATIONAL CENTER ON WAR-RELATED ILLNESSES AND POSTDEPLOYMENT HEALTH ISSUES
MERWYN GREENLICK (Chair), Professor and Chair,
Department of Public Health and Preventive Medicine, Oregon Health Sciences University School of Medicine
DAN BLAZER II, J.P. Gibbons Professor of Psychiatry and Behavioral Sciences,
Duke University Medical Center
DENNIS HOGAN, Director,
Population Studies and Training Center, Brown University
ISABEL HOVERMAN, Clinical Assistant Professor of Medicine,
University of Texas Medical Branch at Galveston, and Austin Internal Medicine Associates
KERRY KILPATRICK, Professor and Chair,
Department of Health Policy and Administration, University of North Carolina at Chapel Hill, School of Public Health
RICHARD KURZ, Dean and Professor,
Department of Health Administration, St. Louis University School of Public Health
PENNY PIERCE, Assistant Professor,
University of Michigan School of Nursing, and
Faculty Associate,
Survey Research Center, Institute for Social Research
GUTHRIE TURNER, Chief Medical Consultant,
Division of Disability Determination Services, State of Washington
PETER WHITEHOUSE, Professor of Neurology, Psychiatry, Organizational Behavior, and Ethics,
Alzheimer Center, Case Western Reserve University School of Medicine
Study Staff
LYLA HERNANDEZ, Study Director
CATHARYN LIVERMAN, Study Director
KYSA CHRISTIE, Project and Research Assistant
PATRICIA SPAULDING, Project Assistant
KATHLEEN STRATTON, Acting Director,
Division of Health Promotion and Disease Prevention
DONNA D. DUNCAN, Division Assistant
Acknowledgments
The committee wishes to express its appreciation to the many individuals who contributed to the completion of this project. We especially want to thank the following workshop presenters who provided the committee with a wealth of information: Craig Hyams, Ralph Ibson, Susan Edgerton, William Cahill, Kim Lipsky, James Riddle, Charles Engel, Karl Friedl, Frank Garland, Frances Murphy, Han K. Kang, Matthew Friedman, Tim Gerrity, Marsha Goodwin, William Brew, Matthew Puglisi, Paul Sullivan, and Lynn Preston.
This report has been reviewed in draft form by individuals chosen for thief diverse perspectives and technical expertise, in accordance with procedures approved by the NRC's Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making the published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their participation in the review of this report:
Margit L. Bleecker, Center for Occupational and Environmental Neurology, Baltimore, MD
Larry R. Churchill, University of North Carolina at Chapel Hill
Maureen Henderson, University of Washington
Gilbert S. Omenn, University of Michigan
William A. Satariano, University of California Berkeley
William J. Schull, University of Texas Health Science Center
William Ray True, St. Louis University Medical Center