Gulf War and Health Volume 4: Health Effects of Serving in the Gulf War (2006) / Chapter Skim
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Estimating the veterans' health risks associated with particular environmental exposures is challenged by the lack of exposure monitoring and of biomarkers to quantify individual exposures of veterans during the deployment retrospectively. CHARGE TO THE COMMITTEE The charge to this IOM committee was to review, evaluate, and summarize peerreviewed scientific and medical literature addressing the health status of Gulf War veterans.
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Although, they have provided valuable information, many of them have limitations that hinder accurate assessment of the veterans' health status. Common study limitations include use of a population that was not representative of the entire Gulf War population, reliance on self-reports rather than objective measures of symptoms, low participation rates, and a period of investigation that was too brief to detect health outcomes with long latency such as, cancer.
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Multisymptom-based medical conditions reported to occur more frequently among deployed Gulf War veterans include fibromyalgia, chronic fatigue syndrome (CFS) , and multiple chemical sensitivity (MCS)
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Those symptoms seem to be linked to reports of exposures to contaminated water and burning of animal waste in the war theater. The committee notes that several studies reported a higher rate of self-reported dyspepsia in deployed Gulf War veterans than in nondeployed veterans.
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However, studies with longer followup indicate that the increased injury rate was restricted to the first several years after the war. With regard to all causes of hospitalization, studies provide some reassurance that excess hospitalizations did not occur among veterans of the Gulf War who remained on active duty through 1994, inasmuch as it has been noted that Gulf War veterans who left the military reported worse health outcomes than those who remained.
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With regard to other adverse reproductive outcomes, the results of one primary study, which had hospital discharge data available, were suggestive of an increased risk of spontaneous abortions and ectopic pregnancies in Gulf War veterans. Numerous studies in several countries examined respiratory outcomes related to deployment to the Gulf War Theater.
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RECOMMENDATIONS The adequacy of the government's response has been both praised and criticized, VA and DOD have expended enormous effort and resources in attempts to address the numerous health issues related to the Gulf War veterans. The information obtained from those efforts, however, has not been sufficient to determine conclusively the origins, extent, and potential long-term implications of health problems potentially associated with veterans' participation in the Gulf War.
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, and postdeployment psychiatric conditions. The committee also recommends that cause-specific mortality in Gulf War veterans continue to be monitored.
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However, Gulf War veterans who left the military reported worse health outcomes than those who remained. · The studies do not demonstrate consistent evidence of increased overall cancer in the Gulf War veterans compared to nondeployed veterans.
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Another study indicated that there might be an increase in brain cancer among such veterans, however, the exposure models are highly uncertain. RECOMMENDATIONS · Pre- and post-deployment screening of health status · Assessment of exposures Surveillance for adverse health outcomes, specifically: cancer, ALS, birth defects, adverse pregnancy outcomes, post-deployment psychiatric outcomes, and mortality.
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