Gulf War and Health Volume 8: Update of Health Effects of Serving in the Gulf War (2010) / Chapter Skim
Currently Skimming:
SUMMARY
SUMMARY
Pages 1-10
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 1... ...
Numerous exposures experienced by veterans during the war have been implicated as the causes of these problems, including exposure to oil-well fire smoke and to the anti–nerve-gas agent prophylactic pyridostigmine bromide. The aggregation of the health problems, often called Gulf War illness or Gulf War syndrome, continues to plague as many as one-third of the veterans who were deployed to the war, and the symptoms are seen in veterans of several of the countries that formed the coalition forces, including the United States, the United Kingdom (UK)
|
From page 2... ...
The committee included in its review only studies that compared the health status of Gulf War veterans with that of nondeployed veterans or veterans deployed elsewhere, such as in Bosnia or Germany. COMMITTEE'S APPROACH During its deliberations, the Update committee held two public sessions at which it heard from numerous interested parties, including representatives of veteran-service organizations and individual Gulf War veterans.
|
From page 3... ...
Once the committee had assessed the studies cited in Volume 4 and evaluated the new studies identified in the more recent literature, it considered the entire body of relevant literature and determined the strength of associations between being deployed to the Gulf War and specific health outcomes on the basis of all the primary studies and supported by the secondary studies. Because the committee was not attempting to link health outcomes to exposures other than deployment to the Persian Gulf theater, for which there is no known animal model, it did not review toxicologic, animal, or experimental studies comprehensively; however, it did evaluate the key epidemiologic and animal cited in the RAC report (see Appendix A)
|
From page 4... ...
CONSIDERATIONS IN IDENTIFYING AND EVALUATING THE LITERATURE The Update committee sought to characterize and weigh the strengths and limitations of the available evidence presented in the studies that it reviewed. For Volume 4 of the Gulf War and Health series, numerous cohort studies and case control studies were objectively reviewed without preconceptions about health outcomes that might be seen in Gulf War veterans.
|
From page 5... ...
Inadequate/Insufficient Evidence to Determine Whether an Association Exists The available studies are of insufficient quality, validity, consistency, or statistical power to permit a conclusion regarding the presence or absence of an association between deployment to the Gulf War and a health outcome in humans. Limited/Suggestive Evidence of No Association There are several adequate studies, covering the full range of levels of exposure that humans are known to encounter, that are consistent in not showing an association between exposure to a specific agent and a health outcome at any level of exposure.
|
From page 6... ...
The committee considered studies that used both population-based cohorts and militaryunit–based cohorts. Population-based studies of particular importance included the large nationally representative study of Gulf War deployed and nondeployed veterans conducted by VA to address congressional mandates, a study of Iowa veterans initiated by the Iowa Persian Gulf Study Group, a study of all Canadian Gulf War veterans, studies of Oregon and Washington veterans conducted by the Portland Environmental Hazards Research Center, and a study of Kansas veterans.
|
From page 7... ...
Although for the most part the Update committee considered the same health outcomes as did the Volume 4 committee, there were several differences: the Update committee added two new health outcomes: genitourinary diseases and diseases of the blood and blood-forming organs. The committee also used the term multisymptom illness to refer to a health outcome rather than the International Classification of Diseases, 9th revision, category of "signs, symptoms, and abnormal clinical and laboratory findings." Chronic fatigue syndrome and multiple chemical sensitivity were included in the section on multisymptom illnesses; hospitalization and mortality studies were discussed in the relevant health-outcome sections; and chronic widespread pain was included in the section on fibromyalgia.
|
From page 8... ...
These psychiatric disorders persist for at least 10 years after deployment. • Gastrointestinal symptoms consistent with functional gastrointestinal disorders such as irritable bowel syndrome and functional dyspepsia.
|
From page 9... ...
The Update committee reiterates that need but notes that it is difficult if not impossible 20 years after the war to reconstruct the exposures to which the veterans were subjected in theater or to establish years after deployment the predeployment physical and mental health status of the veterans for comparison purposes. Therefore, the committee believes that future studies of Gulf War veterans -- and indeed any veteran population -- need to be adequately designed to • Provide sufficient statistical power (precision)
|
From page 10... ...
Given the high prevalence of persistent symptoms and the steady advances in our understanding of genetics, molecular diagnostics, and imaging, it is now possible to plan and carry out adequately powered studies to identify inherited genetic variants, molecular profiles of gene expression, other epigenetic markers (for example, modifications of DNA structure related to environmental exposures) , specific viral exposures, signatures of immune activation, and brain changes identified by sensitive imaging measures that distinguish Gulf War veterans who have persistent medical symptoms from healthy deployed or nondeployed veterans.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.