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Pages 1-12

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From page 1...
... 105-277, the Persian Gulf War Veterans Act, and P.L. 105-368, the Veterans Programs Enhancement Act.
From page 2...
... THE COMMITTEE'S APPROACH The committee held two public sessions to put its efforts in context and to clarify an approach to its task. The committee heard from representatives of VA and from several Gulf War veterans about their health conditions that have persisted since the war, particularly the symptoms associated with Gulf War illness.
From page 3...
... Many of the secondary studies relied on self-reports of various diagnoses rather than an examination by a health professional or a medical record review. The Volume 10 committee also included a number of studies that did not meet the criteria for a primary or secondary study, but nonetheless provided information on the health of Gulf War veterans.
From page 4...
... The cohort studies of Gulf War veterans and the derivative studies have contributed greatly to our understanding of veterans' health, but they have some of the limitations that are commonly encountered in epidemiologic studies, such as lack of representativeness, selection bias, lack of control for potential confounding factors, self-reporting of health outcomes, and self-reporting of exposure. The committee considered studies that used both population-based cohorts and cohorts based on military units.
From page 5...
... The committee concludes that although the existence of an animal model would be advantageous for identifying and evaluating treatment strategies for Gulf War illness, it cautions that developing such an animal model is not possible given researchers' inability to realistically determine the exposures associated with Gulf War service, let alone the frequency, duration, or dose of those exposures, or the effect of multiple exposures. FINDINGS AND RECOMMENDATIONS Between 1994 and 2014, federally funded research on Gulf War veterans has totaled more than $500 million.
From page 6...
... is the signature adverse health outcome of having served in the Persian Gulf region. Multiple studies found that some Gulf War veterans, regardless of their country of origin and their different deployment-related exposures, have persistent, debilitating, and varying symptoms of Gulf War illness.
From page 7...
... • Gastrointestinal symptoms consistent with functional gastrointestinal disorders such as irritable bowel syndrome and functional dyspepsia • Chronic fatigue syndrome • Gulf War illness Limited/Suggestive Evidence of an Association • Amyotrophic lateral sclerosis (ALS) • Fibromyalgia and chronic widespread pain • Self-reported sexual difficulties Inadequate/Insufficient Evidence to Determine Whether an Association Exists • Any cancer • Cardiovascular conditions or conditions of the blood and blood-forming organs • Endocrine and metabolic conditions • Neurodegenerative conditions other than ALS • Neurocognitive and neurobehavioral performance • Migraines and other headache disorders • Other neurologic conditions • Respiratory conditions • Structural gastrointestinal conditions • Skin conditions • Musculoskeletal system conditions • Genitourinary conditions • Specific birth defects • Adverse pregnancy outcomes (e.g., miscarriage, stillbirth, preterm birth, and low birth weight)
From page 8...
... One large study of Gulf War veterans found an increased incidence of lung cancer based on state and VA cancer registry data from 1991 to 2006 for deployed vs nondeployed veterans, but neither veteran group had a greater risk when compared with the general population, and the study did not adjust for smoking status. Thus, the Volume 10 committee finds that there continues to be inadequate/insufficient evidence to determine whether deployed Gulf War veterans are at increased risk of having any cancer, including lung cancer and brain cancer.
From page 9...
... For future conflicts, however, collecting exposure information before, during, and after deployment, preferably using individual environmental monitoring devices and military health and administrative records to capture such information as vaccine administration, troop location, and toxicant concentrations, will permit a more accurate assessment of actual exposures. The committee also finds that efforts to model or otherwise reconstruct the exposures that Gulf War veterans experienced during deployment are also unlikely to yield useful results.
From page 10...
... and particular health outcomes, in general the results have been remarkably consistent. What is striking about this and prior Gulf War and Health committees' findings is that the health conditions found to be associated with Gulf War deployment are primarily mental health disorders and functional medical disorders.
From page 11...
... To ignore available treatments that may improve the functioning of any of these organ systems would be to do a disservice to our Gulf War veterans. R  ecommendation: Future Gulf War research should place top priority on the identification and development of effective therapeutic interventions and management strategies for Gulf War illness.


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