Health Consequences of Service During the Persian Gulf War Recommendations for Research and Information Systems (1996) / Chapter Skim
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Introduction
Introduction
Pages 14-25
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From page 14... ...
Some of these were physiological, but many were from recognized environmental and external agents such as diesel fumes; microbes; the hostile, hot sandy desert environment; vaccines; oil well fires; and specific occupational exposures. However, there were also potent psychological stresses of several kinds.
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From page 15... ...
The majority of men and women who served in the Gulf returned home and resumed their normal activities win little noticeable difficulty. For others, however, a wide range of physical, chemical, and psychological stressors and exposures appear to have had health effects disproportionate to the brevity of active combat and the relatively low combat casualty rate.
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From page 16... ...
The DVA registry was later mandated in PL 102-585 (Appendix A) as the DVA Persian Gulf War Veterans Health Registry, to include all who served in the Gulf (whether their present status was active, reserve, or National Guard, including those who left the service)
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From page 17... ...
as the PG Expert Scientific Committee to advise the DVA Assistant Chief Medical Director for Environmental Medicine and Public Health, and subsequently the DVA Undersecretary for Health, about medical findings affecting PG veterans. The committee was charged to review all aspects of patient care and medical diagnoses and to provide professional consultation as needed.
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From page 18... ...
After the first meeting, the task force requested that the charge be changed to focus deliberations on the cause and effect of the full range of exposures to low levels of chemicals as well as environmental pollutants, endemic biologics, and other health hazards that might affect veterans of the PGW An interim report was released on March 15, 1994; the final report was released in June 1994 (DSB, 1994~. The medical nature and the cause or causes of a GWS remained undefined by the task force.
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From page 19... ...
was a Technology Assessment Workshop held April 27-29, 1994, "The Persian Gulf Experience and Health" (NIH Technology Assessment Workshop Panel, 19949. This two-and-a-half-day workshop considered four questions: (1)
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The most recently established official group to review the health concerns of PG veterans is the Presidential Advisory Committee (PAC) on Gulf War Veterans' Illnesses, established by Executive Order 12961, May 26, 1995.
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To meet this charge, the committee heard presentations (Appendix D) and reviewed written materials from representatives of DVA and DoD through May 1996; reviewed relevant scientific literature, protocols, reports of findings, and other documents; held a public meeting; reviewed unsolicited materials received (Appendix C)
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From page 22... ...
More extensive discussions of epidemiologic research design and definitions of epidemiologic terms can be found in standard references (Fletcher et al., 1995; Lillienfeld and Stolley, 1994~. As we have indicated, individuals deployed during the PGW were at risk of exposure to a myriad of environmental, occupational, medical, psychological, and battle-related health risks.
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From page 23... ...
However, success in attaining the scientific and public health goals will require reliable and relevant information, scientifically sound analysis and interpretation, and availability of effective treatment and prevention resources and modalities. To provide a framework for our recommendations in Chapter 2 and for the evaluations in subsequent chapters, we outline some key scientific and procedural issues related to health risk assessment goals.
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From page 24... ...
, predeployment demographic information on health and medical interventions such as vaccinations was incomplete and possibly inaccurate, there was little standardization and operationalization of data on disease symptoms and signs, follow-up was difficult and incomplete (DoD and DVA databases did not communicate effectively) , very little personalized exposure information was available, and changes over time made some data unavailable and reduced or modified possible reference populations.
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From page 25... ...
, data quality, and intersystem linkages; and the clinical registries of DVA and DoD are obtaining standardized, relevant data. Even when considering the difficulties and cautions in interpreting research as described above, the committee believes that there is a sound basis for epidemiologic studies, as well as basic science studies, relevant to an understanding of health consequences of service in the PGW.
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