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From page 383...
... , 215, 217,220,223,227228,232,235,241,244-245 sarin, 9-10, 21, 169-170, 174-175, 176, 177, 178, 180, 186, 187, 190, 194195 see also Pyridostigmine bromide Acute cholinergic symptoms/syndrome, 9-13, 19, 366 sarin, 9-10, 170-172, 173, 188, 190, 192, 193, 196, 198 Acute effects, general, 4, 72, 189 anthrax vaccines, 15, 16, 19,277-287 (passim) , 304, 313 383 botulinum toxoid vaccines, 17, 19, 290, 291,293-294,313 multiple vaccinations, 17, 297,306 organophosphate toxicity, 13,213 pyridostigmine bromide (PB)
From page 384...
... , 173 Alcohol abuse, 45,49 Alkaline phosphatase (ALP) , 150 Aluminum hydroxide adjuvant, 274,276 Alzheimer's disease, 213, 227 American College of Rheumatology, 355 American Psychiatric Association, 345, 346,360 Ammunition depleted uranium, 5, 6, 92-93, 98,326 sarin, 172 see also Armor Animal studies, 2, 71-72, 80, 99,351 anthrax vaccines, 21, 277-280, 330 botulinum toxoid vaccines, 21, 288, 289-291,330 cyclosarin, 186-187 depleted uranium, 99, 100-101,151, 327 fatigue, 72,351 multiple vaccinations, 297-299 pain, 72 pyridostigmine bromide (PB)
From page 385...
... , 273 toxicity of, 271-272, 273 see also Vaccines Anxiety, 49, 57,171,196,226, 350,354 Armed Forces Epidemiologic Board, 295 Armor, depleted uranium, 5, 91-92 Army Center for Health Promotion and Preventive Medicine, 93-94 Army Medical Corps, 9 Army Medical Research Institute of Infectious Diseases, 284, 285-286, 292 Arthritis, 299-300, 302, 309 Asbestos, 34, 78, 79 Asthma,45,49,215,231,236,237 Atropine, 11,208,228,237 385 ATSDR, see Agency for Toxic Substances and Disease Registry Attention deficits, 27, 51 sarin, 171 Autoimmune diseases, 273 arthritis, 299-300,302, 309 diabetes mellitus, 298-299 fibromyalgia, 45, 46,48, 49, 62,343, 352,355-360 (passim) systemic lupus erythematosus, 157,284, 311 see also Myasthenia gravis AVIP, see Anthrax Vaccine Immunization Program B Baltimore cohort, Gulf War veterans, 21, 93,326 Beneficiary Identification and Records Locator Subsystem, 54-55 BEIR, see Committee on the Biological Effects of Ionizing Radiation Biological warfare agents, general, 1,34, 35, 48,325 see also Anthrax vaccines; Botulinum toxoid vaccines; Nerve agents; Vacc~nes Birth defects, 56-57, 61(n.25)
From page 386...
... , 289, 290-291 neuromuscular effects, 288, 289 number of vaccinations given, 268 pain, 288, 292, 293, 294 short-term malaise, 288, 294 surveillance, 269 veterans, studies of Gulf War veterans, 285, 293 Brain Alzheimer's disease, 213, 227 blood-brain barrier, 11, 177, 207, 219220 cyclosarin, '86-187 depleted uranium, 103 electroencephalography, 10, 103, 181, 187, 191, 199, 372 pyridostigmine bromide (PB) , 11, 207, 217, 219-220, 247 satin, 10, 175-176, 177, 180, 181, 182, 186-187, 191, 195, 196, 199 see also Neuropsychological effects Britain, see United Kingdom Bronchi pyridostigmine bromide (PB)
From page 387...
... AIDS, case definition, 345-346 anthrax vaccines, 283, 284 botulinum toxoid vaccines, 288, 293294 chronic fatigue syndrome, case definition, 354 multiple vaccines, 295, 296,304, 305306 vaccine surveillance, 269, 270, 283, 284 Central Intelligence Agency, 172, 173, 196 Central nervous system (CNS) depleted uranium, 99, 103 myasthenia gravis, 224 pyridostigmine bromide (PB)
From page 388...
... anthrax vaccines, 284,285 depleted uranium studies, 91-92, 326 hospitalization studies, 55-56, 189-190 previous research on Gulf War health effects, 30 pyridostigmine bromide (PB) , 208, 209 registry programs, 40-43, 77, 357 sarin, 9, 172, 173, 189, 196 squalene, 307 vaccines, 284, 285, 295,329-330 Department of Energy (DOE)
From page 389...
... , 62, 104 ammunition containing, 5, 6, 92-93, 98, 326 animal studies, 99, 100-101, 151, 327 armor, 5, 91-94 chronic effects, general, 102-103 cohort studies, 21, 93,326-327 developmental and reproductive effects, 8, 19, 104-105, 157 exposure, 6, 31, 92, 93-94,326 gastrointestinal effects, 8, 19, 104 genetic factors, 8, 19, 158 hematologic effects, 8, 19, 99 historical perspectives, 91-92 ingestion, 6, 93, 96, 98-99 inhalation, 6, 93 injection, 99 musculoskeletal effects, 8, 99 neuropathy, 99, 103, 151, 153 renal effects, 7-8, 99, 150 research recommendations, 21, 326-327 respiratory effects, 98 tantalum (Ta) , 98-99, 100, 101, 103 wounds, 93, 102-103 see also Uranium Depression, 350, 354, 355 epidemiologic studies, 45, 46, 48, 49, 52,62 organophosphate pesticides, 370 pyridostigmine bromide (PB)
From page 390...
... , 12,223,251 E Edema anthrax vaccines, 15, 275, 276, 277, 278, 283, 284 botulinum toxoid vaccines, 292 sarin, 171 see also Inflammation Electrocardiography (EKG) , 158, 235, 244 Electroencephalography (EEG)
From page 391...
... , 282,283, 297 botulinum toxoid vaccines, 268 sarin, 9, 18, 19,31, 170-173, 178, 182183, 188 terrorism, viii, 3, 10, 70,177-178, 188 smoke, 1,27-28,33-34,48 depleted uranium, 6, 93 oil-well fires, 1, 27,31,33 uranium, depleted uranium, 6, 31, 92, 93-94, 326 occupational exposure, 6-7, 19, 31, 108, 111, 113, 114, 115-117, 120, 121, 123-129, 130, 134, 135, 138, 140-141, 142,149,159 see also Dose and dose-response; Dermal exposure; Epidemiology; Ingestion; Inhalation Eyes, see Visual and ocular effects; Visual evoked potential F Fatigue, 1, 27, 32,39,343, 350-360 (passim) animal studies, 72,351 botulinum toxoid vaccines, 288(n.10)
From page 392...
... anthrax vaccines, 283 squalene, 307 Genetic factors, 71-72 anthrax vaccines, 280 botulinum toxoid vaccines, 290-291 depleted uranium, 8, 19, 158 individual variability, 31, 197-198, 220-222, 244-245, 272,334 multiple vaccines, 298 organophosphates, 31, 53 pyridostigmine bromide, 21, 220-222, 244-245,328,329 research recommendations, 21, 328, 329 sarin, 21, 53,183, 187, 197-198,328 uranium, 8, 19, 100-101, 157, 158 vaccines, 272, 273,280,290-291 see also DNA; RNA Genitourinary system and urinalysis, 47, 54 depleted uranium, 158 pyridostigmine bromide (PB) , 12, 208, 225-226 registry data, 42 satin, 171, 177-178 uranium, 97, 100-101, 119,123, 124, 150 see also Renal effects; Sexual functlonmg Germany, sarin development, 8 GGT, see Gamma-glutamyltransferase
From page 393...
... , 210 sarin, 177 squalene, 308 uranium, 19, 97, 100, 104, 108-109, 158 Hepatitis vaccines, 295, 296 Herpes simplex virus, 310 HIAA, see 5-hydroxyindoleacetic acid HIB, see Haemophilus influenzas type B Histocompatibility, 273 Historical perspectives, 28-29, 30, 339, 343 393 AIDS, 345-346 anthrax vaccines, 272, 274, 281, 283284,287 Bosnian conflict, 39, 50-51, 250, 303, 304, 358 botulinum toxoid vaccines, 16, 288, 291, 293 chemical warfare agents, testing of military volunteers, 189 depleted uranium, 91-92 fatigue syndrome, 354 Kurdish/Iraqi conflict, 34 Operation Desert Storm, significant dates, 1, 9, 27, 32, 172-174, 209 organophosphates, general, 182 pyridostigmine bromide (PB) , 207, 225 satin, 8, 191 Japan, terrorist attack, 3, 10, 177178, 188, 191-196, 199 squalene, 307 vaccines, general, 267, 268, 294, 295, 300-303; see also specific vaccines supra HIV, see AIDS Hoffman-La Roche, 207 Hormones, 230, 244, 244 contraceptives, 230 follicle-stimulating hormone, 157 GH-releasing hormone (GHRH)
From page 394...
... , 213 Immune system, 351, 360 allergies, 51, 284, 309 anthrax vaccine, impacts on, 279, 284, 285, 290-292,306 botulinum toxoid vaccines, pathological response to, 290-292 histocompatibility, 273 humoral immune response, 276-277 hypersensitivity, 31, 49, 82, 218, 236, 271, 272,278, 284, 288, 290, 297, 298-299 macrophages, respiratory, 154, 272, 275 multiple vaccines, 17, 296, 297-298 myasthenia gravis, 3, 11, 12, 70, 71, 207, 208, 209, 224-225, 227-228, 230, 231, 250-251 squalene, 309,311,312 uranium, 8, 154, 156-157, 158 vaccines, response to, 17, 271-272, 273, 278, 284, 288, 290, 296, 297, 298-299 see also Antibodies; Antigens; Inflammation Immunizations, see Vaccines Immunoconglutinin (IC) , 299-300 Immunoglobulin, 311 Infectious diseases, 342 AIDS, 310,342,345 epidemiologic studies, 59, 72 gastrointestinal, 59-60 meningitis, 284, 295, 296 registry data, 42 see also Anthrax vaccines; Biological warfare agents, general; Botulinum INDEX toxoid vaccines; Measles-mumpsrubella; Vaccines Inflammation, 272, 355, 356 anthrax vaccines, 278, 281, 284, 286, 287, 297 botulinum toxoid vaccines, 290, 293294 multiple vaccinations, 17, 297,306 squalene, 309 see also Edema Influenza vaccines, 295, 310-311 Ingestion anthrax, 272(n.3)
From page 395...
... status anthrax vaccines, 274, 283-284 botulinum toxoid vaccines, 16, 288, 293 pyridostigmine bromide (PB) , 208 In vitro studies, 72, 158 anthrax vaccines, 275 Iowa Persian Gulf study, 45,46, 48, 49, 52,57,60,62,333,358 Iran-Iraq conflict, sarin, 8 Isopropyl methylphosphonoflouridate, see Sarin 395 J Japan, sarin terrorist attacks, 3, 10, 177178, 188, 191-196, 199,327 K Kidneys, see Renal effects L Lactate dehydrogenase (LDH)
From page 396...
... , 11, 12, 208, 240, 241,248, 249 sarin, 171, 174, 188 MMR, see Measles-mumps-rubella Monitoring System for Adverse Events Following Immunization, 296 Mood disorders, 50, 54, 195 INDEX see also Depression; Multisymptom illness Mortality, 39, 40, 54-55, 74, 82 anthrax vaccines, 277, 278 anticholinesterases, 190 cancer, 6-7, 108-109, 117, 128, 114, 117-118, 126-130, 128, 131-142 influenza vaccines, 311 multiple vaccines, 302-303 phosphate fertilizer production workers 112, 11~115, 130, 132, 148, 152, 159 sarin, 179, 188, 190 uranium workers, 112-118, 119-120, 125-127, 129, 151 bone cancer, 143 cancer, general, 117, 128, 114, 117118, 126-127, 128, 131 cardiovascular factors, 158 lung cancer, 6-7, 108-109, 113, 117-118, 128-130, 132-142 lymphatic cancer, 142-143, 144-145 neuropathy, 151-152 respiratory disease, nonmalignant, 159 Motor functions, see Convulsions; Psychomotor effects MPA, see Methylphosphonic acid Multiple chemical sensitivity (MCS) , 46, 49, 350, 352, 356-357, 358, 359 see also Interactions, chemical Multiple vaccinations, 14, 17-18, 19, 21, 51, 270, 285, 295-306, 314 acute effects, 17, 297, 306 age factors, 305 animal studies, 297-299 anthrax vaccine as part of,301, 304 .cancer and, 299 Centers for Disease Control and Prevention (CDC)
From page 397...
... , 11, 12, 211-213,220-221,223, 226, 230, 232-233,246, 248,251 397 registry data, 40-41,42 sarin, 9, 10, 171, 173, 179-180, 187, 190,193, 194,197,327 uranium, 72, 105, 123, 158, 160 see also Chronic fatigue syndrome; Cramps; Fatigue; Psychomotor effects Myasthenia gravis,3, 11, 12, 70, 71, 207, 208, 209, 224-225,227-228,230, 231,250-251 N National Center for Toxicological Research, 183 National Death Index, 117 National Institute of Allergy and Infectious Diseases, 310 National Institute for Occupational Safety and Health, 114-115 National Institutes of Health, 30, 274 National Library of Medicine, 341 National Occupational Safety and Health Administration, 114-115 National Technical Information Service, 341 National Vaccine Injury Compensation Program, 269 Nausea and vomiting anthrax vaccines, 284,285 pyridostigmine bromide (PB) , 11, 12, 208,214, 226, 245, 251 sarin, 171 Nerve agents, 1, 28 see also Antidotes; Central nervous system; Cyclosarin; Pyridostigmine bromide; Sarin Neostigmine, 210, 228,242 Neuromuscular effects, 52 anthrax vaccines, 281, 284,285, 286 botulinum toxoid vaccines, 289, 290 depleted uranium, 8, 99 electromyography (EMG)
From page 398...
... , 181, 182, 183, 187 Neuropsychological effects, 47, 51, 351 anxiety, 49, 57, 171, 196, 226, 350,354 attention deficits, 27, 51, 171 malaise, anthrax vaccines, 15, 281, 283, 284, 285 botulinum toxoid vaccines, 288, 294 organophosphates, general, 367-375 pyridostigmine bromide (PB) , 13,213214,227,233-235,236, 242-244,252 sarin, 171, 175, 180, 188, 195, 195, 197, 328 uranium exposure, 151 see also Cognitive dysfunction; Mental disorders; P§ychological effects Nicotinic effects pyridostigmine bromide (PB)
From page 399...
... , 181-182, 183, 192, 197,213,217,218,248,249,252, 328 occupational exposure, non-military, 188, 191, 199 organophosphate binding (OP-AChE) , 9, 174-175, 177, 178, 180, 186, 208, 210, 366 psychological effects, 367-375 sexual function, 370 smoking and, 371 see also Cyclosarin; Pyridostigmine bromide; Sarin p Pain, 48, 49 animal studies, 72
From page 400...
... , 156, 157 Pro-opiomelanocortin (POM) , 213 Protective antigen vaccines, 274, 276277,279-280,281,282 Psychological factors, 46 anxiety, 49, 57, 171, 196, 226,350,354 malaise, anthrax vaccines, 15, 281, 283, 284, 285 botulinum toxoid vaccines, 288, 294 individual variability, 31 multiple vaccinations, 304 sarin, other, 171, 175, 180, 188, 197, 328
From page 401...
... 209, 214, 223, 225-226, 230, 236, 242, 251 nausea and vomiting, 11, 12, 208, 214,226,245,251 salivation, 11, 12, 208, 214, 225, 226, 242, 251 gender factors, 226, 231, 239, 244 genetic factors, 21, 220-222, 244-245, 328, 329 genitourinary system and urinalysis, 12, 208, 225-226 growth hormone, 12, 209, 220, 222224, 251, 334 headaches, 236 hematologic effects, 11, 208, 210, 211212, 244-245, 244 hepatic effects, 210 historical perspectives, 207, 225 hypothalamic-pituitary-adrenal processes, 209, 220, 223, 250-251 ingestion, 11, 12, 207-209, 210-211, 214, 223, 225, 234, 236, 237, 238, 240, 251 injection, 11, 207, 231, 236-237 interactions, chemical, 187, 209, 217220, 229-230,235, 248, 328, 328, 330, 334 lungs, 231, 237 mood disorders, 246 myasthenia gravis, 3, 11, 12, 70, 71, 207, 208, 209,224-225, 227-228, 230, 231, 250-251 nausea and vomiting, 11, 12, 208, 214, 226, 245, 251 neuromuscular effects, 11, 12, 211-213, 220-221, 223, 226, 230, 232-233, 246, 248, 251 neuropathy, general, 11, 12, 13, 53, 219-220, 247-249, 252, 328 nicotinic effects, 11, 208, 211, 223, 226, 230, 237, 240, 251 pain, 11, 12, 236 peripheral nervous system, 213, 247 perspiration, 11, 12,225 pharmacodynamics, 217-219, 230, 244 posttraumatic stress disorder, 246
From page 402...
... , 215, 217, 220, 223, 235, 241, 244-245 satin, 9, 169-170, 175, 176 uranium, 96 see also Nicotinic effects; terms listed under Cholinergic effects Recordkeeping, viii-ix, 55(n.17) , 61-62 anthrax vaccines, 284 botulinum toxoid vaccines, 268 phosphate fertilizer production workers, exposure, 130 uranium workers, exposure, 124 vaccines, 21, 268, 269, 270, 284,330 Red blood cells (RBCs)
From page 403...
... , 9-10,21, 169-170, 174-175, 176, 177, 178, 180,186,187,190,194-195 acute effects, 9, 18, 19, 21, 180, 188, 193-194, 199, 328 animal studies, 10, 175-176, 177, 178187, 288 antidotes, 170, 179 brain, 10, 175-176, 177, 180, 181, 182, 186-187, 191, 195, 196, 199 central nervous system, general, 170, 171, 176-177, 182, 191, 195, 196, 327 chronic effects, general, 183, 188, 191192, 193, 198 cognitive effects, general, 171, 181, 197 convulsions, 10, 170, 175, 176, 179, 188, 192, 193 cramps, 171 dermal exposure, 8, 169, 176 developmental effects, 186, 187 dose factors, 9, 10, 18, 19, 173, 176, 178-183, 186, 188, 192, 199, 288, 327 edema, 171 exposure, general, 9, 18, 19, 31, 170173, 178, 182-183, 188 terrorist attacks, viii, 3, 10, 70, 177178, 188 fatigue, 171, 189, 193, 194, 195, 198, 199,327, 328 gastrointestinal effects, 171, 180
From page 404...
... 404 gender factors, 196, 197 genetic factors, 21, 53, 183, 187, 197 198, 328 genitourinary system and urinalysis, 171, 177-178 headaches, 10, 171, 193, 194, 198 hematologic effects, 177, 178, 188, 190, 191, 192, 194-195 hepatic effects, 177 historical perspectives, 8, 191 Japan, terrorist attack, 3, 10, 177 178, 188, 191-196, 199 hospitalizations, 188, 189-190, 193 195 ingestion, 176 inhalation, 169, 174, 176, 189 Japan, terrorist attack, 3, 10, 177 178, 188, 191-196, 199 injection, 176, 186, 189 insecticides and, 8, 10, 188,328 interactions, chemical, 181, 187, 328 insecticides and, 8, 10, 188, 328 lungs, 171, 174 memory loss, 171 mood disorders, 195, 197, 199 mortality, 179, 188, 190 nausea and vomiting, 171 neuromuscular effects, 9, 10, 171, 173, 179-180, 187, 190, 193, 194, 197, 327 neuropathy, 9-10, 175-176, 180-185, 186-187, 190, 192, 193, 194, 197, 327-328 convulsions, 10, 170, 175, 176, 179, 188, 192, 193 nicotinic effects, 170, 171, 175 pain, 10, 171, 171, 193, 194, 198; see also "headaches " supra peripheral nervous system, 170 perspiration, 171 posttraumatic stress disorder, 10, 195 196, 198 posturography, 10, 196, 199 psychological effects, 171, 175, 180, 188, 195, 195, 197, 328 psychomotor effects, 10, 171, 175, 180, Socialfactors 196, 199 receptor-mediated actions, general, 9, 169-170, 175, 176 red blood cells, 177, 178, 190, 191 INDEX renal effects, 177 reproductive system effects, 186, 187, 197 research recommendations, 21, 327-328 respiratory effects, 171, 173, 174, 179180,188,190,193,194 salivation, 171 sexual functioning, 197 sleep disturbance, 10, 171, 191, 194, 195, 199 stress, general, 176 terrorists attacks, viii, 3, 10, 70, 177178, 188 toxicokinetics, 17~178 veterans, studies of Gulf War veterans, 172-174, 187-190, 196-197 visual and ocular effects, 10, 195, 196, 199, 171, 173, 174, 175, 188, 192, 193, 194, 195, 196, 199, 327 see also Cyclosarin; Pyridostigmine bromide Serotonin, 176 Sex-based differences, see Gender factors Sexual functioning, 48, 49 organophosphate pesticides, 370 sarin, 197 Skeletal effects, see Musculoskeletal effects Skin, see Dermal exposure; Dermal tissue, other; Injection delivery; Perspiration; Rashes SLE, see Systemic lupus erythematosus Sleep disturbance, 52, 351, 355 pyridostigmine bromide, 226 registry data, 42 sarin, 10, 171, 191, 194, 195, 199 Smoke, 1, 27-28, 33-34, 48 depleted uranium, 6, 93 oil well fires, 1, 27, 31, 33 Smoking, tobacco, 75, 81 organophosphate pesticides, 371 sarin exposure and difficulty in, 194 uranium miners/processors, 6, 7, 107, 108,114, 120, 121,127, 130, 135,137, 138,139,141-142,154,156,159 disease classification, 343, 348, 349 individual variability, 31 living conditions, 33, 35
From page 405...
... , 98-99, 100, 101, 103 Tennessee Eastman Corporation, Oak Ridge plant uranium processing workers, 7, 118-121, 122, 123, 131148 (passim) , 152, 159 405 Terrorist attacks, satin, viii, 3, 10, 70, 177-178, 188 Testicular cancer, 60 Thermoregulation, 33, 216-217, 235, 237-240 see also Perspiration Tobacco use, see Smoking Tokyo, Japan, see Sarin Toxicokinetics anthrax vaccines, 275 antigens, general, 271-272, 273 botulinum toxoid vaccines, 289-291 genetic factors, 31, 63 multiple vaccines, 296-299 organophosphates,31 pyridostigmine bromide (PB)
From page 406...
... , 269, 270, 284, 296 Vaccines, viii, 4, 14-18, 19, 49, 51, 267324 acute effects, general, 270, 271 antibodies, adverse reactions, 17, 272, 298
From page 407...
... . clnatlons VAERS, see Vaccine Adverse Events Reporting System Varicella vaccines, 295 VEP, see Visual evoked potential Vestibular nerve, 52, 197,327 Veterans Administration, see Department of Veterans Affairs Veterans, studies of Gulf War veterans, 43-62,325 anthrax vaccines, 285, 286, 293 botulinum toxoid vaccines, 285, 293 clinical definitions, 43-44, 54,347348,349-361 Canadian, 39, 45, 46, 48-49, 285,333, 358 Iowa Persian Gulf study, 45, 46,48,49, 52, 57, 60, 62,358,333,358 multiple vaccinations, 299-300 multisymptom illness, 17, 51, 54, 154, 303-304 pyridostigmine bromide (PB)
From page 408...
... , 240, 248, 249 sarin, 10, 195, 196, 199, 327 Vomiting, see Nausea and vomiting INDEX W Weather, 33, 235, 243 Weight loss, 52, 245 White blood cells, see Lymphocytes Women, see Gender factors World Health Organization, 346, 360 Wounds, depleted uranium, 93, 102-103 y Yellow fever vaccines, 295, 296, 3(1'


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