Don't Blame Gulf War for Illness [balance]

Don't Blame Gulf War for Illness

Study Says British Vets' Symptoms Not From Persian Gulf Service

Nov. 25, 2002 -- If there's a distinct "Gulf War syndrome" that afflicts veterans of that conflict a decade ago, British researchers say it also occurs in their soldiers who served thousands of miles away ... or never even saw battle.

In a study published in the Nov. 26 edition of Neurology, investigators say they found no specific medical problems linked to service in the Gulf War that weren't similar to those reported by soldiers who served in Bosnia or never even deployed. Their conclusion comes after doing medical evaluations on 110 veterans, after surveying nearly 8,200.

"Physical examinations of all participants were generally unremarkable," lead researcher M.K. Sharief, MD, PhD, of Guy's Hospital in London, says in a news release. "The symptoms reported by Gulf War veterans are not associated with objective dysfunction resulting from service in the Gulf."

His finding is the latest chapter on the ongoing debate on whether Gulf War vets exposed to hazardous substances now suffer a distinct cluster of symptoms not experienced by veterans of other wars. These include muscle and joint pain, weakness, and stiffness, as well as fatigue, numbness, and other neurological problems -- a cluster of complaints that have been classified "Gulf War syndrome."

In addition, a U.S. study by the Department of Veterans Affairs shows that they are twice as likely as other military personnel and the general population to have amyotrophic lateral sclerosis (ALS), a degenerative neurological condition often known as "Lou Gehrig's disease."

An estimated 100,000 of the nearly 700,000 American veterans have reported these symptoms. Like their American counterparts, many of the 50,000 British soldiers who served in operations Desert Storm and Desert Shield report a higher rate of distinct symptoms that occurred within months of their return from active duty.

"The notion of clusters of diseases is one that comes up all the time, and it is very hard to prove," says neurologist Lewis Rowland, MD, of Columbia-Presbyterian Medical Center, who wrote an accompanying editorial to the Neurology study. "I'm not sure it will ever be resolved."

He tells WebMD the medical community remains skeptical of a distinct war-produced syndrome because the studies invite the opportunity of bias. "My specialty is ALS, and if you look at those studies, the veterans were solicited to find out if they had ALS with an implication that there would be some sort of lawsuit."

However, others say that there is clear evidence of a distinct "Gulf War syndrome" and question the way the British study was conducted.

"This study provides no useful information to help understand why 100,000 Gulf War veterans are seriously ill because it compares mildly ill people with well people," says Robert Haley, MD, a University of Texas Southwestern Medical Center researcher who has worked on 15 published studies on Gulf War syndrome.

Haley's research indicates that up to 90% of the troops were exposed to low levels of nerve gas that was deployed when Iraqi storehouses were bombed.

"Between the U.S. and Britain, about 100,000 veterans have distinct neurological symptoms related to damage in deep brain structures -- and these biochemical abnormalities in cells are seen in brain imaging scans," he tells WebMD. "This British study did not examine this. But even if it had, I doubt they would have found anything because they are comparing veterans who are mildly ill with all kinds of aches and pains, not seriously ill people with specific symptoms."

A member of the Presidential Advisory Committee on Gulf War Veterans' Illnesses under President Clinton, who reviewed "dozens of studies involving thousands of veterans" related to Gulf War syndrome, is also convinced that the Gulf War produced distinct medical problems.

"It's not the result of an attempt to extract money from the government," Arthur Caplan, PhD, tells WebMD. "The evidence is there: Some problems result from exposure to certain solvents or chemicals, others show a response to oil fires or bad water. There is a cluster of symptoms caused by a cluster of causes. But these are not the anxiety, cold sweats, and other posttraumatic stress syndrome symptoms that we've seen since the Civil War. These are specific to the Gulf War."

SOURCES: Neurology, Nov. 26, 2002 • Lewis Rowland, MD, professor of neurology, Columbia University, and editor-in-chief, Neurology Today • Robert Haley, MD, professor of internal medicine, University of Texas Southwestern Medical Center, Dallas • Arthur Caplan, PhD, director of the Center for Biomedical Ethics, University of Pennsylvania, and member of Presidential Advisory Committee on Gulf War Veterans' Illnesses. -->