In its 10th report on the health effects of the 1990-91 Persian Gulf War, the Institute of Medicine of the National Academies of Sciences says progress has been minimal in understanding the health effects to military servicemembers in the war.
“Gulf War and Health: Volume 10: Update of Health Effects of Serving in the Gulf War,” suggests the Veterans Affairs Department should shift its focus from searching for links between environmental exposures during the war and veterans’ illnesses to monitoring and treating those who develop illnesses related to their deployment.
The report notes that more than $500 million has been spent between 1994 and 2014 on federally funded research on Persian Gulf War veterans, but said “there has been little substantial progress in our overall understanding of the health effects” from the war.
The report has drawn fire from veterans health advocates, according to an article written by Patricia Kime in the Military Times. They argue panelists showed a bias in selecting which studies to review for the report. “IOM committees should not be made up of former VA officials and their friends,” Rick Weidman, executive director for policy and governmental affairs for Vietnam Veterans of America,” said in the article.
“The science is unequivocal, if viewed honestly and in its totality: Toxic exposures were responsible,” Beatrice Golomb, MD, a professor of medicine at the University of California-San Diego and former scientific director for the VA’s Research Advisory Committee on Gulf War Illness, said in the Military Times. “But the IOM doesn’t look at all relevant studies. This ‘don’t look, don’t find’ practice has been a consistent problem in IOM Gulf War reports.”
For the latest study, the U.S. Department of Veterans Affairs requested the academies review available scientific and medical literature regarding health effects in veterans of the Gulf War, paying particular attention to neurological disorders, cancer and Gulf War illness, according to a news release. Gulf War illness is associated with a wide range of symptoms including muscle pain, rashes, fatigue and cognitive problems.
Amyotrophic lateral sclerosis, aka Lou Gehrig’s disease, was the only neurologic disease for which the committee found some evidence for an association with deployment in the Gulf War. The committee said the Gulf War veteran population is still young with respect to the development of other neurodegenerative diseases. Therefore, the effects of deployment on the incidence and prevalence may not yet be obvious.
The committee recommended that the VA should continue to conduct follow-up assessment of Gulf War veterans for neurodegenerative diseases that have long latencies and are associated with aging, such as ALS, Alzheimer’s disease, and Parkinson’s disease.
The committee found inadequate or insufficient evidence to determine whether deployed Gulf War veterans are at increased risk of having any cancer, including lung and brain cancer. The VA should conduct further assessments of cancer incidence, prevalence and mortality because of the long latency of some cancers, the committee said. However, to be informative, future studies also need to account for additional factors, especially smoking.
Although the evidence base for Gulf War illness has increased over the past few years, little new information has increased understanding of the disease or how to effectively treat or manage it. Based on available research data, it does not appear that a single mechanism can explain the multitude of symptoms seen in Gulf War illness, and it is unlikely a definitive causal agent or agents can ever be identified, especially this many years after the war, the committee said. Animal studies that attempt to mirror Gulf War illness have been of minimal use because it is difficult to establish experimental exposures that are representative of those experienced by Gulf War veterans during deployment.
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