From Military.com:
“Researchers Think They've
Found the Cause of Gulf War Illness”
(A Marine Cobra gunship files
over a column of allied tanks during the battle for Khaf ji on Thursday, Jan.
31, 1991 at Saudi Arabia on the Saudi-Kuwait border.)
After nearly 30 years of trying
to prove a theory -- that an environmental toxin was responsible for sickening
roughly 250,000 U.S. troops who served in the 1990-91 Persian Gulf War -- Dr.
Robert Haley says new research confirms that sarin nerve gas caused Gulf War
Illness. Following the Gulf War, nearly one-third of all who deployed reported
unexplained chronic symptoms such as rashes, fatigue, gastrointestinal and
digestive issues, brain "fog," neuropathy, and muscle and joint pain.
Federal agencies spent years broadly dismissing the idea that troops may have
been suffering from exposure to chemical agents, with many veterans
experiencing symptoms sent to mental health providers.
But a study published last week
in the journal Environmental Health Perspectives used genetic research and
survey data to determine that U.S. service members exposed to sarin were more
likely to develop Gulf War Illness, and those who were exposed and had a weaker
variant of a gene that helps digest pesticides were nine times more likely to
have symptoms. "Quite simply, our findings prove that Gulf War illness was
caused by sarin, which was released when we bombed Iraqi chemical weapons
storage and production facilities," said Haley, director of the Division
of Epidemiology in the Internal Medicine Department at University of Texas
Southwestern Medical Center. "There
are still more than 100,000 Gulf War veterans who are not getting help for this
illness and our hope is that these findings will accelerate the search for
better treatment," Haley said.
Originally developed as a
pesticide, the chemical weapon sarin was known to have been stockpiled by Iraqi
President Saddam Hussein prior to and after the 1990-91 Persian Gulf War. The
synthetic nerve agent attacks the central nervous system and brain, killing
victims by triggering an overreaction of neurotransmitters that causes
convulsions and asphyxiation.
Thousands of coalition troops
likely were exposed to sarin and cyclosarin, an organic phosphate also used as
a chemical weapon, when the U.S. destroyed a bunker housing chemical weapons at
the Khamisiyah Ammunition Storage Depot in southern Iraq, sending a plume of
contaminants that spread across a 25-mile radius. Others may have been
subjected to low levels of contaminants, as troops frequently reported that
chemical weapons alarms went off in the absence of any apparent attack. In the
years following the war, veterans who sought medical help at the Department of
Veterans Affairs were greeted with skepticism and sent to psychiatrists for
mental health treatment. Health surveys conducted by the VA in the early 2010s
of Gulf War veterans focused mainly on questions about psychological and
psychiatric symptoms. And in 2013, veterans' suspicions of the lack of concern
at the VA were confirmed when VA whistleblower and epidemiologist Steven
Coughlin came forward to say that the department buried or obscured research
findings that would link physical ailments to military service -- a concerted
effort to deny veterans health care and benefits. Coughlin's charges were later
confirmed by an email sent to staff from former Undersecretary for Benefits
Allison Hickey expressing concern that changing what the VA still calls
"chronic multisymptom illness" to "Gulf War illness" might
"imply a causal link between service in the Gulf and poor health which
could necessitate legislation for disability compensation for veterans who
served in the Gulf."
Research Confirms Earlier,
Smaller Studies For the new study into sarin, Haley and colleagues randomly
selected 1,116 veterans who completed a U.S. Military Health Survey, including
508 who deployed and developed Gulf War Illness and 508 veterans who went but
never developed symptoms. They collected blood and DNA samples from each
participant and asked the veterans whether they heard nerve gas alarms during
their deployment, and if so, how often. The researchers also tested for
variants of a gene that helps the body metabolize pesticides, called PON1. Some
people have variants of this gene that are more effective in breaking down
sarin while others have a variant that helps process chemicals like pesticides
but is less efficient against sarin.
The study found that those who
reported hearing nerve agent alarms and who also had the least robust form of
the gene had a nine-fold chance of having Gulf War Illness. Those with a
genotype that is a mix of the two variants had more than four times the chance
of having Gulf War Illness, while those who just heard nerve agent alarms,
which the researchers used as a proxy for exposure, raised the chance of
developing the condition by nearly four times, although to a lesser degree of
those who have a mix of genes. According to the researchers, the data
"leads to a high degree of confidence that sarin is a causative agent for
Gulf War Illness." "Our hypothesis was, if you have the strong form
of the gene, then when you're exposed to low-level sarin, that gene makes a
strong isoenzyme that destroys sarin in your blood. If you have the weak form
of the gene, the enzyme that it makes is not very strong, so it goes through
your blood into your brain and you get sick," Haley said in an interview
with Military.com. "You've heard the expression 'correlation does not
equal causation,' right? That's true, unless you are dealing with a
gene-environment interaction."
A Mysterious Malady The
mysterious symptoms experienced by thousands of service members, which came to
be known as Gulf War Syndrome and, later, Gulf War Illness, generated
hypotheses of the possible cause, including an additive in anthrax vaccines,
preventive medicines given to troops such as the anti-nerve agent
pyridostigmine bromide, ciprofloxacin, depleted uranium, and exposure to nerve
gas, pesticides or smoke from oil well fires. A congressional
investigation in 1997 concluded that the Departments of Defense and Veterans
Affairs had very little interest in finding a cause and blamed the symptoms as
related to stress or other mental health disorders. In its report, the
Committee on Government Reform and Oversight found that the DoD and VA were
"plagued by arrogant incuriosity and a pervasive myopia that sees a lack
of evidence as proof" that the illness didn't exist. "Sadly,
when it comes to diagnosis, treatment and research for Gulf War veterans, we
find the Federal Government too often has a tin ear, a cold heart and a closed
mind," the report noted.
As Congress investigated the
issue, Haley was studying possible causes, funded by Ross Perot, the Texas
billionaire and Navy veteran known for donating to veterans' charities and
resources, including efforts to help U.S. prisoners of war in Vietnam. Haley's
early work pointed to sarin as a possible cause, but other scientists,
including the medical body of the National Academies of Sciences, Engineering
and Medicine, found his studies to be insufficient in size and suffering from
selection or "recall bias," meaning that vets may or may not remember
whether they heard nerve gas alarms and how often. Haley said the new research
links veterans with Gulf War Illness with their genotype and "cannot be
explained away by errors in recalling the environmental exposure or other
biases in the data."
Others now concur. In an
editorial accompanying the study, Marc Weisskopf, a professor of environmental
epidemiology and psychology at the Harvard T.H. Chan School of Public Health,
and Kimberly Sullivan, a research associate professor with Boston University
School of Public Health, said the study makes a strong case for a causal link
and explains, to some extent, why some troops got sick and some did not. "The
authors' exploration of a gene-environment interaction between presumed nerve
agent exposure and the PON1 gene offers some strong arguments that there is a
true causal effect at work," they wrote in their opinion piece.
The VA has established service
connection for Gulf War veterans with certain chronic, unexplained symptoms,
which the department calls "chronic multisymptom illness" or
"undiagnosed illness." Those who have certain symptoms, such as
chronic fatigue syndrome, fibromyalgia and some gastrointestinal disorders, and
served in the 1990-1991 conflict do not have to prove service connection and
are eligible for benefits including a health exam, health care and disability
compensation. Historically, however, the VA has been strict in determining
service connection. A 2017 Government Accountability Office report found the VA
denied 83% of 102,000 claims filed for Gulf War Illness between 1994 and 2015.
New Hope Haley said the
research could pave the way for more veterans to access health care and
benefits and open up research into possible treatments. He said that the
symptoms are caused by brain inflammation, which may be treatable once
scientists figure out exactly how sarin works. "Once we know, we
could come up with treatments to reverse it," Haley said. "I really
believe this is optimistic and that it means this is not brain damage. This is
not loss of neurons and like a stroke or something that you're never going to
recover from." Among the veterans excited about the new study is
Paul Sullivan, a Persian Gulf War veteran who works as director of veteran
outreach at the law firm Bergmann & Moore and deployed to Iraq as an Army
cavalry scout with the 1st Armored Division in 1991. He said the results
provide evidence that affected veterans need to access care from the VA. "This
landmark study provides a clear path for VA to presume sarin exposure for all
1991 Gulf War veterans," Sullivan said Thursday. "The study provides
a compelling missing scientific link for treatment research for my fellow Gulf
War Veterans disabled since our exposures during Desert Storm." Haley
said he has received letters from veterans asking if they could get tested for
the different types of the PON1 gene and whether it would be helpful. Routine
genetic testing does not include PON1, but further research may lead to a
diagnostic test that would provide peace of mind to veterans, he said. The
research was conducted in collaboration with a survey research team from North
Carolina-based RTI International and funded by the DoD and VA, both of which
have funded thousands of studies on Gulf War Illness despite long-standing
skepticism. "This is the scientific process. Nobody's bad. Nobody's
good. People have their theories. Skepticism is the name of the game. That is
what makes it fun," Haley said.
^ For Decades the Men and Women
who fought during the Gulf War (both Americans and our Foreign Allies) have
suffered. After fighting in Iraq they then had to fight when they came home
(with Congress, with the US Military, with the VA, etc.) to get answers to
their health questions. We abandoned them when they needed us and after they
risked everything for us. Things are slowly changing for the better now, but
that doesn’t make up for the 3 Decades. ^
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