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Since the end of the Gulf War in 1991, many of the approximately 700,000 U.S. veterans have experienced undiagnosed illnesses. They attribute these illnesses to exposure to chemical warfare (CW) agents in plumes -- clouds released from the bombing of Iraqi sites. But in 2000, the Department of Defense (DoD) estimated that of the 700,000 veterans, 101,752 troops were potentially exposed. GAO was asked to evaluate the validity of DoD, the Department of Veterans Affairs (VA), and British Ministry of Defense (MOD) conclusions about troops' exposure. The GAO found that DoD's and MOD's conclusions about troops' exposure to CW agents, based on DoD and CIA plume modeling, cannot be adequately supported. The models were not fully developed for analyzing long-range dispersion of CW agents as an environmental hazard. The modeling assumptions as to source term data -- quantity and purity of the agent -- were inaccurate because they were uncertain, incomplete, and nonvalidated. The plume heights used in the modeling were underestimated and so were the hazard areas. Postwar field testing used to estimate the source term data did not realistically simulate the actual conditions of bombings or demolitions. Finally, the results of both DoD and non-DoD models showed wide divergences as to plume size and path. DoD's and VA's conclusion about no association between exposure to CW agents and rates of hospitalization and mortality, based on two epidemiological studies conducted and funded by DoD and VA, also cannot be adequately supported because of study weaknesses. In both studies, flawed criteria -- DoD's plume model and DoD's estimation of potentially exposed troops based on this model -- were used to determine exposure. This may have resulted in large-scale misclassification. GAO recommended that the DoD and the VA not use the plume-modeling data for any other epidemiological studies of the 1991 Gulf War. VA concurred with the recommendation; DoD and the CIA did not concur.
Questions surrounding Gulf War illness and other health problems resulting from service in the 1990-1991 Gulf War have long plagued veterans and government officials. This 450-page report brings together for the first time the full range of scientific research and government investigations on Gulf War illness. The comprehensive analysis resolves many questions about what caused Gulf War illness and what should be done to address this serious condition, which affects at least one in four Gulf War veterans.--Publisher description.
The increase in environmentally induced diseases and the loosening of regulation and safety measures have inspired a massive challenge to established ways of looking at health and the environment. Communities with disease clusters, women facing a growing breast cancer incidence rate, and people of color concerned about the asthma epidemic have become critical of biomedical models that emphasize the role of genetic makeup and individual lifestyle practices. Likewise, scientists have lost patience with their colleagues' and government's failure to adequately address environmental health issues and to safeguard research from corporate manipulation. Focusing specifically on breast cancer, asthma, and Gulf War-related health conditions-"contested illnesses" that have generated intense debate in the medical and political communities-Phil Brown shows how these concerns have launched an environmental health movement that has revolutionized scientific thinking and policy. Before the last three decades of widespread activism regarding toxic exposures, people had little opportunity to get information. Few sympathetic professionals were available, the scientific knowledge base was weak, government agencies were largely unprepared, laypeople were not considered bearers of useful knowledge, and ordinary people lacked their own resources for discovery and action. Brown argues that organized social movements are crucial in recognizing and acting to combat environmental diseases. His book draws on environmental and medical sociology, environmental justice, environmental health science, and social movement studies to show how citizen-science alliances have fought to overturn dominant epidemiological paradigms. His probing look at the ways scientific findings are made available to the public and the changing nature of policy offers a new perspective on health and the environment and the relationship among people, knowledge, power, and authority.
Although the Gulf War lasted but a few days, many combat troops have suffered lingering health problems that they attribute to their wartime service. In an effort to respond to the health concerns of veterans and their families, the Department of Veterans Affairs contracted with the Institute of Medicine (IOM) to study the scientific evidence concerning associations between agents to which Gulf War veterans may have been exposed and adverse health effects. These are the reports from those studies.
In 1998, in response to the growing concerns that many returning Gulf War veterans began reporting numerous health problems that they believed to be associated with their service in the Persian Gulf, Congress passed two laws which directed the Secretary of Veterans Affairs to enter into a contract with the National Academy of Sciences. They were tasked to review and evaluate the scientific and medical literature regarding associations between illness and exposure to toxic agents, environmental or wartime hazards, and preventive medicines or vaccines associated with Gulf War service. In addition, the Institute of Medicine of the National Academy of Sciences provided conclusions to these studies that were considered when making decisions about compensation to veterans. Gulf War and Health Volume 4: Health Effects of Serving in the Gulf War summarizes in one place the current status of health effects in veterans deployed to the Persian Gulf irrespective of exposure information. This book reviews, evaluates, and summarizes both peer-reviewed scientific and medical literature addressing the health status of Gulf War veterans.
More than 2 decades have passed since the 1990-1991 conflict in the Persian Gulf. During the intervening years, many Gulf War veterans have experienced various unexplained symptoms that many associate with service in the gulf region, but no specific exposure has been definitively associated with symptoms. Numerous researchers have described the pattern of signs and symptoms found in deployed Gulf War veterans and noted that they report unexplained symptoms at higher rates than nondeployed veterans or veterans deployed elsewhere during the same period. Gulf War veterans have consistently shown a higher level of morbidity than the nondeployed, in some cases with severe and debilitating consequences. However, efforts to define a unique illness or syndrome in Gulf War veterans have failed, as have attempts to develop a uniformly accepted case definition. Chronic Multisymptom Illness in Gulf War Veterans is a comprehensive review of the available scientific and medical literature regarding symptoms for chronic multisymptom illness (CMI) among the 1991 Gulf War Veterans. This report evaluates and summarizes the literature in an effort to identify appropriate terminology to use in referring to CMI in Gulf War Veterans. While the report does not recommend one specific case definition over another, Chronic Multisymptom Illness in Gulf War Veterans does recommend the consideration of two case definitions on the basis of their concordance with the evidence and their ability to identify specific symptoms commonly reported by Gulf War veterans. This report recommends that the Department of Veterans Affairs use the term Gulf War illness rather than CMI. The report recommends that that the Department of Veterans Affairs, to the extent possible, systematically assess existing data to identify additional features of Gulf War illness, such as onset, duration, severity, frequency of symptoms, and exclusionary criteria to produce a more robust case definition.