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ALS Risk Appears Increased in Veterans: New Government Report Agrees
Roberta Friedman, Ph.D., Research Department Information Coordinator
Pat Wildman, Director Communications and Public Policy
[Quick Summary: A new report from experts convened by the Institute of
Medicine agrees with prior conclusions that U.S. military veterans appear to
have increased risk of developing ALS. The report recommends additional
research to further assess the relationship between ALS and military service and
determine what factors of military service may cause the disease.]

The Institute of Medicine (IOM) has issued a new report from experts supporting
an association between military service and later development of ALS.
Published reports reviewed by the experts show up to a two fold increased risk
of developing amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s
disease) among veterans deployed in the Persian Gulf War of 1991. Veterans from
other eras, dating from World War II to post Vietnam, also appear to be at
greater risk of developing ALS.
“A diverse panel of experts was able to conclude that existing evidence
supports the increased risk for veterans,” said Lucie Bruijn, Ph.D., science
director and vice president of The ALS Association. “We intend to continue our
efforts to help veterans and to continue to search for the cause and effective
treatment of ALS.”
The ALS Association has worked with Congress and the Administration to
increase funding for ALS research, including research seeking to determine why
veterans are at greater risk of the disease. When the first studies were
published that found a link between ALS and service in the 1991 Persian Gulf
War, The Association strongly supported former Secretary Anthony Principi’s
policy to aid Gulf War veterans with ALS. Under that policy, ALS is considered
a service-connected disease for those veterans who served in the Gulf War
between August 2, 1990 and July 31, 1991.
However, ALS is not presumed to be a service-connected disease for the
thousands of other veterans diagnosed with ALS even though research has
demonstrated elevated rates of ALS in all veterans, regardless of whether they
served in the 1991 Gulf War.
“The IOM’s conclusions help to validate what the ALS community knows all too
well – that if you served in the military, you are more likely to die from ALS,”
said Steve Gibson, vice president of Government Relations and Public Affairs for
The ALS Association. “We strongly support calls for expanding ALS research at
both the Department of Veterans Affairs and the Department of Defense. We also
believe that ALS should be considered a service connected disease regardless of
when a veteran served in the military. And we hope that the Members of the
newly elected 110th Congress will join our fight in support of all veterans with
ALS.”
Four studies have found evidence of the increased risk of ALS in military
veterans, both those who served in the Gulf War and those with any history of
military service, the IOM committee reported. The risk is as much as twice that
in the general population.
Of particular importance, the IOM reviewed a study conducted by researchers
from Harvard University ’s School of Public Health that found that veterans who
served in the military, whether World War II, Korea or Vietnam, are at greater
risk of ALS. According to the IOM report, “[T]he implication is that military
service in general – not confined to exposures specific to the Gulf War – is
related to the development of ALS. The findings, if validated in other studies,
suggest that exposures during military service, even among those with no wartime
service, might be responsible.”
The committee called for new, high quality studies to further investigate the
connection between ALS and military service and to examine those aspects of
military service that may cause the disease.

Factors that might feed into the increased risk of ALS in veterans include
exposure to lead, pesticides or other environmental contacts, use of tobacco or
alcohol or extreme physical exertion.The ALS Association has recognized the need
for larger population based studies and is working with Congress to pass the ALS
Registry Act (HR 4033/S. 1353), legislation that would establish a national ALS
registry at the Centers for Disease Control and Prevention. The registry would
collect data about ALS that could provide vital clues into the causes of the
disease, including why veterans may be at greater risk.
Experts who served on the committee for the report were Richard T. Johnson,
M.D. (chair), Johns Hopkins University, Baltimore, Walter Bradley, D.M.,
University of Miami, Florida, Beate Ritz, M.D., Ph.D., M.P.H., University of
California, Los Angeles, Walter A. Rocca, M.D., M.P.H., Mayo Clinic, Rochester,
Minn., Jeremy Shefner, M.D., Ph.D., State University of New York at Syracuse,
and Christina Wolfson, Ph.D., McGill University, Montreal.

A report issued by the IOM in September was unable to find evidence that
supports the idea of a Gulf War Syndrome but did agree that existing evidence
shows increased risk of ALS among Gulf War veterans (the report is available at
http://www.iom.edu/CMS/3793/24597/36955.aspx).
Copies of the latest IOM report, “Amyotrophic Lateral Sclerosis in Veterans:
Review of the Scientific Literature,” are available from the National Academies
Press; tel. 202-334-3313 or 1-800-624-6242 or on the Internet at
http://www8.nationalacademies.org/on...RecordID=11757.

See The ALS Association’s web site under the research tab for further
information about environmental factors in ALS. Copies of The ALS Association
report: “ALS in the Military: the Unexpected Consequences of Military Service”
also is available at http://www.alsa.org/files/pdf/ALS_Military_Paper.pdf.

For
additional information about The Association’s advocacy efforts to support
military veterans, contact The Association’s Capital office at 202-638-6997.