Persian Gulf War syndrome firmly linked to chemical exposure

CHICAGO (AFP) -- Nearly two decades after veterans of the 1991 Persian Gulf War came home complaining of odd illnesses, enough evidence has been gathered to determine that many of them were sickened by chemical exposure, a study concluded.


And some of the damage was likely caused by pills prescribed to protect against the use of nerve gas and pesticides used to control sand flies, according to the study published in the Proceedings of the National Academy of Sciences.

While the military has subsequently stopped using the pills, the pesticides continue to be used in agriculture and for pest control in homes and offices in the United States and around the globe.

""Enough studies have been conducted, and results shared, to be able to say with considerable confidence that there is a link between chemical exposure and chronic, multi-symptom health problems,"" said study author Beatrice Golomb of the University of California San Diego's school of medicine.

""Furthermore, the same chemicals affecting Persian Gulf War veterans may be involved in similar cases of unexplained, multi-symptom health problems in the general population.""

Golomb examined the results of scores of studies looking at the health impact of the class of chemicals to which the veterans were exposed either through pesticides, the anti-nerve gas pills or the demolition of a weapons depot containing the nerve gas sarin.

Her study linked exposure to the chemicals to Persian Gulf War syndrome, a chronic health problem which affected between 26 and 32 percent of deployed troops.

Symptoms routinely reported by these veterans include memory problems, trouble sleeping, muscle or joint pain, fatigue, rashes and breathing problems.

While the findings ""do not imply that all illness in Persian Gulf War veterans"" is the result of this exposure it ""may account for some or perhaps much of the excess illness seen in Persian Gulf War veterans"" she concluded.

Golomb also discovered why some veterans were sickened while others with equal or greater chemical exposure were not affected.

""There is evidence that genetics have something to do with how a body handles exposure to these chemicals,"" Golomb said.

""Some people are genetically less able to withstand these toxins and evidence shows that these individuals have higher chance of suffering the effects of exposure.""

Some 250,000 service members were given the bromide pills as a preventative measure. Those with the mutations that reduced their ability to detoxify the pills were at significantly higher risk of illness, Golomb found.

Previous studies have shown that this mutation is also linked to increased rates of some neurological diseases, such as amyotrophic lateral sclerosis (ALS) or Lou Gehrig's disease.

Hello. I retired from the military a year ago after a 40-year career. I finished as a Colonel, but served as a Captain of armored cavalry during the Gulf War. I took issued pyridostigmine bromide before combat began, my unit was in the wind plume of the Sarin nerve gas explosion (verified by DOD), and organophosphate pesticides were used liberally in our sleeping and living tents for months. I was diagnosed by Mayo Clinic as having Myasthenia Gravis just a couple of months before I retired. I am wondering if there is any concrete evidence which links this pretty rare disease with exposure to the different things I was exposed to in 1991. Thanks for any information.

I don't know of anything concrete and the majority of my research has been towards ALS but here is what I know. ALS is presumed service connected if you served in the Southwest Theater of Operations between Aug. 2, 1990, to July 31, 1991. Two independent studies and a data review have shown that service in the military in general increases the chance of developing ALS in some cases 2.5 times yet only those who served in the Gulf between those dates are presumed service connected. Concrete no but awfully coincidental.

This is another article Bobby had posted elsewhere which talks about AChEIs which is Sarin.

Gulf War Illness Strongly Linked to Chemical Exposure
By Amanda GardnerHealthDay Reporter
Monday, March 10, 2008; 12:00 AM


MONDAY, March 10 (HealthDay News) -- A new scientific review finds a strong association between exposure to certain chemicals and the Gulf War illness suffered by many veterans.

The class of chemicals, known as acetylcholinesterase inhibitors (AChEIs), are found in pesticides, nerve agents and in pills given to soldiers to protect against nerve agents. The review, which was conducted by researchers at the University of California, San Diego, looked at 115 papers on the topic.

"Some of this has been stated for a while," said Joy Ray Miller, an assistant professor of pharmacy practice at the Irma Lerma Rangel College of Pharmacy at Texas A&M Health Science Center. "This article pulls it all together. It's definitely something to be aware of for our future veterans and for the military that's out there now. There are so many variants in the article that we can't really say as a matter of fact that [AChEIs cause the symptoms], but I think there are enough coincidences going on that we can have a pretty good understanding that maybe we should do something differently."

Veterans of the 1990-1991 Persian Gulf War have a higher rate of "chronic multi-symptom health problems" than either non-deployed military personnel or those deployed in other regions. In fact, 26 percent to 32 percent of personnel deployed to the Persian Gulf during this period have chronic health problems, a range that may actually understate the magnitude of the problem, according to the study, published in this week's issue of theProceedings of the National Academy of Sciences.

Symptoms of the syndrome include fatigue, mood-cognition problems and musculoskeletal symptoms.

Although the exact causes remain unknown, evidence is mounting to suggest that exposure to organophosphate and carbamate acetylcholinesterase inhibitors (AChEIs), including pyridostigmine bromide (PB), pesticides and nerve agents, may be responsible.

The authors of this paper looked at epidemiological studies assessing the link between these chemicals and symptoms observed in Gulf War vets.

Many of the studies reported a link between exposure to AChEI and chronic symptoms.

An estimated 250,000 personnel received the carbamate pyridostigmine bromide (PB) as a pretreatment for potential exposure to nerve agents. Those who took more pills had a higher incidence of symptoms.

Also, an estimated 41,000 service members may have been overexposed to pesticides, which were used to control vector-borne disease, and 100,000 personnel may have been exposed to low levels of sarin nerve agent after the demolition of the Khamisiyah munitions depot in Iraq.

The symptoms are akin to those suffered by agricultural workers exposed to AChEIs, said the study authors, as well as symptoms suffered by victims of the sarin terrorist attacks in Japan.

Exposure to AChEIs could also be linked to the higher rate of amyotrophic lateral sclerosis (ALS), or Lou Gehrig's disease, in Gulf War veterans. Sporadic ALS has been associated with exposure to agricultural chemicals.

And men and women with the Gulf War symptoms were more likely to have lower concentrations and activity levels of enzymes which work to clear AChEIs from the system. Genetics may impact the way the body processes these chemicals, specifically the actions of these related enzymes.

"They're giving certain people so many of these nerve agent pills or pesticides, and [the authors] say that some people metabolize them and some not," Miller said. "Are we really giving a toxic dose apart from the genetics? What are they giving and have they really tested the amounts that they're giving? Are we overdosing?"

More information

There's more on Gulf War syndrome at the University of Chicago Medical Center.

SOURCES: Joy Ray Miller, Pharm.D., assistant professor, pharmacy practice, Irma Lerma Rangel College of Pharmacy, Texas A&M Health Science Center, Kingsville; March 10-14, 2008,Proceedings of the National Academy of Sciences