A decade after the Gulf War, questions persist about illnesses reported by veterans. About 20% of Gulf War-deployed veterans receive some form of disability compensation.2 A sizable number of veterans report having fatigue, rash, headache, muscle and joint pain, and loss of memory (Joseph, 1997; Murphy et al., 1999). An increased prevalence of those symptoms has been borne out by large controlled studies of deployed and nondeployed military personnel3 from four countries—the United States, the United Kingdom, Denmark, and Canada. That so many Gulf War veterans report unexplained4 symptoms and disability has prompted concerns about their exposure to potentially hazardous agents during the Gulf War. The US government has invested substantially in health research to understand veterans’ illnesses, search for their causes, and find effective treatments (CDC, 1999; IOM, 2001; Research Working Group, 1999).
This appendix describes the research that has addressed three fundamental questions about illnesses in Gulf War veterans:5 What are the nature and prevalence of veterans’ symptoms and illnesses? Do their unexplained symptoms warrant classification as a new syndrome? Are exposures to specific biologic, chemical, and radiologic agents during the Gulf War associated with veterans’ symptoms and illnesses? Those questions are designed to guide the reader through a complex body of research. The appendix summarizes studies of Gulf War veterans’ symptoms, diagnosable illnesses, mortality, and hospitalizations; and it provides a brief overview of the Gulf War veterans registry programs established by the Department of Veterans Affairs (VA) and the Department of Defense (DOD). The
Department of Epidemiology and Biostatistics, School of Public Health and Health Services, George Washington University, and independent medical writer.
About 155,000 of the more than 700,000 Gulf War veterans receive various degrees of disability compensation or a disability pension from the Department of Veterans Affairs (Sullivan, P, personal communication, Dec. 14, 2001).
Many studies have compared the health of military personnel deployed to the Gulf War with that of military personnel who were not deployed to the Gulf War but served during the same period (Gulf War era). Some studies have a comparison cohort of military personnel who served in another deployment (such as Bosnia).
Unexplained symptoms or unexplained illnesses mean that health complaints cannot be accounted for or explained by current medical diagnoses.
This appendix uses the term Gulf War veterans in the broadest sense. Unless otherwise specified, the term denotes all military personnel who served in the Gulf War theater between August 2, 1990, and June 13, 1991, regardless of whether they later continued on active duty, returned to the reserves or National Guard, or left military service.