In response to the concerns of the Gulf War veterans about their unexplained illnesses, the US Department of Veterans Affairs (VA) asked the Institute of Medicine (IOM) to conduct a study to evaluate the scientific literature on chemical, biologic, and physical agents to which military personnel in the gulf were potentially exposed and possible long-term adverse health outcomes. In addition, Congress passed two laws in 1998—the Persian Gulf War Veterans Act (PL 105-277) and the Veterans Programs Enhancement Act (PL 105-368)—that called for the review of the scientific literature on specified agents with regard to long-term adverse health outcomes. That legislation directs IOM to study a number of diverse chemical, biologic, and physical agents (listed in Box 1.1). IOM divided the task into several reviews. It has completed four reports: Gulf War and Health, Volume 1: Depleted Uranium, Pyridostigmine Bromide, Sarin, Vaccines (IOM 2000); Gulf War and Health, Volume 2: Insecticides and Solvents (IOM 2003); Gulf War and Health Volume 3: Fuels, Combustion Products, and Propellants (IOM 2005); and Gulf War and Health, Volume 4: Health Effects of Serving in the Gulf War (IOM 2006). The present report is the fifth volume in the series. An additional, related report has also been published: Gulf War and Health: Updated Literature Review of Sarin (IOM 2004).

Since VA asked IOM to conduct the above-mentioned study and PL 105-277 and PL 105-368 were enacted, the United States has again entered into military conflicts in southwest and south-central Asia—Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Therefore, VA has asked IOM to make this report relevant to the military personnel serving in OEF and OIF in addition to those who served in the 1991 Gulf War.

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