Given the large number of agents to study, IOM divided the task into several reviews, which are now complete: 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: Updated Literature Review of Sarin (IOM, 2004); Gulf War and Health, Volume 3: Fuels, Combustion Products, and Propellants (IOM, 2005); Amyotrophic Lateral Sclerosis in Veterans: Review of the Scientific Literature (IOM, 2006a); Gulf War and Health, Volume 4: Health Effects of Serving in the Gulf War (IOM, 2006b); Gulf War and Health, Volume 5: Infectious Disease (IOM, 2007); Gulf War and Health, Volume 6: Physiologic, Psychologic, and Psychosocial Effects of Deployment-Related Stress (IOM, 2008); and Gulf War and Health, Volume 7: Long-Term Consequences of Traumatic Brain Injury (IOM, 2009).

In 2005, the Department of Veterans Affairs (VA) requested that the IOM appoint a committee, the Committee on Gulf War and Health: A Review of the Medical Literature Relative to Gulf War Veterans’ Health, to review that body of literature and to summarize what was known about the then current status of the veterans’ health. In 2006 the committee produced a report, Gulf War and Health, Volume 4: Health Effects of Serving in the Gulf War that summarized the overall health effects in veterans and noted which health outcomes are more evident in Gulf War veterans than in their nondeployed counterparts, irrespective of the specific exposures experienced by the deployed veterans. This current report is an update of Volume 4, covering the literature published since 2006 on the health effects seen in veterans deployed to the Persian Gulf in 1990-1991.

THE GULF WAR SETTING1

In Gulf War and Health, Volume 4, that committee’s charge was not to review the scientific evidence on the possible health effects of various agents to which Gulf War veterans were potentially exposed, but rather to look at the prevalence of the various health effects seen in Gulf War deployed veterans and to determine if that prevalence was greater than that seen in veterans who served in the military during the Gulf War but were not deployed. The current committee (the Update committee) is also not charged with looking at whether a specific exposure could cause a health effect, but like the Volume 4 committee, the Update committee recognized that its members needed to have an appreciation of the Gulf War experience, including the magnitudes of possible exposures for all the military forces that served in the gulf, including those deployed to the region after the war ended. Therefore, in addition to reviewing studies from the United States, the committee reviewed studies of Gulf War veterans from Australia, Canada, Denmark, the United Kingdom, Kuwait, and France.

The information in this section provides a context for the many scientific articles that the current committee reviewed and an appreciation (albeit limited) of the collective experience of Gulf War veterans. It is compiled from many sources including Gunby (1991), Hyams et al. (1995), IOM (1995, 1996, 1999), Joellenbeck et al. (1998), Lawler et al. (1997), NIH Technology Assessment Workshop Panel (1994), PAC (1996, 1997), Persian Gulf Veterans Coordinating Board (1995), Ursano and Norwood (1996), and VA (1998).

1

This section is adapted from Gulf War and Health, Volume 1 (IOM, 2000) and Gulf War and Health, Volume 4 (IOM, 2006).



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