Outcomes with Objective Measures or Diagnostic Medical Tests Associated with Specific Gulf War Exposures

  • Among studies that examined pulmonary outcomes in associations with specific exposures in the Gulf War Theater, exacerbation of asthma associated with oil-well fire smoke has been indicated.

  • With respect to nerve agents at Khamisiyah, no study using objective estimates of exposure has found associations with pulmonary function measures or physician-diagnosed respiratory disease. Another study indicated that there might be an increase in brain cancer among such veterans; however, the exposure models are highly uncertain.

Recommendations

  • Pre- and post-deployment screening of health status.

  • Assessment of exposures.

  • Surveillance for adverse health outcomes, specifically cancer, ALS, birth defects, adverse pregnancy outcomes, post-deployment psychiatric outcomes, and mortality.

Organization of the Report

Chapter 2 provides a brief background in epidemiology and describes the committee’s methods for choosing the epidemiologic studies that are reviewed in later chapters. Chapter 3 describes the major Gulf War cohorts and provides information about the numerous studies that have been derived from them; the chapter includes a summary table that lists all the original cohorts and their derivative studies. The original table of studies was provided in Volume 4 and has been updated here. Chapter 4 describes and analyzes the studies of health outcomes in Gulf War veterans; it also provides the basis for the committee’s conclusions and recommendations, which are presented in Chapter 5. Appendix A briefly reviews the toxicity of cholinesterase inhibitors such as organophosphate pesticides and the adverse health outcomes that might result from exposure to them. Brief biographical sketches of the committee members are provided in Appendix B.

REFERENCES

Cheng, Y. S., Y. Zhou, J. Chow, J. Watson, and C. Frazier. 2001. Chemical composition of aerosols from kerosene heaters burning jet fuels. Aerosol Science and Technology 35(6):949-957.

Costa, L., W. Li, R. Richter, D. Shih, A. Lusis, and C. Furlong. 1999. The role of paraoxonase (PON1) in the detoxification of organophosphates and its human polymorphism. Chemico-Biological Interactions 119-120:429-438.

Department of Veterans Affairs. 1998. Consolidation and Combined Analysis of the Databases of the Department of Veterans Affairs Persian Gulf Health Registry and the Department of Defense Comprehensive Clinical Evaluation Program. Washington, DC: Environmental Epidemiology Service, Department of Veterans Affairs.

DoD (Department of Defense). 2001. Environmental Exposure Report: Pesticides, Final Report. Falls Church, VA: Department of Defense.

Gunby, P. 1991. Physicians provide continuum of care for Desert Storm fighting forces. Journal of the American Medical Association 265(5):557-559.



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