patients listed in the Department of Veterans Affairs (VA) Persian Gulf War Veterans Health Registry (subsequently referred to in the text as the Persian Gulf Health Registry), and looked at some of their case records. We also talked with other physicians interested in this case material, including one who has helped a few of these patients at her own expense. We have also followed the coverage of unexplained illnesses referred to as the ''mystery illness'' or "Gulf War Syndrome" (GWS) by the public media.

ORGANIZATION OF THE REPORT

Following the introduction, this report contains two additional chapters. In the second chapter, the committee presents findings and recommendations that should be implemented as soon as possible. Implementing these recommendations is necessary only to enable certain critical research on the health effects associated with service in the Persian Gulf War (PGW), and to establish infrastructure and procedures to support health studies related to possible future military encounters. The chapter is divided into three sections: "Data and Databases," "Coordination/Process," and "Considerations of Study Design Needs." This chapter precedes the supporting background chapter because the committee believes its findings and recommendations are the most important part of the report.

The third chapter provides a general overview and discussion of the actions taken and the steps involved in defining the Persian Gulf health arena. The chapter is divided into the following sections: "Boards and Committees," "Population-Based Activities," "Health-Outcome-Based Activities—Completed or Well Underway," "Health-Outcome-Based Activities—New or Just Beginning," and "Exposure-Based Activities."

Appendix A comprises the putative outcomes and exposures that the committee has been, and will continue to, evaluate and modify as additional information becomes available; Appendix B is a listing of invited presentations; Appendix C contains relevant portions of the laws that are mentioned in this report.

Included in Appendix D are the dates of each IOM committee meeting, a list of persons who presented or submitted testimony for the committee's public meeting, and a list of persons who have subsequently sent materials to the IOM committee.

Appendix E includes a list of activities known to this committee to be related to the Persian Gulf health experience, as of September 1994 and Appendix F includes a timeline of events beginning with the invasion of Kuwait and continuing with events and activities related to this report.



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