likelihood of increased risk of adverse health outcomes among Gulf War veterans due to exposure to the agents examined in this report.

RESEARCH RECOMMENDATIONS

The committee’s charge was to review the scientific literature on the potential health effects of agents to which Gulf War veterans may have been exposed. Of the many stressors and biological and chemical agents in the Gulf War theater, this report has reviewed the literature on the agents that were of most concern to the veterans and their representatives. Subsequent IOM studies will examine the literature on other Gulf War-related agents.

The committee considered the evidence for each of the agents in turn, as if each one were the only risk factor for adverse health effects. It did so because committee members sought to learn how each agent, in the absence of all of the others, might affect human health. The committee realized through the course of this study, however, that there may also be a need to examine the impact of the total experience of deployment and war on veterans’ health. Such an approach may help elucidate the nature of the illnesses in Gulf War veterans in a way that is not possible by examining single agents. Unfortunately, most of the studies conducted to date focus only on single agents. Yet integrating the various stressors, biological and chemical exposures, the complexities faced by military personnel during all phases of deployment, and the issues surrounding war may provide a more realistic approach toward understanding veterans’ health issues and may provide insights for preventing illnesses in future deployments.

The committee has developed the recommendations in Table 2 for future research, based on its review of the literature on each of the putative agents. These recommendations highlight areas of scientific uncertainty and, if implemented, will help to resolve important questions about the effect of the Gulf War on the health of the veterans.

Finally, this report takes its place alongside several other recent IOM reports on the health of Gulf War veterans. Although the conclusions and recommendations presented here will not end the controversy surrounding Gulf War veterans’ illnesses, this report will provide a scientific basis for consideration by the Department of Veterans Affairs as they develop a compensation program for veterans. The committee hopes that its deliberations, along with the work of many others, will add to the body of accumulating knowledge about the health of Gulf War veterans.



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