Many Gulf War veterans suffer from an array of health problems and symptoms (e.g., fatigue, muscle and joint pain, memory loss, rash) that are not specific to any one disease and are not easily classified by standard diagnostic coding systems. Population-based studies have found higher prevalence of self-reported symptoms in Gulf War veterans compared to nondeployed Gulf War era veterans or other control groups (see Chapter 2; Iowa Persian Gulf Study Group, 1997; Goss Gilroy, 1998; Unwin et al., 1999). All Gulf War veterans do not experience the same array of symptoms, which has complicated ongoing efforts to determine if there is a unique Gulf War syndrome or if there is overlap with other symptom-based disorders. Thus, the nature of the symptoms suffered by many Gulf War veterans does not point to an obvious diagnosis, etiology, or standard treatment (see Chapter 2).

Although the committee’s charge was to review the scientific evidence on the possible health effects of various agents to which Gulf War veterans were exposed, the committee realized at the onset that it needed to have as complete an understanding of the Gulf War experience as possible. The committee sought to understand the Gulf War setting and veterans’ experiences. For that reason, the committee met with representatives of veterans’ groups and opened its meetings whenever possible to hear from veterans, researchers, and other members of the interested public (see Appendixes A and B).

The following information provides a context for the many scientific articles that the committee reviewed and provides an appreciation (albeit limited) of the collective experiences of Gulf War veterans. This information is compiled from many sources including presentations by veterans and other speakers at the committee’s public meetings (see Appendix B) (Gunby, 1991; NIH, 1994; Hyams et al., 1995; IOM, 1995, 1996, 1999; Persian Gulf Veterans Coordinating Board, 1995; Ursano and Norwood, 1996; PAC, 1996, 1997; Lawler et al., 1997; Joellenbeck et al., 1998; U.S. Department of Veterans Affairs, 1998).

The pace of the buildup for the war was unprecedented. Within 5 days after Iraq invaded Kuwait, the United States and other coalition countries began moving troops into the region. By September 15, 1990, the number of American service members reached 150,000 and included nearly 50,000 reservists. Within the next month, another 60,000 troops arrived in Southwest Asia, and in November an additional 135,000 reservists and guard members were called up. By February 24, 1991, more than 500,000 U.S. troops had been deployed to the Persian Gulf region.