veterans, and other interested persons who made the committee aware of their experiences or their health status and provided information about research. This information helped the committee by providing details on the Gulf War experience, in identifying particular agents and health issues of concern, and in providing a context for the committee’s work.

The committee and staff reviewed more than 10,000 abstracts of scientific and medical articles related to the agents selected for study. The full text of more than 1,000 peer-reviewed journal articles, many of which are described in this report, were carefully reviewed by the committee (see Appendix C for a complete description of the committee’s literature review strategy).


Chapter 2 provides an overview of major studies that have been conducted on the health of Gulf War veterans. It highlights the complexity of efforts to understand the nature of the veterans’ illnesses, reviews some of the many studies that have provided data on the symptomatology of illnesses in Gulf War veterans, and discusses the limitations of these studies. Chapter 3 outlines the methods used by the committee to review the literature, the issues it debated while considering the evidence, and its criteria for reaching conclusions about the strength of the evidence for or against associations between adverse health effects and specific agents.

The next four chapters review the scientific literature on each of the agents chosen for study: depleted uranium (Chapter 4), sarin and cyclosarin (Chapter 5), pyridostigmine bromide (Chapter 6), and the anthrax and botulinum toxoid vaccines (Chapter 7). Each of these chapters explains the use of the agent during the Gulf War, contains an overview of the toxicology of the agent, describes the results of animal studies, and provides detailed descriptions of human studies. Further, when evidence was available on combinations of chemicals or other agents, the committee includes that information in its discussion. The committee provides conclusions in each of the chapters about the strength of the relationship between the agent and the possibility of adverse health outcomes. Finally, where there are gaps in the information, the committee makes recommendations for future research efforts in those areas (Chapter 8).


Goss Gilroy Inc. 1998. Health Study of Canadian Forces Personnel Involved in the 1991 Conflict in the Persian Gulf, Vol. 1. Ottawa, Ontario: Goss Gilroy Inc. Prepared for the Department of National Defence.

Gunby P. 1991. Physicians provide continuum of care for Desert Storm fighting forces. JAMA 265(5):557–558.

Hyams KC, Hanson K, Wignall FS, Escamilla J, Oldfield EC III. 1995. The impact of infectious diseases on the health of US troops deployed to the Persian Gulf during Operations Desert Shield and Desert Storm. Clin Infect Dis 20:1497–1504.

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