tween exposed and unexposed veterans could influence the rates of health outcomes. This information is also lacking for the Gulf War veteran population. Indeed most of the evidence that the committee used to form its conclusions about the association of the putative agents and health effects comes from studies of populations exposed to these agents in occupational and clinical settings, rather than from studies of Gulf War veterans. Due to the lack of exposure data on veterans, the committee could not extrapolate from the level of exposure in the studies that it reviewed to the level of exposure in Gulf War veterans. Thus, the committee could not determine the likelihood of increased risk of adverse health outcomes among Gulf War veterans due to exposure to the agents examined in this report.


Ballantyne B. 1992. Exposure–dose–response relationships. In: Sullivan JB Jr, Krieger GR, eds. Hazardous Materials Toxicology: Clinical Principles of Environmental Health. Baltimore, MD: Williams & Wilkins. Pp. 24–30.

Brachman PS, Gold H, Plotkin S, Fekety FR, Werrin M, Ingraham NR. 1962. Field evaluation of a human anthrax vaccine. Am J Public Health 52:632–645.

Brooks SM, Gochfeld M, Herzstein J, Jackson RJ, Schenker MB. 1995. Environmental Medicine. New York: Mosby-Year Book, Inc.

Cohrssen JJ, Covello VT. 1989. Risk Analysis: A Guide to Principles and Methods for Analyzing Health and Environmental Risks. Washington, DC: Council on Environmental Quality, Executive Office of the President.

Ellwood JM. 1998. Critical Appraisal of Epidemiological Studies and Clinical Trials. 2nd edition Oxford: Oxford University Press.

Evans AS. 1976. Causation and disease: The Henle-Koch postulates revisited. Yale J Biol Med 49(2):175–195.

FDA (Food and Drug Administration). 1998. Center for Drug Evaluation and Research Handbook. [Online]. Available: (accessed April 2000).

Hill AB. 1965. The environment and disease: Association or causation? Proc R Soc Med 58:295–300.

Hill AB. 1971. Principles of Medical Statistics. New York: Oxford University Press.

IOM (Institute of Medicine). 1991. Adverse Effects of Pertussis and Rubella Vaccines. Washington, DC: National Academy Press.

IOM (Institute of Medicine). 1994a. Adverse Events Associated with Childhood Vaccines: Evidence Bearing on Causality. Washington, DC: National Academy Press.

IOM (Institute of Medicine). 1994b. Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. Washington, DC: National Academy Press.

IOM (Institute of Medicine). 1996. Veterans and Agent Orange: Update 1996. Washington, DC: National Academy Press.

IOM (Institute of Medicine). 1999. Veterans and Agent Orange: Update 1998. Washington, DC: National Academy Press.

IOM (Institute of Medicine). 2000. Clearing the Air: Asthma and Indoor Air Exposures. Washington, DC: National Academy Press.

Kramer MS, Lane DA. 1992. Causal propositions in clinical research and practice. J Clin Epidemiol 45(6):639–649.

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