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Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
×

Index

A

Acetylcholine (ACh), 9

botulinum toxoid vaccines, 288(n.10), 289

pyridostigmine bromide (PB), 11, 12, 13, 207–216 (passim), 224, 227–228

sarin, 18, 19, 21, 169–170, 175, 176, 188, 192, 198

Acetylcholinesterase (AChE)

cyclosarin, 186

organophosphate binding (OP-AChE), 9, 174–175, 177, 178, 180, 186, 208, 210, 366

pyridostigmine bromide binding (PB-AChE), 9, 11, 13, 53, 208, 210–213 (passim), 215, 217, 220, 223, 227–228, 232, 235, 241, 244–245

sarin, 9–10, 21, 169–170, 174–175, 176, 177, 178, 180, 186, 187, 190, 194–195

see also Pyridostigmine bromide

Acute cholinergic symptoms/syndrome, 9–13, 19, 366

sarin, 9–10, 170–172, 173, 188, 190, 192, 193, 196, 198

Acute effects, general, 4, 72, 189

anthrax vaccines, 15, 16, 19, 277–287 (passim), 304, 313

botulinum toxoid vaccines, 17, 19, 290, 291, 293–294, 313

multiple vaccinations, 17, 297, 306

organophosphate toxicity, 13, 213

pyridostigmine bromide (PB), 214, 224, 234, 250–251

sarin, 9, 18, 19, 21, 180, 188, 193–194, 199, 328

squalene, 309, 310, 311

vaccines, 270, 271;

see specific vaccines supra

uranium, 99

see also specific acute symptoms

Adjuvants, vaccines, 270, 271, 274, 276, 279, 280, 290

squalene, 268, 280, 307–312, 340

Adrenal gland, see Hypothalamic-pituitary-adrenal processes

Adenovirus vaccines, 295

Age factors, 41, 43, 74

anticholinesterases, 190

multiple vaccinations, 305

organophosphate pesticides, 371–375

phosphate fertilizer production workers, 130

pyridostigmine bromide, 227, 228, 236, 238, 242, 244, 246–247

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
×

uranium workers, 116–117, 119, 121, 128, 134–135, 138, 149

vaccines, 302, 311–312

Agency for Toxic Substances and Disease Registry (ATSDR), 94, 99, 106

Agent Orange, 29, 334

AIDS, 310, 342, 345

Air Force Technical Applications Center (AFTAC), 173

Alcohol abuse, 45, 49

Alkaline phosphatase (ALP), 150

Aluminum hydroxide adjuvant, 274, 276

Alzheimer’s disease, 213, 227

American College of Rheumatology, 355

American Psychiatric Association, 345, 346, 360

Ammunition

depleted uranium, 5, 6, 92–93, 98, 326

sarin, 172

see also Armor

Animal studies, 2, 71–72, 80, 99, 351

anthrax vaccines, 21, 277–280, 330

botulinum toxoid vaccines, 21, 288, 289–291, 330

cyclosarin, 186–187

depleted uranium, 99, 100–101, 151, 327

fatigue, 72, 351

multiple vaccinations, 297–299

pain, 72

pyridostigmine bromide (PB), 209, 210–211, 213, 214, 215, 218–219, 220

sarin, 10, 175–176, 177, 178–187, 288

squalene, 308–309

uranium, 21, 96, 97–98, 99–106, 107, 151, 159, 327

vaccines, 271, 272, 277–280, 288, 289–291, 297–299, 308–309, 330

see also Primate equilibrium platform

Anthrax Vaccine Expert Committee, 284

Anthrax Vaccine Immunization Program, 15, 274, 330

Anthrax vaccines, vii, 1, 2, 4, 14, 15–16, 19, 21, 28, 268, 272, 274–287, 306, 312–313, 330, 335

acute effects, 15, 16, 19, 277–287 (passim), 304, 313

animal studies, 21, 277–280, 330

antibodies, 279, 285, 306

antigens, general, 15, 54, 274–277 (passim), 279–280

cardiovascular system, 278, 280

cellular processes, general, 272, 276, 301, 302

chronic effects, 19, 287, 312–313

clinical studies, 15–16, 19, 282–283, 284–287, 334

dermal effects, 15, 16, 272(n.3), 279, 281–287 (passim)

dose factors, 274–275, 278, 285

edema, 15, 275, 276, 277, 278, 283, 284

exposure routes, 272(n.3), 275

dermal, 272(n.3), 282, 283

ingestion, 272(n.3)

inhalation, 272(n.3), 276–277, 282, 283

injection delivery, 15, 279–286 (passim), 297

FDA, 14, 267, 274, 283–284, 287, 313

fever, 16, 277–278, 282, 284, 285, 287

gastrointestinal effects, 272(n.3), 285

gender factors, 286

genetic effects, 280

headaches, 281, 284, 285

historical perspectives, 272, 274, 281, 283–284, 287

hospitalization following administration, 284, 286

immune system pathologies, 279, 284, 285, 290–292, 306

inflammation, 278, 281, 284, 286, 287, 297

live attenuated spore vaccines, 274, 276, 277–279, 281, 297

lymphatic system, 278

mental disorders, 284

mortality, 277, 278

multiple vaccinations, 301, 304

nausea and vomiting, 284, 285

neuromuscular effects, 281, 284, 285, 286

neuropathy, general, 285

number of vaccinations given, 15, 267, 274, 284

pain, 281–282, 284, 285, 286

protective antigen vaccines, 274, 276–277, 279–280, 281, 282

rashes, 284, 285

reproductive system effects, 226

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
×

research recommendations, 313

respiratory effects, 272(n.3), 276–277, 282, 283

short-term malaise, 15, 281, 283, 284, 285

squalene, 309–310

surveillance, 269

veterans, studies of Gulf War veterans, 285, 286, 293

visual and ocular effects, 286

Antibodies

adverse reactions to vaccines, 17, 272, 298

anthrax vaccines, 279, 285, 306

botulinum toxoid vaccines, 288(n.11), 290, 293, 306

lymphocytes, 158, 272, 278, 301, 302

squalene, 309, 311

uranium, 152, 156–157, 312

see also Autoimmune diseases;

Vaccines

Anticholinesterase, 9, 170, 174, 189, 190, 199, 328, 372

age factors, 190

genetic factors, 31

see also Cyclosarin;

Sarin

Antidotes

cyclosarin, 186

sarin, 170, 179

see also Pyridostigmine bromide

Antigens, 271–272, 273

anthrax vaccines, 15, 54, 274–277 (passim), 279–280

botulinum toxoid vaccines, 290

human leukocyte antigen (HLA), 273

toxicity of, 271–272, 273

see also Vaccines

Anxiety, 49, 57, 171, 196, 226, 350, 354

Armed Forces Epidemiologic Board, 295

Armor, depleted uranium, 5, 91–92

Army Center for Health Promotion and Preventive Medicine, 93–94

Army Medical Corps, 9

Army Medical Research Institute of Infectious Diseases, 284, 285–286, 292

Arthritis, 299–300, 302, 309

Asbestos, 34, 78, 79

Asthma, 45, 49, 215, 231, 236, 237

Atropine, 11, 208, 228, 237

ATSDR, see Agency for Toxic Substances and Disease Registry

Attention deficits, 27, 51

sarin, 171

Autoimmune diseases, 273

arthritis, 299–300, 302, 309

diabetes mellitus, 298–299

fibromyalgia, 45, 46, 48, 49, 62, 343, 352, 355–360 (passim)

systemic lupus erythematosus, 157, 284, 311

see also Myasthenia gravis

AVIP, see Anthrax Vaccine Immunization Program

B

Baltimore cohort, Gulf War veterans, 21, 93, 326

Beneficiary Identification and Records Locator Subsystem, 54–55

BEIR, see Committee on the Biological Effects of Ionizing Radiation

Biological warfare agents, general, 1, 34, 35, 48, 325

see also Anthrax vaccines;

Botulinum toxoid vaccines;

Nerve agents;

Vaccines

Birth defects, 56–57, 61(n.25), 62, 104–105

Bladder, see Genitourinary system and urinalysis

Blood, see Cardiovascular system;

Hematologic effects

Blood-brain barrier

pyridostigmine bromide (PB), 11, 207, 219–220

sarin, 177

Bone cancer, 19, 109, 143, 146, 159

Bones, see Musculoskeletal effects

Bosnian conflict, 39, 50–51, 250, 303, 304, 358

Botulinum toxoid vaccines, vii, 1, 2, 4, 14, 16–17, 19, 21, 28, 34, 287–294, 297–298, 301, 306

acetylcholine (ACh), 288(n.10), 289

acute effects, 16, 17, 19, 290, 291, 293–294, 313

animal studies, 21, 288, 289–291, 330

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
×

antibodies, 288(n.11), 290, 293, 306

chronic effects, 19, 294, 313–314

clinical studies, 19, 291–294, 333

cramps, 288

dermal tissue, 290, 292, 294

dose factors, 288, 289, 293

edema, 292

fatigue, 288(n.10)

FDA, 16, 288, 293

fever, 288(n.10), 294

genetic factors, 290–291

headaches, 294

hematologic effects, 293

historical perspectives, 16, 288, 291, 293

immune system, impacts on, 290–292

inflammation, 290, 293–294

ingestion, 287–288

injection, 16, 288, 293

neuropathy, general, 288(n.10), 289, 290–291

neuromuscular effects, 288, 289

number of vaccinations given, 268

pain, 288, 292, 293, 294

short-term malaise, 288, 294

surveillance, 269

veterans, studies of Gulf War veterans, 285, 293

Brain

Alzheimer’s disease, 213, 227

blood-brain barrier, 11, 177, 207, 219–220

cyclosarin, 186–187

depleted uranium, 103

electroencephalography, 10, 103, 181, 187, 191, 199, 372

pyridostigmine bromide (PB), 11, 207, 217, 219–220, 247

sarin, 10, 175–176, 177, 180, 181, 182, 186–187, 191, 195, 196, 199

see also Neuropsychological effects

Britain, see United Kingdom

Bronchi

pyridostigmine bromide (PB), 11, 12, 208, 214, 215, 225, 230, 237

sarin, 171

Butyrylcholinesterase (BuChE), 21, 53, 177, 178, 186, 214, 218, 220–221, 245, 250, 329

C

Canada

Gulf War veterans, 39, 45, 46, 48–49, 285, 333, 358

uranium mine workers, 109

Cancer, 55, 79

bone, 19, 109, 143, 146, 159

liver, 79

lung, 6–7, 19, 79, 100, 108–109, 110, 113, 117–118, 121, 123, 128–142, 159

lymphatic, 19, 100, 123, 142–143, 144–145, 159

mortality, 117, 128, 114, 117–118, 126–127, 128, 131

multiple vaccinations, 299

registry data, 42

testicular, 60

uranium, 6–7, 19, 100, 114, 117–118, 121, 126–145 (passim), 159

Carbamates, 34, 169, 207, 210, 213, 219

Cardiovascular system

anthrax vaccines, 278, 280

chest pain, 42, 171

cyclosarin, 187

peripheral vascular resistance, 228–229

pyridostigmine bromide (PB), 215–216, 228–229, 230, 235–236, 245, 249

registry data, 42

sarin, 171, 181, 187, 194–195

uranium, 8, 19, 96, 100, 105, 108–109, 126, 158, 160

vaccines, 272

Case-control studies, 43–44, 52–53, 71, 75, 77, 82, 250

organophosphate pesticides, 370

uranium exposure, 108, 121, 127, 138

CDR, see Comprehensive Epidemiology Data Resource (CEDR)

Cellular processes, general

anthrax vaccines, 272, 276, 301, 302

lymphocytes, 158, 272, 301, 302

lymphomas, 142

pyridostigmine bromide (PB), 219–220

see also Cancer;

DNA;

Genetic factors;

DNA;

Immune system;

Receptor-mediated actions;

Red blood cells;

RNA

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
×

Center for Health Promotion and Preventive Medicine (CHPPM), 93–94

Centers for Disease Control and Prevention (CDC)

AIDS, case definition, 345–346

anthrax vaccines, 283, 284

botulinum toxoid vaccines, 288, 293–294

chronic fatigue syndrome, case definition, 354

multiple vaccines, 295, 296, 304, 305–306

vaccine surveillance, 269, 270, 283, 284

Central Intelligence Agency, 172, 173, 196

Central nervous system (CNS)

depleted uranium, 99, 103

myasthenia gravis, 224

pyridostigmine bromide (PB), 12, 213, 217, 219–220, 223, 224, 226, 235, 240, 241, 247, 251

sarin, 170, 171, 176–177, 182, 191, 195, 196, 327

squalene, 308

uranium, 99, 102, 103

see also Brain

Chemical Abstracts Service, 339–340

Chemical agent-resistant coating, 34

Chemical warfare agents, general, 1, 34, 35, 48, 178, 189–190, 325

see also Antidotes;

Cyclosarin;

Nerve agents;

Sarin

Chlorinated hydrocarbons, 34

Cholinergic effects, see Acetylcholine;

Acetylcholinesterase;

Acute cholinergic symptoms/syndrome;

Anticholinesterase;

Butyrylcholinesterase;

Growth-releasing hormone;

Pyridostigmine bromide

Cholinesterase (ChE), see Pyridostigmine bromide;

Sarin

Chronic effects, general, 4, 13, 49, 50, 51, 53, 54, 58(n.21), 59, 61

anthrax vaccines, 19, 287, 312–313

botulinum toxoid vaccines, 19, 294, 313–314

depleted uranium, 102–103

multiple vaccinations, 17, 298–299, 304

pyridostigmine bromide (PB), 13, 14, 214–215, 252–253

sarin, 183, 188, 191–192, 193, 198

squalene, 311

uranium, 100, 102–103

vaccines, 17, 271, 287, 294, 198–199, 303, 304, 311, 312–314, 330

see also Multisymptom illness;

specific anatomical and chronic diseases and symptoms

Chronic fatigue syndrome (CFS), ix, 27, 45, 48–50 (passim), 62, 342, 343, 350, 354, 356–357, 358, 360, 361

see also Fatigue;

Fibromyalgia;

Multisymptom illness

Clinical studies, 54, 76–77, 82

anthrax vaccines, 15–16, 19, 282–283, 284–287, 334

case definitions, 43–44, 54, 343–361

botulinum toxiod vaccinations, 19, 291–294, 333

fibromyalgia, 355

multiple vaccinations, 17, 305–306

pyridostigmine bromide (PB), 12, 19, 209, 222–231, 249, 329

vaccines, 15–17, 19, 270, 271, 282–283, 284–287, 291–294, 305, 306, 310–311, 333

Cognitive dysfunction, 351, 354, 356, 359

attention deficits, 27, 51, 171

depleted uranium, 153

epidemiological studies, 45–49 (passim), 52, 53, 54, 62, 246, 247–248

memory loss, 1, 27, 39, 40–41, 42, 52, 171, 311, 351

multisymptom illness, 17, 51, 54, 154, 303–306, 342–345

pyridostigmine bromide (PB), 53, 224, 227, 233–235, 236, 242–243, 246, 247–248

sarin, 171, 181, 197

Cohort studies, 13, 44–54, 61, 73–75, 82

depleted uranium, 21, 93, 326–327

organophosphate pesticides, 369

phosphate fertilizer processing workers, 112, 114–115, 130, 131, 132, 148, 152, 159

sarin, 190

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
×

uranium miners and processing workers, 112–114, 115–121, 122, 123–149, 151–152, 154–157, 158, 159

vaccinations, 17, 274, 281, 291, 299, 300–303, 306, 314

see also Occupational exposure, nonmilitary;

Veterans, studies of Gulf War Veterans

Colorado Plateau states, uranium millers, 108, 111, 112, 130, 131, 132, 144

Committee on the Biological Effects of Ionizing Radiation, 107, 143

Compensation of veterans, 20, 28

Comprehensive Clinical Evaluation Program, 40

Comprehensive Epidemiology Data Resource (CEDR), 117

Computerized posturography, sarin, 10, 196, 199

Concentration deficits, see Attention deficits

Controlled studies, viii–ix, 7, 32, 39, 48–62, 74, 76–77, 82, 358

anthrax vaccines, 278

birth defects, 56

botulinum toxoid vaccines, 288(n.10), 291–293

case-control studies, 43–44, 52–53, 71, 75, 77, 82, 108, 121, 127, 138, 250, 370

fibromyalgia, 356

organophosphate pesticides, 370–375

pyridostigmine bromide (PB), 13, 227, 231–245 (passim)

sarin, 10, 181, 193, 327

uranium exposure, 7, 108, 121, 127, 138

vaccines, 270, 278, 288(n.10), 291–293, 301, 301–303

see also Clinical studies

Convulsions, sarin, 10, 170, 175, 176, 179, 188, 192, 193

Cost and cost-benefit factors, 2

compensation of veterans, 20, 28

vaccines, 268

Cramps, 51

botulinum toxoid vaccines, 288

pyridostigmine bromide (PB), 11, 12, 214, 223, 226, 251

sarin, 171

uranium exposure, 151

Cross-sectional studies, 45–48, 61, 73, 75–76, 81, 368, 369

multiple vaccinations, 305

pyridostigmine bromide (PB), 247, 248, 250

Cyclosarin, 2, 9, 28, 172, 173–174, 186–187, 198, 340

see also Pyridostigmine bromide;

Sarin

Cytokines, 272, 275

Czechoslovakia, uranium miners, 109

D

Databases, 54–55, 69, 339–341

Death, see Mortality

DEET, see N,N-diethyl-m-toluamide

Demographic factors, 41, 43, 348

see also Age factors;

Gender factors;

Racial and ethnic factors;

Socioeconomic status

Department of Defense (DoD)

anthrax vaccines, 284, 285

depleted uranium studies, 91–92, 326

hospitalization studies, 55–56, 189–190

previous research on Gulf War health effects, 30

pyridostigmine bromide (PB), 208, 209

registry programs, 40–43, 77, 357

sarin, 9, 172, 173, 189, 196

squalene, 307

vaccines, 284, 285, 295, 329–330

Department of Energy (DOE), 116, 117

Department of Health and Human Services

Agency for Toxic Substances and Disease Registry, 94, 99, 106

Anthrax Vaccine Expert Committee, 284

National Institutes of Health, 30, 114–115, 274, 310

see also Centers for Disease Control and Prevention;

Food and Drug Administration

Department of Veterans Affairs, 54

committee study, background, vii, 2, 28, 70

compensation of veterans, 20, 28

depleted uranium, 93

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
×

previous research on Gulf War health effects, 30

registry programs, 40–43, 58, 77, 357, 358

Depleted uranium (DU), vii, viii, 1, 2, 5–8, 28, 34, 83, 90–93, 98–99

ammunition containing, 5, 6, 92–93, 98, 326

animal studies, 99, 100–101, 151, 327

armor, 5, 91–94

chronic effects, general, 102–103

cohort studies, 21, 93, 326–327

developmental and reproductive effects, 8, 19, 104–105, 157

exposure, 6, 31, 92, 93–94, 326

gastrointestinal effects, 8, 19, 104

genetic factors, 8, 19, 158

hematologic effects, 8, 19, 99

historical perspectives, 91–92

ingestion, 6, 93, 96, 98–99

inhalation, 6, 93

injection, 99

musculoskeletal effects, 8, 99

neuropathy, 99, 103, 151, 153

renal effects, 7–8, 99, 150

research recommendations, 21, 326–327

respiratory effects, 98

tantalum (Ta), 98–99, 100, 101, 103

wounds, 93, 102–103

see also Uranium

Depression, 350, 354, 355

epidemiologic studies, 45, 46, 48, 49, 52, 62

organophosphate pesticides, 370

pyridostigmine bromide (PB), 233, 245

see also Chronic fatigue syndrome;

Posttraumatic stress disorder

Dermal exposure

anthrax, 272(n.3), 282, 283

sarin, 8, 169, 176

uranium, 96, 151, 156

see also Injection delivery

Dermal tissue, other, 47, 51

anthrax, 272(n.3), 282, 283

anthrax vaccines, 15, 16, 272(n.3), 279, 281–287 (passim)

botulinum toxoid vaccines, 290, 292, 294

pyridostigmine bromide (PB), 215

registry data, 42

sand, blown, 33

uranium, 19, 105, 158

see also Injection delivery;

Perspiration;

Rashes

Developmental effects

birth defects, 56–57, 61(n.25), 62, 104–105

depleted uranium, 8, 19, 104–105, 157

sarin, 186, 187

uranium, 8, 19, 104–105, 157, 158

Diabetes mellitus, 298–299

Diagnosis, vii, 43–44, 56

case definitions, 43–44, 54, 343–361

chronic fatigue syndrome, 354, 356–357, 358–359

Diagnostic and Statistical Manual of Mental Disorders, 58, 346, 360

electrocardiography (EKG), 158, 235, 244

electroencephalography (EEG), 10, 103, 181, 187, 191, 199, 372

electromyography (EMG), 190, 232, 233, 249

International Classification of Diseases, 56, 346, 360

multisymptom illness, 17, 51, 54, 154, 303–306, 342–365

posttraumatic stress disorder, 57, 58, 342

posturography, 10, 196, 199

pyridostigmine bromide (PB) effects, 12, 223

registry data, 40–43

symptom clustering, 43, 44, 48, 49, 50–51, 349

see also specific symptoms (e.g., Pain)

Diagnostic and Statistical Manual of Mental Disorders, 58, 346, 360

Diarrhea, 60

registry data, 42

pyridostigmine bromide (PB), 11, 208, 214, 226, 230, 251

uranium, 156

Diet, 33, 307–308

Digestive system, see Gastrointestinal effects

Diphtheria-tetanus-pertussis vaccines, 268, 295, 296, 299, 300, 301

DNA

anthrax vaccines, 280

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
×

pyridostigmine bromide (PB), 220

sarin, 183

uranium effects, 157

Dose and dose-response, viii, 78–79, 83, 357

anthrax vaccines, 274–275, 278, 285

botulism toxin, 288, 289, 293

committee study methodology, 4, 18, 78

cyclosarin, 186

depleted uranium, 103

multiple exposures and varying doses, 29, 79

pyridostigmine bromide (PB), 11, 12, 14, 208–209, 210–211, 214, 215, 218, 219, 223–238 (passim), 247–248, 251, 252, 329

sarin, 9, 10, 18, 19, 173, 176, 178–183, 186, 188, 192, 199, 288, 327

squalene, 308, 312

uranium, 7, 90, 91, 103, 108, 115–116, 117–118, 120, 121, 123, 125, 128, 130, 135–140, 141, 142, 159

vaccines, general, 272

see also Exposure;

Multiple vaccinations

DSM-III, see Diagnostic and Statistical Manual of Mental Disorders

DTP, see Diphtheria-tetanus-pertussis vaccines

Drug delivery, see Injection delivery

Dysarthria, pyridostigmine bromide (PB), 12, 223, 251

E

Edema

anthrax vaccines, 15, 275, 276, 277, 278, 283, 284

botulinum toxoid vaccines, 292

sarin, 171

see also Inflammation

Electrocardiography (EKG), 158, 235, 244

Electroencephalography (EEG)

depleted uranium, 103

organophosphate pesticides, 372

sarin, 10, 181, 187, 191, 199

Electromyography (EMG), 190, 232, 233, 249

Emotional effects, see Anxiety;

Depression;

Malaise, short-term, Mental disorders;

Mood disorders;

Neuropsychological effects;

Psychological factors

Employment, see terms beginning “Occupational”

Encephalitis vaccines, 295

Enzyme-linked immunosorbent assay (ELISA), 311

Eosinophils, 158, 342

Epidemiology, general, 32, 40, 43–62, 71, 72–76, 82, 83, 84–85, 357–358

birth defects, 56–57, 61(n.25), 62, 104–105

case definitions, 43–44, 54, 343–361

committee study methodology/agenda, 4–5, 18–19, 333

cognitive dysfunction, 45–49 (passim), 52, 53, 54, 62, 246, 247–248

depression, 45, 46, 48, 49, 52, 62

evidence, assessment criteria, 4–5, 18–19, 78–81, 82;

see also “case definitions” supra

fatigue, 45–49 (passim), 54, 62, 357–358

fibromyalgia, 45, 46, 48, 49, 62, 343, 352, 355–360 (passim)

infectious diseases, general, 59, 72

injuries, 48, 49, 55

general health status, 43–54

hospitalizations, 55–57, 60, 61, 188, 189–190, 193–195, 284, 286, 311, 368

limitations of, 60–62, 73, 74–76, 82, 83, 84–85, 123–128, 130, 140–142, 143, 252

multiple vaccinations, 305

musculoskeletal effects, 40–41, 42, 45, 46, 48, 49

organophosphate pesticides, 53, 366–377

population-based studies, vii, 3–4, 6, 10, 13, 18, 21, 32, 35, 44–51, 191–193;

see also Registry programs

posttraumatic stress disorder (PTSD), 45, 46, 48, 49, 57–59, 62, 246

pyridostigmine bromide (PB), 13–14, 21, 48, 71, 209, 245–250, 252, 329

sarin, 4, 71, 188, 189–192, 193–195

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
×

specific health endpoints, 54–60

stress-related disorders, 46, 49, 51, 57–59, 57–59, 123

symptom clustering, 43, 44, 48, 49, 50–51, 349

multisymptom illness, 17, 51, 54, 154, 303–306, 342–365

uranium-induced lung cancer, 6–7, 19, 100, 114, 117–118, 126–127, 128–130, 132–142

uranium, 106–121;

see also "uranium” under Occupational exposure, non-military

see also Case-control studies;

Cohort studies;

Cross-sectional studies;

Mortality;

Occupational exposure, noncombat military personnel;

Occupational exposure, non-military;

Recordkeeping;

Registry programs;

Statistical techniques

Erythrocytes, see Red blood cells

Estrogen

contraceptive pills, 273

vaccines, response to, 273

Ethnicity, see Racial and ethnic factors

Event-related potential (ERP)

sarin, 10, 195, 196, 199, 327

see also Visual evoked potential

Experimental allergic encephalomyelitis, 309

Exposure, 18–19, 43, 49, 51, 71, 72, 73–77, 81–85, 99, 360

case definition, 348

community study, methodology/agenda, viii, 2–3, 4–5, 18, 29, 35, 335

depleted uranium, 6, 31, 92, 93–94, 326

duration, 29, 31, 71, 72, 76

uranium, 71, 116–117, 121, 126, 130

multiple exposures and chemical interactions, 29, 31, 79, 298–299;

see also Interactions, chemical

multiple chemical sensitivity (MCS), 46, 49, 350, 352, 356–357, 358, 359

organophosphate pesticides, long-term, 366–377

phosphate fertilizer production workers, 112, 114–115, 130, 132, 148, 152, 159

registry programs, 40

routes, 71, 80, 94–96;

see also Dermal exposure;

Ingestion;

Inhalation;

Injection delivery

anthrax, 15, 272(n.3), 275, 276–277, 279–286 (passim), 282, 283, 297

botulinum toxoid vaccines, 268

sarin, 9, 18, 19, 31, 170–173, 178, 182–183, 188

terrorism, viii, 3, 10, 70, 177–178, 188

smoke, 1, 27–28, 33–34, 48

depleted uranium, 6, 93

oil-well fires, 1, 27, 31, 33

uranium,

depleted uranium, 6, 31, 92, 93–94, 326

occupational exposure, 6–7, 19, 31, 108, 111, 113, 114, 115–117, 120, 121, 123–129, 130, 134, 135, 138, 140–141, 142, 149, 159

see also Dose and dose-response;

Dermal exposure;

Epidemiology;

Ingestion;

Inhalation

Eyes, see Visual and ocular effects;

Visual evoked potential

F

Fatigue, 1, 27, 32, 39, 343, 350–360 (passim)

animal studies, 72, 351

botulinum toxoid vaccines, 288(n.10)

epidemiological studies, 45–49 (passim), 54, 62, 357–358

fibromyalgia, 45, 46, 48, 49, 62, 343, 352, 355–360 (passim)

multiple vaccinations, 304, 306, 314

pesticides, organophosphate, 367–375

pyridostigmine bromide (PB), 211, 226, 230, 233, 236, 245, 329

registry data, 40–41, 42

myasthenia gravis, 3, 11, 12, 70, 71, 207, 208, 209, 224–225, 227–228, 230, 231, 250–251

sarin, 171, 189, 193, 194, 195, 198, 199, 327, 328

squalene, 311

see also Chronic fatigue syndrome

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
×

Federal government, 28–29, 39

see also Legislation;

Regulatory factors;

specific departments and agencies

Fernald Feed Materials Production Center, 117–118, 121, 122, 135, 137

Fertilizers, see Phosphate fertilizers

Fever

anthrax vaccines, 16, 277–278, 282, 284, 285, 287

botulinum toxoid vaccines, 288(n.10), 294

yellow fever vaccines, 295, 296, 301

Fibromyalgia, 45, 46, 48, 49, 62, 343, 352, 355–360 (passim)

Fires, see Smoke

Follicle-stimulating hormone (FSH), 157

Food, see Diet

Food and Drug Administration (FDA)

anthrax vaccines, 14, 267, 274, 283–284, 287, 313

Investigational New Drug (IND) status,

anthrax vaccines, 274, 283–284

botulinum toxoid vaccines, 16, 288, 293

pyridostigmine bromide (PB), 208

pyridostigmine bromide (PB), 11, 207, 208

squalene, 307, 309

vaccine surveillance, 269

Formaldehyde, 274, 288, 289–290, 292

Fort Bragg Booster Study, 285, 293

Fort Detrick Studies, 17, 274, 281, 291, 299, 300–303, 306, 314

Freedom of Information Act (FOIA), 283

G

Gamma-aminobutyric acid (GABA), 175

Gamma-glutamyltransferase (GGT), 150

Gas chromatograph-mass spectroscopy (GC-MS), 191, 194

Gastrointestinal effects, 47, 51, 60

anthrax, 272(n.3)

anthrax vaccines, 285

depleted uranium, 8, 19, 104

infections, 59–60

pyridostigmine bromide (PB), 11, 12, 208. 209, 214, 223, 225–226, 230, 236, 242, 251

registry data, 42

sarin, 171, 180

uranium, 8, 19, 104, 156, 158, 160

see also Diarrhea;

Ingestion;

Nausea and vomiting;

Salivation

Gender factors, 41, 43, 74

anthrax vaccines, 286

organophosphate pesticides, 371–375

phosphate fertilizer production workers, 115

pyridostigmine bromide, 226, 231, 239, 244

sarin, 196, 197

testicular cancer, 60

uranium processing workers/miners, 117, 118, 119, 121, 149, 157

women, symptoms specific to, 51–52

see also Sexual functioning

General Accounting Office (GAO)

anthrax vaccines, 283

squalene, 307

Genetic factors, 71–72

anthrax vaccines, 280

botulinum toxoid vaccines, 290–291

depleted uranium, 8, 19, 158

individual variability, 31, 197–198, 220–222, 244–245, 272, 334

multiple vaccines, 298

organophosphates, 31, 53

pyridostigmine bromide, 21, 220–222, 244–245, 328, 329

research recommendations, 21, 328, 329

sarin, 21, 53, 183, 187, 197–198, 328

uranium, 8, 19, 100–101, 157, 158

vaccines, 272, 273, 280, 290–291

see also DNA;

RNA

Genitourinary system and urinalysis, 47, 54

depleted uranium, 158

pyridostigmine bromide (PB), 12, 208, 225–226

registry data, 42

sarin, 171, 177–178

uranium, 97, 100–101, 119, 123, 124, 150

see also Renal effects;

Sexual functioning

Germany, sarin development, 8

GGT, see Gamma-glutamyltransferase

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
×

GH-releasing hormone (GHRH), 222–223, 224

Growth hormone, pyridostigmine bromide (PB), 12, 209, 220, 222–224, 251, 334

Guillain-Barré syndrome, 284

Gulf War, background and setting, 1, 9, 27, 32, 172–174, 209

see also Veterans, studies of Gulf War veterans

H

Haemophilus influenzae type B (HIB), 296

Headaches, 1, 39, 350, 351, 354

anthrax vaccines, 281, 284, 285

botulinum toxoid vaccines, 294

pyridostigmine bromide (PB), 236

registry data, 40–41, 42

sarin, 10, 171, 193, 194, 198

Heat, 33, 235, 243

see also Thermoregulation

Hematologic effects, 54

botulinum toxoid vaccines, 293

depleted uranium, 8, 19, 99

lymphocytes, 158, 272, 301, 302

multiple vaccines, 301–302

pyridostigmine bromide (PB), 11, 208, 244

rheumatoid factor, 299–300, 302

sarin, 177, 178, 188, 192, 194–195

squalene, 311

uranium, 8, 19, 96, 97, 99, 105–106, 109, 157–158

see also Cardiovascular system;

Red blood cells

Hepatic effects, 79

pyridostigmine bromide (PB), 210

sarin, 177

squalene, 308

uranium, 19, 97, 100, 104, 108–109, 158

Hepatitis vaccines, 295, 296

Herpes simplex virus, 310

HIAA, see 5-hydroxyindoleacetic acid

HIB, see Haemophilus influenzae type B

Histocompatibility, 273

Historical perspectives, 28–29, 30, 339, 343

AIDS, 345–346

anthrax vaccines, 272, 274, 281, 283–284, 287

Bosnian conflict, 39, 50–51, 250, 303, 304, 358

botulinum toxoid vaccines, 16, 288, 291, 293

chemical warfare agents, testing of military volunteers, 189

depleted uranium, 91–92

fatigue syndrome, 354

Kurdish/Iraqi conflict, 34

Operation Desert Storm, significant dates, 1, 9, 27, 32, 172–174, 209

organophosphates, general, 182

pyridostigmine bromide (PB), 207, 225

sarin, 8, 191

Japan, terrorist attack, 3, 10, 177–178, 188, 191–196, 199

squalene, 307

vaccines, general, 267, 268, 294, 295, 300–303;

see also specific vaccines supra

HIV, see AIDS

Hoffman-La Roche, 207

Hormones, 230, 244, 244

contraceptives, 230

follicle-stimulating hormone, 157

GH-releasing hormone (GHRH), 222–223, 224

growth hormone, 12, 209, 220, 222–224, 251, 334

hypothalamic-pituitary-adrenal processes, 354, 360

pyridostigmine bromide (PB), 209, 220, 223, 250–251

luteinizing hormone (LH), 157

pineal gland, 220

vaccines, response to, 273

Hospitalization, 39, 55–57, 60, 61

anthrax vaccines, 284, 286

influenza vaccines, 311

organophosphate insecticides, 368

sarin, 188, 189–190, 193–195

HPA, see Hypothalamic-pituitary-adrenal

Human leukocyte antigen (HLA), 273

Humoral immune response, 276–277

HSV, see Herpes simplex virus

5-hydroxyindoleacetic acid, 176

5-hydroxytryptamine, see Serotonin

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
×

Hypersensitivity, immune response, 31, 49, 82, 218, 236, 271, 272, 278, 284, 288, 290, 297, 298–299

Hypothalamic-pituitary-adrenal processes, 354, 360

pyridostigmine bromide (PB), 209, 220, 223, 250–251

I

IC, see Immunoconglutinin

ICRP, see International Commission on Radiological Protection

Iminodipropionitrile (IDNP), 213

Immune system, 351, 360

allergies, 51, 284, 309

anthrax vaccine, impacts on, 279, 284, 285, 290–292, 306

botulinum toxoid vaccines, pathological response to, 290–292

histocompatibility, 273

humoral immune response, 276–277

hypersensitivity, 31, 49, 82, 218, 236, 271, 272, 278, 284, 288, 290, 297, 298–299

macrophages, respiratory, 154, 272, 275

multiple vaccines, 17, 296, 297–298

myasthenia gravis, 3, 11, 12, 70, 71, 207, 208, 209, 224–225, 227–228, 230, 231, 250–251

squalene, 309, 311, 312

uranium, 8, 154, 156–157, 158

vaccines, response to, 17, 271–272, 273, 278, 284, 288, 290, 296, 297, 298–299

see also Antibodies;

Antigens;

Inflammation

Immunizations, see Vaccines

Immunoconglutinin (IC), 299–300

Immunoglobulin, 311

Infectious diseases, 342

AIDS, 310, 342, 345

epidemiologic studies, 59, 72

gastrointestinal, 59–60

meningitis, 284, 295, 296

registry data, 42

see also Anthrax vaccines;

Biological warfare agents, general;

Botulinum toxoid vaccines;

Measles-mumps-rubella;

Vaccines

Inflammation, 272, 355, 356

anthrax vaccines, 278, 281, 284, 286, 287, 297

botulinum toxoid vaccines, 290, 293–294

multiple vaccinations, 17, 297, 306

squalene, 309

see also Edema

Influenza vaccines, 295, 310–311

Ingestion

anthrax, 272(n.3)

botulism, 287–288

contraceptive pills, 230

depleted uranium, 6, 93, 96, 98–99

polio vaccines, oral, 268, 296

pyridostigmine bromide (PB), 11, 12, 207–209, 210–211, 214, 223, 225, 234, 236, 237, 238, 240, 251

sarin, 176

squalene, 307–308, 311

uranium, 6, 93, 96, 98–99, 100, 105, 123, 147, 149–150, 151

see also Gastrointestinal effects

Inhalation

anthrax, 272(n.3), 276–277, 282, 283

depleted uranium, 6, 93

sarin, 169, 174, 176, 189

Japan, terrorist attack, 3, 10, 177–178, 188, 191–196, 199

uranium, 93, 94–96, 97, 97–98, 99, 100, 105, 106, 115, 118–120, 121, 123, 142–143, 154, 156, 158

see also Lung cancer;

Lungs;

Respiratory system;

Smoke;

Smoking, tobacco

Injection delivery

anthrax vaccines, 15, 279–286 (passim), 297

botulinum toxoid vaccines, 16, 288, 293

depleted uranium, 99

multiple vaccines, 295–296, 297

pyridostigmine bromide (PB), 11, 207, 231, 236–237

sarin, 176, 186, 189

squalene, 309, 312

uranium, 99, 144

Injuries

epidemiological data, 48, 49, 55

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
×

registry data, 42

uranium exposure, accidental deaths, 109

wounds, depleted uranium, 93, 102–103

Insecticides and insect repellants, 1, 21, 34, 48, 53, 247, 340, 366–377

fatigue, 367–375

gender factors, 371–375

genetic factors, 53

N,N-diethyl-m-toluamide (DEET), 217, 218, 248

sarin and, 8, 10, 188, 328

vaccines and, 305

see also Organophosphates

Interactions, chemical, 29, 46, 71–72, 78, 334

multiple chemical sensitivity (MCS), 46, 49, 350, 352, 356–357, 358, 359

phosphate fertilizer production workers, 130

pyridostigmine bromide (PB), 187, 209, 217–220, 229–230, 235, 248, 328, 328, 330, 334

research recommendations, 21, 325, 328

sarin, 175–178 (passim), 181, 187, 328

insecticides and, 8, 10, 188, 328

uranium, 154, 159

vaccines, 272, 296, 330

insecticides and, 305

multiple vaccinations, 14, 17–18, 19, 21, 51, 270, 285, 295–306, 314

Internal Revenue Service, 114–115, 116

International Atomic Energy Agency, 268

International Classification of Diseases (ICD), 56, 346, 360

International Commission on Radiological Protection, 89

Intravenous injections, see Injection delivery

Investigational New Drug (IND) status

anthrax vaccines, 274, 283–284

botulinum toxoid vaccines, 16, 288, 293

pyridostigmine bromide (PB), 208

In vitro studies, 72, 158

anthrax vaccines, 275

Iowa Persian Gulf study, 45, 46, 48, 49, 52, 57, 60, 62, 333, 358

Iran–Iraq conflict, sarin, 8

Isopropyl methylphosphonoflouridate, see Sarin

J

Japan, sarin terrorist attacks, 3, 10, 177–178, 188, 191–196, 199, 327

K

Kidneys, see Renal effects

L

Lactate dehydrogenase (LDH), 101, 150, 187, 214–215

Leishmaniasis, 59

Legislation

Freedom of Information Act, 283

Persian Gulf War Veterans Act, 2, 28

Public Law 103-446, 61

Veterans Programs Enhancement Act, 2, 28

see also Regulatory factors

LH, see Luteinizing hormone

Linde Air Products Company, 116–117, 134

Live attenuated spore vaccines, 274, 276, 277–279, 281, 297

Liver, see Hepatic effects

Longitudinal studies, see Cohort studies;

Epidemiology

Lung cancer, 79

uranium, 6–7, 19, 100, 108–109, 110, 113, 117–118, 121, 123, 128–142, 159

Lungs, 142

pyridostigmine bromide (PB), 231, 237

sarin, 171, 174

uranium, 96, 97–98, 99, 100, 108–109, 114, 117, 121, 123, 154–156

see also Inhalation

Lupus, see Systemic lupus erythematosus

Luteinizing hormone (LH), 157

Lymphatic system

anthrax vaccines, 278

cancer, 19, 100, 123, 142–143, 144–145, 159

uranium, 6, 95, 100, 106, 109, 123, 135, 142–143

Lymphocytes, 158, 272, 301, 302

anthrax vaccines, 278

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
×

M

Macrophages, respiratory, 154, 272, 275

Malaise, short-term, 354

anthrax vaccines, 15, 281, 283, 284, 285

botulinum toxoid vaccines, 288, 294

Malaria, 230

Mallinckrodt Chemical Works, 118–119. 121, 122

Mass spectroscopy, 119

Gas chromatograph-mass spectroscopy (GC-MS), 191, 194

Matsumoto, Japan, see Sarin

MCS, see Multiple chemical sensitivity

Measles-mumps-rubella vaccines, 268, 295, 296, 300

Memory loss, 1, 27, 39, 52, 351

registry data, 40–41, 42

sarin, 171

Men, see Gender factors

Meningitis, 284, 295, 296

Mental disorders, 46, 47, 48, 50

alcohol abuse, 45, 49

anthrax vaccines, bipolar disorder, 284

definition of, 345, 347

mood disorders, general, 50, 54, 195;

see also Multisymptom illness

organophosphates, 367

pyridostigmine bromide (PB), 246

registry data, 41–42

sarin, 195, 197, 199

uranium, 109, 151

see also Attention deficits;

Depression;

Memory loss;

Posttraumatic stress disorder

Mestinon bromide, see Pyridostigmine bromide

Methodology, see Research methodology

Methylphosphonic acid, 177–178

Minority groups, see Racial and ethnic factors

Miosis

pyridostigmine bromide (PB), 11, 12, 208, 240, 241, 248, 249

sarin, 171, 174, 188

MMR, see Measles-mumps-rubella

Monitoring System for Adverse Events Following Immunization, 296

Mood disorders, 50, 54, 195

see also Depression;

Multisymptom illness

Mortality, 39, 40, 54–55, 74, 82

anthrax vaccines, 277, 278

anticholinesterases, 190

cancer, 6–7, 108–109, 117, 128, 114, 117–118, 126–130, 128, 131–142

influenza vaccines, 311

multiple vaccines, 302–303

phosphate fertilizer production workers, 112, 114–115, 130, 132, 148, 152, 159

sarin, 179, 188, 190

uranium workers, 112–118, 119–120, 125–127, 129, 151

bone cancer, 143

cancer, general, 117, 128, 114, 117–118, 126–127, 128, 131

cardiovascular factors, 158

lung cancer, 6–7, 108–109, 113, 117–118, 128–130, 132–142

lymphatic cancer, 142–143, 144–145

neuropathy, 151–152

respiratory disease, nonmalignant, 159

Motor functions, see Convulsions;

Psychomotor effects

MPA, see Methylphosphonic acid

Multiple chemical sensitivity (MCS), 46, 49, 350, 352, 356–357, 358, 359

see also Interactions, chemical

Multiple vaccinations, 14, 17–18, 19, 21, 51, 270, 285, 295–306, 314

acute effects, 17, 297, 306

age factors, 305

animal studies, 297–299

anthrax vaccine as part of, 301, 304

cancer and, 299

Centers for Disease Control and Prevention (CDC), 295, 296, 304, 305–306

chronic effects, general, 17, 298–299, 304

clinical studies, 17, 305–306

diphtheria-tetanus-pertussis vaccines, 268, 295, 296, 299, 300, 301

fatigue, 304, 306, 314

genetic factors, 298

hematologic effects, 301–302

historical perspectives, 295, 300–303

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
×

immune system response, 17, 296, 297–298

inflammation, 17, 297, 306

injection, 295–296, 297

measles-mumps-rubella vaccines, 268, 295, 296

mortality, 302–303

posttraumatic stress disorder, 304, 305

prescribed for military personnel, list, 295

psychological factors, 304

socioeconomic status, 305

veterans, studies of Gulf War veterans, 299–300

Multisymptom illness, 17, 51, 54, 154, 303–306, 342–365

symptom clustering, 43, 44, 48, 49, 50–51, 349

veterans, studies of Gulf War veterans, 17, 51, 54, 154, 303–304

see also Posttraumatic stress disorder

Multivariate analysis, 7, 108, 114

sarin-induced effects, 191

uranium-induced effects, 7, 126, 138, 140–141

Mumps, see Measles-mumps-rubella

Munitions, see Ammunition

Musculoskeletal effects, 47

anthrax vaccines, 281, 284, 285, 286

arthritis, 299–300, 302, 309

bone cancer, 19, 109, 143, 146, 159

botulinum toxoid vaccines, 288, 289

depleted uranium, 8, 99

electromyography (EMG), 190, 232, 233, 249

epidemiological studies, general, 40–41, 42, 45, 46, 48, 49

fibromyalgia, 45, 46, 48, 49, 62, 343, 352, 355–360 (passim)

multisymptom illness, 17, 51, 54, 154, 303–306, 342–365

myasthenia gravis, 3, 11, 12, 70, 71, 207, 208, 209, 224–225, 227–228, 230, 231, 250–251

pain, 27, 39, 40, 42, 45, 46, 48, 49, 72, 193. 194, 198, 281, 284, 285, 286, 288, 293–294, 350, 351, 354, 355

pyridostigmine bromide (PB), 11, 12, 211–213, 220–221, 223, 226, 230, 232–233, 246, 248, 251

registry data, 40–41, 42

sarin, 9, 10, 171, 173, 179–180, 187, 190, 193, 194, 197, 327

uranium, 72, 105, 123, 158, 160

see also Chronic fatigue syndrome;

Cramps;

Fatigue;

Psychomotor effects

Myasthenia gravis, 3, 11, 12, 70, 71, 207, 208, 209, 224–225, 227–228, 230, 231, 250–251

N

National Center for Toxicological Research, 183

National Death Index, 117

National Institute of Allergy and Infectious Diseases, 310

National Institute for Occupational Safety and Health, 114–115

National Institutes of Health, 30, 274

National Library of Medicine, 341

National Occupational Safety and Health Administration, 114–115

National Technical Information Service, 341

National Vaccine Injury Compensation Program, 269

Nausea and vomiting

anthrax vaccines, 284, 285

pyridostigmine bromide (PB), 11, 12, 208, 214, 226, 245, 251

sarin, 171

Nerve agents, 1, 28

see also Antidotes;

Central nervous system;

Cyclosarin;

Pyridostigmine bromide;

Sarin

Neostigmine, 210, 228, 242

Neuromuscular effects, 52

anthrax vaccines, 281, 284, 285, 286

botulinum toxoid vaccines, 289, 290

depleted uranium, 8, 99

electromyography (EMG), 190, 232, 233, 249

epidemiological studies, general, 40–41, 42, 45, 46, 48, 49

fibromyalgia, 45, 46, 48, 49, 62, 343, 352, 355–360 (passim)

Guillain-Barré syndrome, 284

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
×

multisymptom illness, 17, 51, 54, 154, 303–306, 342–365

myasthenia gravis, 3, 11, 12, 70, 71, 207, 208, 209, 224–225, 227–228, 230, 231, 250–251

pain, muscle and joint, 27, 39, 40, 42, 45, 46, 48, 49, 72, 193. 194, 198, 281, 284, 285, 286, 288, 293–294, 350, 351, 354, 355

pyridostigmine bromide (PB), 11, 12, 211–213, 220–221, 223, 226, 230, 232–233, 246, 248, 251

registry data, 40–41, 42

sarin, 9, 10, 171, 173, 179–180, 187, 190, 193, 194, 197, 327

uranium, 72, 105, 123, 158, 160

see also Chronic fatigue syndrome;

Fatigue;

Psychomotor effects

Neuropathy, general, 46, 47, 52

Alzheimer’s disease, 213, 227

anthrax vaccine, 285

botulinum toxoid vaccines, 288(n.10), 289, 290–291

cyclosarin, 186–187

depleted uranium, 99, 103, 151, 153

genetic factors, 53

pyridostigmine bromide, 21, 220–222, 244–245, 328, 329

sarin, 21, 53, 183, 187, 197–198, 328

insecticides, 53

myasthenia gravis, 3, 11, 12, 70, 71, 207, 208, 209, 224–225, 227–228, 230, 231, 250–251

organophosphate-induced delayed neuropathy (OPIDN), 181–182, 183, 192, 197, 213, 217, 218, 248, 249, 252, 328

organophosphates, general, 367–368, 371–375

pyridostigmine bromide (PB), 11, 12, 13, 53, 219–220, 247–249, 252, 328

registry data, 42

sarin, 9–10, 175–176, 180–185, 186–187, 190, 192, 193, 194, 197, 327–328

convulsions, 10, 170, 175, 176, 179, 188, 192, 193

squalene, 308, 309

uranium, 19, 99, 102–103, 123, 151–153

vestibular nerve, 52, 197, 327

see also Acetylcholine;

Acetylcholinesterase;

Acute

cholinergic symptoms/syndrome;

Anticholinesterase;

Brain;

Butyrylcholinesterase;

Central nervous system;

Chronic

fatigue syndrome;

Convulsions;

Cyclosarin;

Nerve agents;

Neuromuscular effects;

Pain;

Peripheral nervous system;

Psychomotor effects

Neuropathy target esterase (NTE), 181, 182, 183, 187

Neuropsychological effects, 47, 51, 351

anxiety, 49, 57, 171, 196, 226, 350, 354

attention deficits, 27, 51, 171

malaise,

anthrax vaccines, 15, 281, 283, 284, 285

botulinum toxoid vaccines, 288, 294

organophosphates, general, 367–375

pyridostigmine bromide (PB), 13, 213–214, 227, 233–235, 236, 242–244, 252

sarin, 171, 175, 180, 188, 195, 195, 197, 328

uranium exposure, 151

see also Cognitive dysfunction;

Mental disorders;

Psychological effects

Nicotinic effects

pyridostigmine bromide (PB), 11, 208, 211, 223, 226, 230, 237, 240, 251

sarin, 170, 171, 175

N,N-diethyl-m-toluamide (DEET), 217, 218, 248, 334

Nuclear Regulatory Commission, 90, 92

Nutrition, see Diet

O

Oak Ridge, Tennessee, uranium processing workers, 7, 118–121, 122, 131–148 (passim), 152, 159

Occupational exposure, noncombat military personnel, 1, 27, 34

anthrax vaccines, 284–285

botulinum toxoid vaccines, 291–292

Occupational exposure, non-military, 74–75, 80

anthrax vaccines, 272, 282

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
×

botulinum toxoid vaccines, 16, 288

multiple vaccinations, 17

organophosphates, 188, 191, 199

phosphate fertilizer production workers, 112, 114–115, 130, 132, 152

sarin, 188, 191

uranium miners/processors, viii, 3, 6–7, 19, 21, 71, 89, 98, 106, 107–121, 122, 123–152, 154–159, 340–341

age factors, 116–117, 119, 121, 128, 134–135, 138, 149

bone cancer, 19, 109, 143, 146, 159

cardiovascular effects, 108–109, 126, 158, 160

cancer, general, 6–7, 19, 114, 117–118, 126–127, 128, 131, 135

dermal effects, 158, 160

gastrointestinal effects, 156, 158, 160

gender factors, 117, 118, 119, 121, 149, 157

genitourinary effects, 119, 123, 124, 150

genotoxicity, 158, 160

hematological effects, 109, 157–158, 160

hepatic effects, 19, 108–109, 158

immunologic effects, 154, 156–157, 158, 160

lung cancer, 6–7, 19, 79, 100, 108–109, 110, 113, 117–118, 121, 123, 128–142, 159

lymphatic cancer, 19, 100, 123, 142–143, 144–145, 159

mortality, see “uranium workers” under Mortality

musculoskeletal effects, 123, 158, 160

neuropathy, 151–152, 160

ocular effects, 158, 160

race/ethnicity, 112, 113, 116, 119, 121

renal disease, 19, 115, 123, 147–151, 159

reproductive/developmental effects, 157, 158, 160

respiratory effects, 19, 108–109, 153–156, 159, 160;

see also “lung cancer” supra

socioeconomic status, 7, 117, 121, 138, 141

vaccines, 15, 16, 272, 282, 288, 294–295

Ocular effects, see Visual and ocular effects;

Visual evoked potential

Office of Technology Assessment, 30

Office of the Special Assistant for Gulf War Illnesses, 268

Oil well fires, 1, 27, 31, 33

OP-AChE bond, 9, 174–175, 177, 178, 180, 186, 210, 366

Oral delivery, see Ingestion

Ordnance, see Ammunition

Organophosphate-induced delayed neuropathy (OPIDN), 181–182, 183, 192, 196, 197, 212–213, 217, 218–219, 248, 249, 252, 328

Organophosphates, general, 1, 13, 28, 34, 53, 175, 182–183, 188, 213, 328, 330, 340, 369

acute effects of toxicity, 13, 213

age factors, 371–375

animal studies, 10

depression, 370

epidemiologic studies, 53, 366–377

fatigue, 367–375

genetic factors, 31, 53

neuropathy, 367–368, 371–375

organophosphate-induced delayed neuropathy (OPIDN), 181–182, 183, 192, 197, 213, 217, 218, 248, 249, 252, 328

occupational exposure, non-military, 188, 191, 199

organophosphate binding (OP-AChE), 9, 174–175, 177, 178, 180, 186, 208, 210, 366

psychological effects, 367–375

sexual function, 370

smoking and, 371

see also Cyclosarin;

Pyridostigmine bromide;

Sarin

P

Pain, 48, 49

animal studies, 72

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
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anthrax vaccines, 281–282, 284, 285, 286

botulinum toxoid vaccines, 288, 292, 293, 294

chest, 42, 171

muscle and joint, 27, 39, 40, 42, 45, 46, 48, 49, 72, 193. 194, 198, 281, 284, 285, 286, 288, 293–294, 350, 351, 354, 355

pyridostigmine bromide (PB), 11, 12, 236

registry data, 40, 41, 42

sarin, 10, 171, 171, 193, 194, 198

uranium, 151, 156

see also Cramps;

Headaches;

Nausea and vomiting

Paints, 1, 27, 34

Paraoxonase/arylesterase 1 (PON1), 221–222, 250, 328, 329

PB, see Pyridostigmine bromide

PB-AChE bond, 9, 11, 13, 53, 208, 210–213 (passim), 215, 217, 220, 223, 235, 241, 244–245

Peer review

anthrax vaccines, 15, 280, 286, 287, 312, 313

botulinum toxoid vaccines, 291

committee study methodology, 3, 18, 35, 61(n.26), 70

sarin, 173

uranium, 94

PEP, see Primate equilibrium platform

Peripheral nervous system, 50

pyridostigmine bromide (PB), 213, 247

sarin, 170

squalene, 308

uranium, 151

Peripheral vascular resistance, 228–229

Persian Gulf Registry and Uniform Protocol, 40

Persian Gulf War Veterans Act, 2, 28

Perspiration

pyridostigmine bromide (PB), 11, 12, 225

sarin, 171

see also Thermoregulation

Pesticides, see Insecticides and insect repellants

Petroleum and petrochemical products, 1, 14, 27–28, 30, 34, 48

oil well fires, 1, 27

Pharmacodynamics, pyridostigmine bromide (PB), 217–219, 230, 244

Pharmacokinetics

pyridostigmine bromide (PB), 244

uranium, 94–99

Phosphate fertilizers, worker exposure, 112, 114–115, 130, 131, 132, 148, 152, 159

Pituitary gland, see Hypothalamic-pituitary-adrenal processes

Plague vaccines, 295

Polio virus, 226

vaccines, 268, 296

POM, see Pro-opiomelanocortin

PON1, see Paraoxonase/arylesterase 1

Population-based studies, vii, 3–4, 6, 10, 13, 18, 21, 32, 35, 44–62, 70

see also Occupational exposures, military personnel;

Occupational exposures, nonmilitary;

Registry programs

Portsmouth Uranium Enrichment Facility, 115–116, 131, 132, 134, 145, 148, 152, 159

Posttraumatic stress disorder (PTSD), 342

diagnosis, 57, 58, 342

epidemiologic studies, 45, 46, 48, 49, 57–59, 62, 246

multiple vaccinations, 304, 305

pyridostigmine bromide (PB), 246

sarin, 10, 195–196, 198

Posturography, see Computerized posturography

Presidential Advisory Committee, 172

Primate equilibrium platform, sarin, 180

Prolactin (PL), 156, 157

Pro-opiomelanocortin (POM), 213

Protective antigen vaccines, 274, 276–277, 279–280, 281, 282

Psychological factors, 46

anxiety, 49, 57, 171, 196, 226, 350, 354

malaise,

anthrax vaccines, 15, 281, 283, 284, 285

botulinum toxoid vaccines, 288, 294

individual variability, 31

multiple vaccinations, 304

sarin, other, 171, 175, 180, 188, 197, 328

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
×

see also Mental disorders;

Neuropsychological effects;

Posttraumatic stress disorder;

Stress, general

Psychomotor effects

depleted uranium, 103

dysarthria, 12, 223, 251

pyridostigmine (PB), 11, 12, 227, 223, 233, 240, 241, 242, 251

sarin, 10, 171, 175, 180, 196, 199

see also Convulsions;

Musculoskeletal effects

Public Law 103–446, 61

Pyrethroids, 34

Pyridostigmine bromide (PB), vii, viii, 1, 2, 3, 4, 8–9, 11–14, 19, 28, 34, 207–264, 330, 340

acetylcholine (ACh), 11, 12, 13, 207–216 (passim), 224, 227–228

Acetylcholinesterase (AChE), PB binding, 9, 11, 13, 53, 208, 210–213 (passim), 215, 217, 220, 223, 227–228, 232, 235, 241, 244–245

acute effects, 214, 224, 234, 250–251

age factors, 227, 228, 236, 238, 242, 244, 246–247

animal studies, 209, 210–211, 213, 214, 215, 218–219, 220

brain, 11, 207, 217, 219–220, 247

central nervous system, general, 12, 213, 217, 219–220, 223, 224, 226, 235, 240, 241, 247, 251

chronic effects, general, 13, 14, 214–215, 252–253

clinical studies, 12, 19, 209, 222–231, 249, 329

cognitive effects, general, 53, 224, 227, 233–235, 236, 242–243, 246, 247–248

cramps, 11, 12, 214, 223, 226, 251

dermal tissue, 215

depression, 233, 245

diagnosis of effects, 12, 223

dose factors, 11, 12, 14, 208–209, 210–211, 214, 215, 218, 219, 223–238 (passim), 247–248, 251, 252, 329

dysarthria, 12, 223, 251

epidemiological studies, 13–14, 21, 48, 71, 209, 245–250, 252, 329

fatigue, 211, 226, 230, 233, 236, 245, 329

FDA status, 11, 207, 208

gastrointestinal effects, 11, 12, 208. 209, 214, 223, 225–226, 230, 236, 242, 251

nausea and vomiting, 11, 12, 208, 214, 226, 245, 251

salivation, 11, 12, 208, 214, 225, 226, 242, 251

gender factors, 226, 231, 239, 244

genetic factors, 21, 220–222, 244–245, 328, 329

genitourinary system and urinalysis, 12, 208, 225–226

growth hormone, 12, 209, 220, 222–224, 251, 334

headaches, 236

hematologic effects, 11, 208, 210, 211–212, 244–245, 244

hepatic effects, 210

historical perspectives, 207, 225

hypothalamic-pituitary-adrenal processes, 209, 220, 223, 250–251

ingestion, 11, 12, 207–209, 210–211, 214, 223, 225, 234, 236, 237, 238, 240, 251

injection, 11, 207, 231, 236–237

interactions, chemical, 187, 209, 217–220, 229–230, 235, 248, 328, 328, 330, 334

lungs, 231, 237

mood disorders, 246

myasthenia gravis, 3, 11, 12, 70, 71, 207, 208, 209, 224–225, 227–228, 230, 231, 250–251

nausea and vomiting, 11, 12, 208, 214, 226, 245, 251

neuromuscular effects, 11, 12, 211–213, 220–221, 223, 226, 230, 232–233, 246, 248, 251

neuropathy, general, 11, 12, 13, 53, 219–220, 247–249, 252, 328

nicotinic effects, 11, 208, 211, 223, 226, 230, 237, 240, 251

pain, 11, 12, 236

peripheral nervous system, 213, 247

perspiration, 11, 12, 225

pharmacodynamics, 217–219, 230, 244

posttraumatic stress disorder, 246

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
×

psychological effects, 13, 213–214, 227, 233–235, 236, 242–244, 252

psychomotor effects, 11, 12, 227, 223, 233, 240, 241, 242, 251

rashes, 215, 225

red blood cells, 210, 211–212, 244–245

renal effects, 11, 208, 210

reproductive effects, 215, 226

research methodology, issues, 6–7, 11, 13, 19, 100, 108–109, 110, 113, 117–118, 121, 123, 128–142, 159, 231, 237

research recommendations, 21, 328–329

respiratory effects, 11, 12, 208, 214, 215, 221, 225, 230–231, 235, 236–237

salivation, 11, 12, 208, 214, 225, 226, 242, 251

sleep disturbance, 226

stress, general, 226, 243–244, 328

thermoregulation, 216–217, 237–240

perspiration, 11, 12, 225

veterans, studies of Gulf War veterans, 209, 225–226, 245, 246–250, 252

visual and ocular effects, 11, 12, 208, 225, 233, 240–242, 248, 249

R

Rabies vaccines, 295

Racial and ethnic factors, 41, 43, 60, 74

phosphate fertilizer production workers, 115

uranium workers, 112, 113, 116, 119, 121

Radiation effects, 48, 49

see also Depleted uranium;

Uranium

Rank of personnel, 41, 305

Rashes, 1, 27, 51, 52, 351

anthrax vaccines, 284, 285

pyridostigmine bromide (PB), 215, 225

registry data, 39, 40, 42

Receptor-mediated actions

anthrax vaccines, 275

botulinum toxoid vaccines, 289

organophosphate binding (OP-AChE), 9, 174–175, 177, 178, 180, 186, 210, 366

pyridostigmine bromide binding (PB-AChE), 9, 11, 13, 53, 208, 210–213 (passim), 215, 217, 220, 223, 235, 241, 244–245

sarin, 9, 169–170, 175, 176

uranium, 96

see also Nicotinic effects;

terms listed under Cholinergic effects

Recordkeeping, viii–ix, 55(n.17), 61–62

anthrax vaccines, 284

botulinum toxoid vaccines, 268

phosphate fertilizer production workers, exposure, 130

uranium workers, exposure, 124

vaccines, 21, 268, 269, 270, 284, 330

Red blood cells (RBCs)

pyridostigmine bromide (PB), 210, 211–212, 244–245

sarin, 177, 178, 190, 191

uranium, 96

Registry programs, 39, 40–43, 58, 77, 357, 358, 368

uranium, 94, 99, 106, 114, 149

Regulatory factors

uranium, 90, 92

vaccines, 294

see also Food and Drug Administration;

Legislation

Renal effects

depleted uranium, 7–8, 99, 150

pyridostigmine bromide (PB), 11, 208, 210

sarin, 177

uranium, 7–8, 19, 72, 97, 99, 100, 101–102, 115, 123, 147–151, 159

see also Genitourinary system and urinalysis

Reproductive system, 52, 56–57, 61(n.25)

anthrax vaccines, 226

birth defects, 56–57, 61(n.25), 62, 104–105

depleted uranium, 8, 19, 104–105, 157

pyridostigmine bromide (PB), 215, 226

sarin, 186, 187, 197

sexual functioning, 48, 49, 197, 370

uranium, 104–105, 157, 158, 160

Research methodology, viii–ix, 69–85, 334, 335, 342–365

clinical case definitions, 43–44, 54, 343–361

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
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committee study, viii, 2–5, 18, 28, 32, 34–35, 40, 69–71, 78, 325, 339–341

disease classification, 342–365

dose factors, 4, 18, 78

evidence, assessment criteria, 4–5, 18–19, 78–81, 82–84

exposure, 69–70, 123–125

posttraumatic stress disorder, 58

pyridostigmine bromide (PB), 6–7, 11, 13, 19, 100, 108–109, 110, 113, 117–118, 121, 123, 128–142, 159, 231, 237

sarin, 173

uranium effects, 123–128, 153, 159

vaccine studies, 269–271

see also Animal studies;

Clinical studies;

Cohort studies;

Epidemiology;

Peer review;

Recordkeeping;

Statistical techniques

Research recommendations, 20, 325–330

anthrax vaccines, 21, 330

botulinum toxoid vaccines, 21, 330

depleted uranium, 21, 326–327

genetic factors, 21, 328, 329

interactions, chemical, 21, 325, 328

pyridostigmine bromide, 21, 328–329

sarin, 21, 327–328

vaccines, 21, 329–330

Respiratory effects, 46, 49, 52, 351, 356

anthrax, 272(n.3), 276–277

anthrax vaccine, 282, 283

asthma, 45, 49, 215, 231, 236, 237

botulinum toxoid vaccines, 289

bronchi, 11, 12, 171, 208, 214, 215, 225, 230, 237

depleted uranium, 98

infections, 59

macrophages, respiratory, 154, 272, 275

pyridostigmine bromide (PB), 11, 12, 208, 214, 215, 221, 225, 230–231, 235, 236–237

sarin, 171, 173, 174, 179–180, 188, 190, 193, 194

shortness of breath, 42

uranium, 19, 94–96, 97–98, 99, 100, 108–109, 153–156, 159

lung cancer, 6–7, 19, 100, 108–109, 110, 113, 117–118, 121, 123, 128–142, 159

lungs, other, 96, 97–98, 99, 100, 108–109, 114, 117, 121, 123, 154–156

see also Inhalation;

Lung cancer;

Lungs

Rheumatoid factor, 299–300, 302

Rubella, see Measles-mumps-rubella

S

Salivation

pyridostigmine bromide (PB), 11, 12, 208, 214, 225, 226, 242, 251

sarin, 171

Sand, 1, 27, 33, 34

Sarin, vii, 2, 4, 8–10, 28, 169–204, 340

acetylcholine (ACh), 18, 19, 21, 169–170, 175, 176, 188, 192, 198

acetylcholinesterase (AChE), 9–10, 21, 169–170, 174–175, 176, 177, 178, 180, 186, 187, 190, 194–195

acute effects, 9, 18, 19, 21, 180, 188, 193–194, 199, 328

animal studies, 10, 175–176, 177, 178–187, 288

antidotes, 170, 179

brain, 10, 175–176, 177, 180, 181, 182, 186–187, 191, 195, 196, 199

central nervous system, general, 170, 171, 176–177, 182, 191, 195, 196, 327

chronic effects, general, 183, 188, 191–192, 193, 198

cognitive effects, general, 171, 181, 197

convulsions, 10, 170, 175, 176, 179, 188, 192, 193

cramps, 171

dermal exposure, 8, 169, 176

developmental effects, 186, 187

dose factors, 9, 10, 18, 19, 173, 176, 178–183, 186, 188, 192, 199, 288, 327

edema, 171

exposure, general, 9, 18, 19, 31, 170–173, 178, 182–183, 188

terrorist attacks, viii, 3, 10, 70, 177–178, 188

fatigue, 171, 189, 193, 194, 195, 198, 199, 327, 328

gastrointestinal effects, 171, 180

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
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gender factors, 196, 197

genetic factors, 21, 53, 183, 187, 197–198, 328

genitourinary system and urinalysis, 171, 177–178

headaches, 10, 171, 193, 194, 198

hematologic effects, 177, 178, 188, 190, 191, 192, 194–195

hepatic effects, 177

historical perspectives, 8, 191

Japan, terrorist attack, 3, 10, 177–178, 188, 191–196, 199

hospitalizations, 188, 189–190, 193–195

ingestion, 176

inhalation, 169, 174, 176, 189

Japan, terrorist attack, 3, 10, 177–178, 188, 191–196, 199

injection, 176, 186, 189

insecticides and, 8, 10, 188, 328

interactions, chemical, 181, 187, 328

insecticides and, 8, 10, 188, 328

lungs, 171, 174

memory loss, 171

mood disorders, 195, 197, 199

mortality, 179, 188, 190

nausea and vomiting, 171

neuromuscular effects, 9, 10, 171, 173, 179–180, 187, 190, 193, 194, 197, 327

neuropathy, 9–10, 175–176, 180–185, 186–187, 190, 192, 193, 194, 197, 327–328

convulsions, 10, 170, 175, 176, 179, 188, 192, 193

nicotinic effects, 170, 171, 175

pain, 10, 171, 171, 193, 194, 198;

see also “headaches” supra

peripheral nervous system, 170

perspiration, 171

posttraumatic stress disorder, 10, 195–196, 198

posturography, 10, 196, 199

psychological effects, 171, 175, 180, 188, 195, 195, 197, 328

psychomotor effects, 10, 171, 175, 180, 196, 199

receptor-mediated actions, general, 9, 169–170, 175, 176

red blood cells, 177, 178, 190, 191

renal effects, 177

reproductive system effects, 186, 187, 197

research recommendations, 21, 327–328

respiratory effects, 171, 173, 174, 179–180, 188, 190, 193, 194

salivation, 171

sexual functioning, 197

sleep disturbance, 10, 171, 191, 194, 195, 199

stress, general, 176

terrorists attacks, viii, 3, 10, 70, 177–178, 188

toxicokinetics, 176–178

veterans, studies of Gulf War veterans, 172–174, 187–190, 196–197

visual and ocular effects, 10, 195, 196, 199, 171, 173, 174, 175, 188, 192, 193, 194, 195, 196, 199, 327

see also Cyclosarin;

Pyridostigmine bromide

Serotonin, 176

Sex-based differences, see Gender factors

Sexual functioning, 48, 49

organophosphate pesticides, 370

sarin, 197

Skeletal effects, see Musculoskeletal effects

Skin, see Dermal exposure;

Dermal tissue, other;

Injection delivery;

Perspiration;

Rashes

SLE, see Systemic lupus erythematosus

Sleep disturbance, 52, 351, 355

pyridostigmine bromide, 226

registry data, 42

sarin, 10, 171, 191, 194, 195, 199

Smoke, 1, 27–28, 33–34, 48

depleted uranium, 6, 93

oil well fires, 1, 27, 31, 33

Smoking, tobacco, 75, 81

organophosphate pesticides, 371

sarin exposure and difficulty in, 194

uranium miners/processors, 6, 7, 107, 108, 114, 120, 121, 127, 130, 135, 137, 138, 139, 141–142, 154, 156, 159

Social factors

disease classification, 343, 348, 349

individual variability, 31

living conditions, 33, 35

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
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Social Security Administration, 114–115, 116, 119

Socioeconomic status

organophosphate pesticides, 371

uranium workers, 7, 117, 121, 138, 141

Solvents, 1, 27, 34, 48

Soviet Union, 281

Special Immunization Safety Study, 284–285

Speech, see Dysarthria

Squalene, 268, 280, 307–312, 340

Statistical techniques, 4, 7, 8, 55(n.12), 79, 82

aggregation of data, 44

clinical classifications, 347

factor analysis, 44, 52, 53–54, 246, 347

uranium effects, 125–127, 159

vaccine studies, 270–271

see also Epidemiology;

Multivariate analysis

Stool, see Feces

Stress, general, 1, 21, 28, 35, 46, 49, 51, 57–59, 334

living conditions, 33, 35

multiple vaccinations, 305

pyridostigmine bromide, 226, 243–244, 328

sarin and, 176

see also Posttraumatic stress disorder

Subcutaneous drug delivery, see Injection delivery

Sweating, see Perspiration

Swelling, see Edema;

Inflammation

Symptom clustering, 43, 44, 48, 49, 50–51, 349

multisymptom illness, 17, 51, 54, 154, 303–306, 342–365

Systemic lupus erythematosus, 157, 284, 311

T

Tanks, military assault vehicles

depleted uranium, 5, 92–94

Tantalum (Ta), 98–99, 100, 101, 103

Tennessee Eastman Corporation, Oak Ridge plant uranium processing workers, 7, 118–121, 122, 123, 131–148 (passim), 152, 159

Terrorist attacks, sarin, viii, 3, 10, 70, 177–178, 188

Testicular cancer, 60

Thermoregulation, 33, 216–217, 235, 237–240

see also Perspiration

Tobacco use, see Smoking

Tokyo, Japan, see Sarin

Toxicokinetics

anthrax vaccines, 275

antigens, general, 271–272, 273

botulinum toxoid vaccines, 289–291

genetic factors, 31, 63

multiple vaccines, 296–299

organophosphates, 31

pyridostigmine bromide (PB), 210

sarin, 176–178

uranium, 94–99, 327

see also Pharmacokinetics

Toxicological Profile for Uranium, 94

Trauma, injury, see Injuries

Tri-o-cresyl phosphate (TOCP), 182

Tripler Army Medical Center Survey, 286

Tumor necrosis factor (TNF), 275

Typhoid vaccines, 295, 301

U

Union Carbide, Oak Ridge plant uranium processing workers, 7, 118–121, 122, 131–148 (passim), 152, 159

United Kingdom, personnel, 39, 45, 46, 50–51, 356, 357, 358

anthrax vaccines, 274, 281

birth defects, 56–57

multiple vaccines, 303–305, 314

pyridostigmine bromide (PB), 250, 252

registry program, 41

sarin, 190

United Nations Special Commission on Iraq, 9, 172, 268

United Nuclear Corporation, 111, 114

Uranium, 90–167

acute effects, 99

animal studies, 21, 96, 97–98, 99–106, 107, 151, 159, 327

antibodies, 152, 156–157, 312

cancer, 113, 117–118, 121, 123, 128–142, 159

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
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cardiovascular effects, 8, 19, 96, 100, 105, 108–109, 126, 158, 160

case-control studies, 108, 121, 127, 138

central nervous system, general, 99, 102, 103

chronic effects, general, 100, 102–103

cohort studies, 112–114, 115–121, 122, 123–149, 151–152, 154–157, 158, 159

cramps, 151

Department of Energy (DOE), 116, 117

dermal effects, 19, 105, 158

dermal exposure, 96, 151, 156

developmental effects, 8, 19, 104–105, 157, 158

dose factors, 7, 90, 91, 103, 108, 115–116, 117–118, 120, 121, 123, 125, 128, 130, 135–140, 141, 142, 159

exposure, general,

depleted uranium, 6, 31, 92, 93–94, 326

occupational exposure, see also “uranium miners/processors” under Occupational exposure, nonmilitary

gastrointestinal effects, 8, 19, 104, 156, 158, 160

genetic factors, 8, 19, 100–101, 157, 158

genitourinary system and urinalysis, 97, 100–101, 119, 123, 124, 150

hematologic effects, 8, 19, 96, 97, 99, 105–106, 109, 157–158

hepatic effects, 19, 97, 100, 104, 108–109, 158

immune system, 8, 154, 156–157, 158

ingestion, 6, 93, 96, 98–99, 100, 105, 123, 147, 149–150, 151

inhalation, 93, 94–96, 97, 97–98, 99, 100, 105, 106, 115, 118–120, 121, 123, 142–143, 154, 156, 158

injection, 99, 144

interactions, chemical, 154, 159

lung cancer, 6–7, 19, 100, 108–109, 110, 113, 117–118, 121, 123, 128–142, 159

mood disorders, 109, 151

neuromuscular effects, 72, 105, 123, 158, 160

neuropathy, general, 19, 99, 102–103, 123, 151–153

occupational exposures, miners and processors, see also “uranium miners/processors” under Occupational exposure, non-military

pain, 151, 156

peripheral nervous system, 151

pharmacokinetics, 94–99

phosphate fertilizer production workers, 112, 114–115, 130, 132, 148, 152, 159

psychological effects, 151

registry programs, 94, 99, 106, 114, 149

regulatory issues, 90, 92;

see also Nuclear Regulatory Commission

renal effects, 7–8, 19, 72, 97, 99, 100, 101–102, 115, 123, 147–151, 159

reproductive system effects, 104–105, 157, 158, 160

research methodology issues, 123–128, 153, 159

respiratory system, 19, 94–96, 97–98, 99, 100, 108–109, 153–156, 159

lung cancer, 6–7, 19, 100, 108–109, 110, 113, 117–118, 121, 123, 128–142, 159

lungs, other, 96, 97–98, 99, 100, 108–109, 114, 117, 121, 123, 154–156

smoking tobacco, 6, 7, 75, 81, 107, 108, 114, 120, 121, 127, 130, 135, 137, 138, 141–142, 154, 156, 159

visual and ocular effects, 8, 105, 158

see also Depleted uranium

Urinary system, see Genitourinary system and urinalysis

U.S., Uranium Registry, 149

V

VA, see Department of Veterans Affairs

Vaccine Adverse Events Reporting System (VAERS), 269, 270, 284, 296

Vaccines, viii, 4, 14–18, 19, 49, 51, 267–324

acute effects, general, 270, 271

antibodies, adverse reactions, 17, 272, 298

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
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adjuvants, vaccines, 270, 271, 274, 276, 279, 280, 290

squalene, 268, 280, 307–312, 340

age factors, 302, 311–312

animal studies, 271, 272, 277–280, 297–299, 330

cardiovascular effects, general, 272

chronic effects, general, 17, 271, 287, 294, 198–199, 303, 304, 311, 312–314, 330

clinical studies, 15–17, 19, 270, 271, 282–283, 284–287, 291–294, 305, 306, 310–311, 333

cohort studies, 17, 274, 281, 291, 299, 300–303, 306, 314

dose factors, 272

genetic factors, 272, 273, 280, 290–291

hepatitis virus, 295, 296

herpes simplex virus, 310

historical perspectives, general, 267, 268, 294, 295, 300–303

HIV, 310

hormonal effects, 273

immune system response, 17, 271–272, 273, 278, 284, 288, 290, 296, 297, 298–299

influenza, 295, 310–311

insecticides and, 305

interactions, chemical, 272, 296, 330

insecticides and, 305

see also Multiple vaccinations

meningitis, 284, 295, 296

mortality, 302–303, 311

number of military doses delivered, 14, 267, 268, 269

occupational exposures, non-military, 15, 16, 272, 282, 288, 294–295

polio, 268, 296

recordkeeping, 21, 268, 269, 270, 284, 330

research methodology issues, 269–271

research recommendations, 21, 329–330

regulatory factors, 294;

see also Food and Drug Administration

squalene, 268, 280, 307–312, 340

surveillance and reporting, 269, 270

typhoid, 295, 301

veterans studies, Gulf War, 285, 286, 293, 299–300, 303–305, 311–312, 329, 330

visual and ocular effects, 286, 288(n.10), 294

yellow fever, 295, 296, 301

see also Anthrax vaccines;

Botulinum toxoid vaccines;

Centers for Disease Control and Prevention;

Multiple vaccinations

VAERS, see Vaccine Adverse Events Reporting System

Varicella vaccines, 295

VEP, see Visual evoked potential

Vestibular nerve, 52, 197, 327

Veterans Administration, see Department of Veterans Affairs

Veterans, studies of Gulf War veterans, 43–62, 325

anthrax vaccines, 285, 286, 293

botulinum toxoid vaccines, 285, 293

clinical definitions, 43–44, 54, 347–348, 349–361

Canadian, 39, 45, 46, 48–49, 285, 333, 358

Iowa Persian Gulf study, 45, 46, 48, 49, 52, 57, 60, 62, 358, 333, 358

multiple vaccinations, 299–300

multisymptom illness, 17, 51, 54, 154, 303–304

pyridostigmine bromide (PB), 209, 225–226, 245, 246–250, 252

sarin, 172–174, 187–190, 196–197

squalene, 311–312

United Kingdom, 39, 41, 45, 46, 50–51, 56–57, 190, 250, 252, 274, 281, 303–305, 314, 356, 357, 358

uranium, see Depleted uranium

vaccines, 285, 286, 293, 299–300, 303–305, 311–312, 329, 330

Veterans Programs Enhancement Act, 2, 28

Vietnam War

herbicides, 3, 29, 334

Vinyl chloride, 79

Visual and ocular effects

anthrax vaccines, 286

botulinum toxoid vaccines, 288(n.10), 294

miosis, 11, 12, 171, 174, 188, 208, 240, 241, 248, 249

pyridostigmine bromide (PB), 11, 12, 208, 225, 233, 240–242, 248, 249

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
×

sand, 33

sarin, 10, 195, 196, 199, 327, 171, 173, 174, 175, 188, 192, 193, 194, 195, 196, 199, 327

uranium, 8, 105, 158

visual evoked potential (VEP),

pyridostigmine bromide (PB), 240, 248, 249

sarin, 10, 195, 196, 199, 327

Vomiting, see Nausea and vomiting

W

Weather, 33, 235, 243

Weight loss, 52, 245

White blood cells, see Lymphocytes

Women, see Gender factors

World Health Organization, 346, 360

Wounds, depleted uranium, 93, 102–103

Y

Yellow fever vaccines, 295, 296, 301

Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
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Suggested Citation:"Index." Institute of Medicine. 2000. Gulf War and Health: Volume 1: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/9953.
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