July 16, 1998
Exposure To Toxic Substances Does Not Appear To Cause Symptoms Attributed To Gulf War Syndrome
INDIANAPOLIS, IN-- A study in a recent issue of the Journal of Occupational and Environmental Medicine finds no clear evidence of an association between exposure to toxic substances and Gulf War illnesses.
In a study of 18,495 men and women who served on active duty during the Gulf War, Kurt Kroenke, M.D., professor of medicine at the Indiana University School of Medicine and senior research scientist at the Regenstrief Institute for Health Care, and colleagues found that exposure to toxic substances did not appear to cause the symptoms, including joint pain, fatigue, rashes and sleep disorders, that have been labeled by some as Gulf War illnesses.
The veterans were asked to report what they perceived as possible toxic exposures during the conflict. Among those mentioned most often were exposures to fuel, passive cigarette smoke, an antidote to battlefield chemicals, fumes from tent heaters, oil fire smoke, personal pesticide use, anthrax immunizations, botulism immunization and medication to prevent malaria.
The researchers found no apparent association between the specific exposures and the individual symptoms the veterans reported to doctors who examined them through the Department of Defense's Comprehensive Clinical Evaluation Program. For example, despite their form of exposure, half of the veterans surveyed reported symptoms such as joint pain and fatigue. One-third of the study subjects reported sleep problems and more than a quarter reported skin problems, regardless of type of toxic exposure.
"Other studies have shown that health complaints or symptoms increase after stressful experiences such as an earthquake or war. Survivors are likely to suffer sleep disturbance or depression. It is possible that the veterans we studied are responding to stress rather than exposure to specific toxins," said Dr. Kroenke.
Many veterans did not develop problems until long after the end of the war. This fact also led the researchers to conclude that it is unlikely there is a link between exposures during the conflict and the long list of symptoms collectively referred to by some as Gulf War Syndrome.
Symptom onset was delayed in a majority of the veterans until they returned to the U.S. The study found that more than 40 percent of the veterans did not have symptoms until more than a year after they left the Gulf.
According to the study, an "unexpected rise in symptom onset during the third year postwar or later compared to the second postwar year may represent either a true delayed peak in symptom latency, recall bias, introduction of VA disability compensation programs for Gulf War veterans with undiagnosed illnesses, or heightened awareness of symptoms related to increasing media attention."
"This latency also argues against any specific toxin causing the symptoms. As exposures to toxins during the conflict took place over a short time and were not chronic, there is no clear explanation for symptoms occurring years after the end of the war," said Kroenke.
Other members of the study team were Patricia Koslowe, Ph.D., of the Comprehensive Clinical Evaluation Program, Office of the Assistant Secretary of Defense for Health Affairs, and Michael Roy, M.D., M.P.H., of the Uniformed Services University of the Health Sciences and Walter Reed Army Medical Center.
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