Gulf War and health

292 Pages·2006·3.48 MB·English

by  Committee on Gulf War and Health: A Review of the Medical Literature Relative to the Gulf War Veterans' Health

x PREFACE
that more such studies be undertaken for the Gulf War veterans, but, there would be value in
continuing to monitor the veterans for some health end points, specifically, cancer, especially
brain and testicular cancers, neurologic diseases including Amyotrophic Lateral Sclerosis (ALS),
and causes of death. Therefore, despite the serious limitations of the available studies as a group,
they do point the way to actions that might benefit Gulf War and other combat veterans.
I am deeply appreciative of the expert work of our committee members: Marcia Angell,
W. Kent Anger, Michael Brauer, Dedra S. Buchwald, Francesca Dominici, Arthur L. Frank,
Francine Laden, David Matchar, Samuel J. Potolicchio, Thomas G. Robins, George W.
Rutherford, and Carol Tamminga. Although our committee developed conclusions
independently of input from IOM and its staff, we deeply appreciate their hard work and
attention to detail and the extensive research that they conducted to ensure that we had all the
information that we needed from the outset. It has been a privilege and a pleasure to work with
the IOM staff directed by Carolyn Fulco and with our consultant, Miriam Davis. Without them,
this report would not have been possible. Most of all, our committee appreciates the veterans
who served in the Gulf War and who have volunteered again and again to participate in the
health studies that we reviewed. It is for them that we do this work. We hope this report will
inform those who have given so much to our nation about what researchers have been able to
learn about their health.

LYNN R. GOLDMAN, MD, MPH
PROFESSOR
JOHNS HOPKINS UNIVERSITY
Committee on Gulf War and Health: A Review of the Medical Literature Relative
to the Gulf War Veterans’ Health

Board on Population Health and Public Health Practice
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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National
Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National
Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report
were chosen for their special competences and with regard for appropriate balance.
This study was supported by Contract V101(93)P-2155 between the National Academy of Sciences and the
Department of Veterans Affairs. Any opinions, findings, conclusions, or recommendations expressed in this
publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that
provided support for this project.
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www.national-academies.org
.
COMMITTEE ON GULF WAR AND HEALTH: A REVIEW OF THE
MEDICAL LITERATURE RELATIVE TO GULF WAR VETERANS’
HEALTH
LYNN R. GOLDMAN, MD, MPH, (chair) Professor, Bloomberg School of Public Health,
Johns Hopkins University, Baltimore, MD
MARCIA ANGELL, MD, Senior Lecturer on Social Medicine, Department of Social Medicine,
Harvard Medical School, Boston, MA
W. KENT ANGER, PhD, Associate Director for Occupational Research, Center for Research
on Occupational and Environmental Toxicology, Oregon Health and Science University,
Portland, OR
MICHAEL BRAUER, ScD, Professor, School of Occupational and Environmental Hygiene,
University of British Columbia, Vancouver, British Columbia
DEDRA S. BUCHWALD, MD, Director, Harborview Medical Center, University of
Washington, Seattle, WA
FRANCESCA DOMINICI, PhD, Associate Professor, Bloomberg School of Public Health,
Johns Hopkins University, Baltimore, MD
ARTHUR L. FRANK, MD, PhD, Professor, Chair, Department of Environmental and
Occupational Health, Drexel University School of Public Health, Philadelphia, PA
FRANCINE LADEN, ScD, Assistant Professor of Medicine, Channing Laboratory, Harvard
Medical School, Boston, MA
DAVID MATCHAR, MD, Director, Center for Clinical Health Policy Research, Duke
University Medical Center, Durham, NC
SAMUEL J. POTOLICCHIO, MD, Professor, Department of Neurology, George Washington
University Medical Center, Washington, DC
THOMAS G. ROBINS, MD, MPH, Professor, Department of Environmental Health Sciences,
University of Michigan School of Public Health, Ann Arbor, MI
GEORGE W. RUTHERFORD, MD, Professor, Vice-Chair, Department of Epidemiology and
Biostatistics, Division of Preventive Medicine and Public Health, School of Medicine,
University of California, San Francisco, CA
CAROL A. TAMMINGA, M.D., Professor, Department of Psychiatry, University of Texas,
Southwestern Medical Center, Dallas, TX

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STAFF
CAROLYN FULCO, Senior Program Officer
ABIGAIL MITCHELL, Senior Program Officer
DEEPALI PATEL, Senior Program Associate
MICHAEL SCHNEIDER, Senior Program Associate
JUDITH URBANCZYK, Senior Program Associate
HOPE HARE, Administrative Assistant
PETER JAMES, Research Associate
DAMIKA WEBB, Research Assistant
RENEE WLODARCZYK, Intern
NORMAN GROSSBLATT, Senior Editor
ROSE MARIE MARTINEZ, Director, Board on Population Health and Public Health Practice

CONSULTANTS
MIRIAM DAVIS, Independent Medical Writer, Silver Spring, MD
ANNE STANGL, Tulane School of Public Health and Tropical Medicine, New Orleans, LA

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REVIEWERS
This report has been reviewed in draft form by persons chosen for their diverse
perspectives and technical expertise in accordance with procedures approved by the National
Research Council’s Report Review Committee. The purpose of this independent review is to
provide candid and critical comments that will assist the institution in making its published
report as sound as possible and to ensure that the report meets institutional standards for
objectivity, evidence, and responsiveness to the study charge. The review comments and draft
manuscript remain confidential to protect the integrity of the deliberative process. We wish to
thank the following for their review of this report:
ARTHUR K. ASBURY, MD, Department of Neurology, University of Pennsylvania,
Philadelphia, PA
SHARON COOPER, PhD, Professor and Chair, Department of Epidemiology and Biostatistics,
Texas A & M University School of Rural Public Health, College Station, TX
PETER J. DYCK, MD, Director, Peripheral Nerve Research Laboratory, Mayo Clinic College
of Medicine, Rochester, MN
DAVID GAYLOR, PhD, MS, President, Gaylor & Associates, LLC, Eureka Springs, AR
JACK M. GORMAN, MD, President and Psychiatrist in Chief, McLean Hospital, Belmont,
MA
PHILIP GREENLAND, MD, Executive Associate Dean for Clinical and Translational
Research, Northwestern University Feinberg School of Medicine, Chicago, IL
HOWARD KIPEN, MD, MPH, Director, Clinical Research and Occupational Medicine
Division, Environmental & Occupational Health Sciences Institute, UMDNJ-Robert
Wood Johnson Medical School, Piscataway, NJ
JOSEPH LADOU, MD, Editor, International Journal of Occupational and Environmental
Health, Professor, Division of Occupational and Environmental Medicine, University of
California, San Francisco, CA
ELLEN REMENCHIK, MD, MPH, Assistant Professor, Occupational and Environmental
Medicine, The University of Texas Health Center, Tyler, TX
KATHERINE S. SQUIBB, PhD, Associate Professor & Head, Division of Environmental
Epidemiology & Toxicology, University of Maryland School of Medicine, Baltimore,
MD
Although the reviewers listed above have provided many constructive comments and
suggestions, they were not asked to endorse the conclusions or recommendations nor did
they see the final draft of the report before its release. The review of this report was
overseen by David J. Tollerud, Professor and Chair, Department of Environmental and
Occupational Health Sciences, University of Louisville and by Harold Sox, editor,
Annals of Internal Medicine, American College of Physicians of Internal Medicine.
Appointed by the National Research Council, Dr. Sox was responsible for making certain
that an independent examination of this report was carried out in accordance with
institutional procedures and that all review comments were carefully considered.
Responsibility for the final content of this report rests entirely with the authoring
committee and the institution.
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