The status of efforts to identify Persian Gulf War syndrome : hearings before the Subcommittee on Human Resources and Intergovernmental Relations of the Committee on Government Reform and Oversight, House of Representatives, One Hundred Fourth Congress, s

552 Pages·1997·23.1 MB·English

by  United States. Congress. House. Committee on Government Reform and Oversight. Subcommittee on Human Resources and Intergovernmental Relations

(^\ THE STATUS OF EFFORTS TO IDENTIFY PERSIAN
GULF WAR SYNDROME
Y 4, G 74/7; P 43/6
The Status of Effects to Identify P. . .
HEARINGS
BEFORE THE
SUBCOMMITTEE ON HUMAN RESOURCES
AND INTERGOVERNMENTAL RELATIONS
OF THE
COMMITTEE ON GOVERNMENT
REFORM AND OVERSIGHT
HOUSE OF REPRESENTATIVES
ONE HUNDRED FOURTH CONGRESS
SECOND SESSION
MARCH 11, 28; JUNE 25; AND SEPTEMBER 19, 1996
Printed for the use of the Committee on Government Reform and Oversight
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THE STATUS OF EFFORTS TO IDENTIFY PERSIAN
GULF WAR SYNDROME
HEARINGS
BEFORE THE
SUBCOMMITTEE OX HUMAN RESOURCES
AND INTERGO\^RNMENTAL RELATIONS
OF THE
COMMITTEE ON GOVERNMENT
REFORM AND OVERSIGHT
HOUSE OP REPRESENTATIVES
ONE HUNDRED FOURTH CONGRESS
SECOND SESSION
MARCH 11, 28; JUNE 25; AND SEPTEMBER 19, 1996
Printed for the use of the Committee on Government Reform and Oversight
U.S. GOVERNMENT PRINTING OFFICE
36-680CC WASHINGTON 1997
:
ForsalebytheU.S.GovernmentPrintingOffice
SuperintendentofDocuments,CongressionalSalesOffice,Washington,DC 20402
ISBN 0-16-054041-0
COMMITTEE ON GOVERNMENT REFORM AND OVERSIGHT
WILLIAM F. CLINGER, Jr., Pennsylvania, Chairman
BENJAMINA. OILMAN, New York CARDISS COLLINS, Illinois
DAN BURTON, Indiana HENRY A. WAXMAN, CaUfomia
J. DENNIS HASTERT, Illinois TOM LANTOS, California
CONSTANCE A. MORELLA, Maryland ROBERT E. WISE, Jr., WestVirginia
CHRISTOPHER SHAYS, Connecticut MAJOR R. OWENS, New York
STEVEN SCHIFF, New Mexico EDOLPHUS TOWNS, New York
ILEANA ROS-LEHTINEN, Florida JOHN M. SPRATT, Jr., South CaroUna
WILLIAM H. ZELIFF, Jr., New Hampshire LOUISE Mcintosh slaughter. New
JOHN M. McHUGH, New York York
STEPHEN HORN, CaUfomia PAUL E. KANJORSKI, Pennsylvania
JOHN L. MICA, Florida GARYA. CONDIT, CaUfomia
PETER BLUTE, Massachusetts COLLIN C. PETERSON, Minnesota
THOMAS M. DAVIS, Virginia KAREN L. THURMAN, Florida
DAVID M. Mcintosh, Indiana CAROLYN B. MALONEY, New York
JON D. FOX, Pennsylvania THOMAS M. BARRETT, Wisconsin
RANDY TATE, Washington BARBARA-ROSE COLLINS, Michigan
DICK CHRYSLER, Michigan ELEANOR HOLMES NORTON, District of
GIL GUTKNECHT, Minnesota Columbia
MARK E. SOUDER, Indiana JAMES P. MORAN, Virginia
WILLIAM J. MARTINI, New Jersey GENE GREEN, Texas
JOE SCARBOROUGH, Florida CARRIE P. MEEK, Florida
JOHN B. SHADEGG, Arizona CHAKA FATTAH, Pennsylvania
MICHAEL PATRICK FLANAGAN, Illinois BILL BREWSTER, Oklahoma
CHARLES F. BASS, New Hampshire TIM HOLDEN, Pennsylvania
STEVEN C. LaTOURETTE, Ohio ELIJAH CUMMINGS, Maryland
MARSHALL "MARK" SANFORD, South
Carolina BERNARD SANDERS, Vermont
ROBERT L. EHRLICH, Jr., Maryland (Independent)
SCOTT L. KLUG, Wisconsin
James L. Clarke, StaffDirector
Kevin Sabo, General Counsel
Judith McCoy, ChiefClerk
Bud Myers, Minority StaffDirector
Subcommittee on Human Resources and Intergovernmental Relations
CHRISTOPHER SHAYS, Connecticut, Chairman
MARK E. SHOUDER, Indiana EDOLPHUS TOWNS, New York
STEVEN SCHIFF, New Mexico TOM LANTOS, CaUfomia
CONSTANCE A. MORELLA, Maryland BERNARD SANDERS, Vermont (Ind.)
THOMAS M. DAVIS, Virginia THOMAS M. BARRETT, Wisconsin
DICK CHRYSLER, Michigan GENE GREEN, Texas
WILLIAM J. MARTINI, New Jersey CHAKA FATTAH, Pennsylvania
JOE SCARBOROUGH, Florida HENRY A. WAXMAN, CaUfomia
MARSHALL "MARK" SANFORD, South
CaroUna
Ex Officio
WILLIAM F. CLINGER, Jr., Pennsylvania CARDISS COLLINS, IlUnois
Lawrence J. Halloran, StaffDirector
Robert Newman, Professional StaffMember
Thomas M. Costa, Clerk
Cherri Branson, Minority Professional Staff
Cheryl Phelps, Minority Professional Staff
ill)
CONTENTS
Hearingheld on:
March 11, 1996 1
March 28, 1996 133
June 25, 1996 207
September 19, 1996 309
Statementof:
Bailar, John, M.D., chairman. Committee to Review the Health Con-
sequences of Service During the Persian Gulf war, Institute of Medi-
cine, accompanied by David Rail, M.D., foreign secretary; Rob3Ti Y.
Nishimi, Executive Director, President's Advisory Committee on Per-
sian GulfVeterans' Illnesses, accompanied by Maj. Thomas P. Cross;
and Charles Sheehan-Miles, executive director, National Persian Gulf
WarResource Center ....; 41
Baumzweiger, William, neurologist and psychiatrist, Los Angeles, CA;
Claudia Miller, assistant professor, environmental and occupational
medicine, University of Texas Health Science Center, San Antonio,
TX; and Stephanie Padilla, Neiu"otoxicology Division, U.S. Environ-
mentalProtectionAgency, ResearchTrianglePark, North Carolina 480
Buyer, Hon. Steve, a Representative in Congress from the State ofIndi-
ana 315
Clauw, Daniel J., assistant professor ofmedicine, Georgetown University;
Penny F. Pierce, assistant professor, school of nursing. University of
Michigan; and Howard B. Umovitz, research microbiologist 177
Copeland, Sylvia, Persian GulfWarVeterans Illnesses Taskforce, Central
Intelligence Agency; and Frances Murphy, Director, Environmental
Agents Services, DepartmentofVeteransAffairs 390
Diilka, Diane, surviving spouse of Gulf war veteran Joe Dulka; and
William Marcus, toxicolo^st 264
Garthwaite, Thomas, Deputy Under Secretary of Health, Department
of Veterans Affairs, accompanied by Susan Mather, Director, Office
ofPublic Health and Environmental Hazards; Frances Murphy, Direc-
tor, Environmental Agents Service; Timothy Gerrity, Deputy Director,
Medical Research Office; and Quentin Kinderman, Assistant Director,
Compensation and Pension Service 137
Joseph, Stephen, Assistant Secretary of Defense for Health Affairs; J.
Gary Hickman, Director, Atlanta Regional Office, Veterans Benefits
Administration, Department ofVeterans Affairs; and Frances Miirphy,
Director, Environmental Agency Service, Department of Veterans Af-
fairs 217
Martin, Brian, Persian Gvilfwar veteran, accompanied by Wife Kimberly,
Niles, MI; Barry Kapplan, Persian Gulfwar veteran, Southington, CT;
Nancy Kapplan, registered nurse, Southington, CT; Nick Roberts, Per-
sian Gulfwar veteran. Port St. Joe Beach, FL; Denise Nichols, Persian
Gulfwarveteran and registered nurse, WheatRidge, CO 5
Martin, Brian, Persian Gulf war veteran; BiU Gleason, Persian Gulf
war veteran; Randy Wheeler, Persian Gulf war veteran; and Kimo
Hollingsworth, PersianGulfwarveteran 319
Puglisi, Matthew L., assistant director of national veterans affairs, the
American Legion; Lennox E. Gilmer, associate national legislative di-
rector. Disabled American Veterans; KeUi Willard-West, directorofgov-
ernmentrelations,VietnamVeterans ofAmerica; Dennis CuUinan, dep-
uty director of national legislative service, Veterans of Foreign Wars;
and Scott Vanderheyden, Gulf war coordinator, Vietnam Veterans
AgentOrangeVictims, Inc 77
Tuite,James, director, GulfWarResearchFoundation 437
(III)
IV
— Page
Statementof Continued
Upton, Hon. Fred, a Representative in Congress from the State ofMichi-
gan 318
Letters, statements, etc., submitted forthe record:
Bailar, John, M.D., chairman, Committee to Review the Health Con-
sequences of Service During the Persian Gulf war, Institute of Medi-
cine, prepared statementof 43
Baumzweiger, WiUiam, neurologist and psychiatrist, Los Angeles, CA,
prepared statementof 484
Buyer, Hon. Steve, a Representative in Congress from the State ofIndi-
ana, press release 235
Clauw, Daniel J., assistant professor ofmedicine, Georgetown University,
prepared statementof 181
Copeland, Sylvia, Persian GulfWarVeterans IllnessesTaskforce, Central
Intelligence Agency, report entitled, "CIA Report on Intelligence Relat-
ed toGulfWarIllnesses" 390
Cross, Maj. ThomasP., prepared statementof 48
CuUinan, Dennis, deputy directorofnational legislative service, Veterans
ofForeignWarsoftheUnited States, prepared statementof 89
Dulka, Diane, surviving spouse ofGulfwar veteran Joe Dvilka, prepared
statementof 268
Garthwaite, Thomas, Deputy Undersecretary for Health, Department of
VeteransAffairs, prepared statementof 139
Gilmer, Lennox E., associate national legislative director, Disabled Amer-
icanVeterans, prepared statementof 94
Gleason, Bill, Persian Gulfwarveteran, prepared statementof 16
Green, Hon. Gene, a Representative in Congress from the State ofTexas,
prepared statementof. 209, 315
Hickman, J. Gary, Director, Atlanta Regional Office, Veterans Benefits
Administration, Department of Veterans Affairs, prepared statement
of 226
Hollingsworth, Kimo S., Persian Gulf war veteran, prepared statement
of 28
Jeffords, Hon. James M., a U.S. Senator from the State of Vermont,
statementof 108
prepared
Josepn, Stephen, Assistant Secretary ofDefense for Health Affairs, pre-
pared statementof 221
Kapplan, Barry, Persian Gulf war veteran, Southington, CT, prepared
statementof 328
Kapplan, Nancy, registered nurse, Southington, CT, prepared statement
of 337
Komkven, ChrisA., prepared statementof 538
Marcus, William L., Ph.D., D.A.B.T., prepared statementof 279
Martin, Brian T., Persian Gulf war veteran, co-president, International
AdvocacyforGulfWar SjTidrome:
Photographs 370
Prepared statementof 9, 323
Miller, Claudia, assistantprofessor, environmental and occupational med-
icine. University of Texas Health Science Center, San Antonio, TX,
statementof 511
prepared
Murphy, Frances M., Director, Environmental Agents Service, Depart-
mentofVeteransAJRFairs, prepared statementof 412
Navajo Nation on PersianGulfWarS3Tidrome, prepared statementof 109
Nichols, Denise, Persian Gulfwar veteran and registered nurse. Wheat
Ridge, CO, prepared statementof 349
Nishimi, RobjTi Y., Executive Director, President's Advisory Committee
on Persian GulfVeterans' Illnesses, prepared statementof 47
Padilla, Dr. Stephanie, Neurotoxicology Division, U.S. Environmental
Protection Agency, Research Triangle Park, North CaroUna, prepared
statementof 521
Pierce, Penny F., R.N., assistant professor, school ofnursing. University
ofMichigan, prepared statementof 192
Puglisi, Matthew L., assistant director of national veterans affairs, the
American Legion, prepared statementof 79
Rail, David, M.D., foreign secretary. Institute ofMedicine, prepared state-
mentof 63
Roberts, Nick, PersianGvilfwarveteran, prepared statementof 345
Sanders, Hon. Bernard, a Representative in Congress from the State
ofVermont, prepared statementof 537
V
— Page
Letters, statements, etc., submittedforthe record Continued
Shays, Hon. Christopher, a Representative in Congress from the State
ofConnecticut:
Letter from Joseph F. Delfico, Acting Assistant Comptroller General,
General Accounting Office, dated June 21, 1996; a letter from
Dr. Satcher, M.D., Director of Centers for Disease Control and
Prevention, dated June 21, 1996; and a letter from Philip
Landrigan, M.D., and Ethel H. Wise, ProfessorofCommunityMed-
icine and Chairman, Department of Community Medicine, Mount
Sinai Medical Center, datedJune 21 212
Letter from Sandra Stuart, Assistant Secretary of Defense, dated
September 19, 1996 385
Sheehan-Miles, Cheirles, executive director. National Persian Gulf War
Resource Center, prepared statement of 60
Towns, Hon. Edolphus, a Representative in Congress from the State
ofNewYork, prepared statements of 3, 135, 312
Tviite, James, director. Gulf War Research Foundation, material accom-
panyingprepared statement 442
Upton, Hon. Fred, a Representative in Congress from the State ofMichi-
gan, prepared statementof 318
Vanderheyden, Scott, Gulfwar coordinator, Vietnam Veterans Agent Or-
angeVictims, Inc., prepared statementof 102
Walsh, Hon. James T., a Representative in Congress from the State
ofNewYork, prepared statementof 2
Wheeler, Randy, Persian Gulf war veteran, attachments to prepared
statement 20
Willard-West, Kelli, director ofgovernment relations, Vietnam Veterans
ofAmerica, prepared statementof 85

THE STATUS OF EFFORTS TO ffiENTIFY
PERSIAN GULF WAR SYNDROME, PART
I
MONDAY, MARCH 11, 1996
House of Representatives,
Subcommittee on Human Resources and
Intergovernmental Relations,
Committee on Government Reform and Oversight,
Washington, DC.
The subcommittee met, pursuant to notice, at 10:40 a.m., in room
2247, Raybum House Office Building, Hon. Christopher Shays
(chairman ofthe subcommittee) presiding.
Present: Representatives Shays and Davis.
Also present: Representative Upton.
Staff present: Lawrence J. Halloran, staff" director and counsel;
Kate Hickey and Robert Newman, professional staff members;
Thomas M. Costa, clerk; and Cherri Branson and Cheryl Phelps,
minority professional staff.
Mr. Shays. I'd like to call this hearing to order and note the
presence of a quorum and thank everyone for coming and partici-
pating and particularly Mr. Davis for being here to ensure that we
do have a quorum in the beginning moments. He will have to get
on his way.
The problems ofPersian Gulfwar veterans challenge the Federal
Government's capacity to care. Faced with an alarming variety of
symptoms and possible pathologies, the Department of Veterans
Affairs and others have, since 1991, undertaken an impressive
number of studies to explore the illnesses suffered by Gulfwar vet-
erans.
But, so far, studies lead only to more studies; and clinical data
yields more hypotheses than conclusions. These oversight hearings
will examine how ongoing efforts to diagnose, treat and compensate
Gulf war veterans can be more sharply focused and more imbued
with the same sense of urgency with which we committed our
troops to that war. Without that focus, without that urgency, we
risk literally studying the problem to death.
As a Nation, our obligation is to reach reasonable conclusions
about causal relationships between veterans* illnesses and their
service in the Persian Gulfin time to be ofhelp to the living.
There is valid cause for concern that after 4 years of veterans*
complaints and VA study, the research plan is still not coherent,
treatment protocols are still inconsistent and disability determina-
tions remain stalled.
Last month, the President*s Advisory Committee on Gulf war
Veterans' Illnesses concluded that "inadequate response to specific
(1)
peer review, disregard for the importance of allocating scarce re-
search dollars to the best-designed studies and inattention to the
need to communicate effectively with veteran participants are un-
dermining the effectiveness of the Government's research efforts."
We have asked witnesses from the Presidential Advisory Commit-
tee as well as the Institute of Medicine to expand on their conclu-
sions and recommendations regarding a research agenda that will
produce urgently needed answers in the shortest possible time.
We will also hear from Gulf war veterans and veterans' service
organizations to learn how the VA is responding to their needs.
Veterans are frustrated. Veterans and their families are anxious.
They don't want to wait to know the cause of their symptoms or
the prospects for treatment.
But answers come slowly, and veterans are understandably sus-
picious that the Government may not want to find answers that re-
fute military dogma or result in billions of dollars in health care
and compensation costs.
Our oversight mission is to stand watch over the process to make
sure nothing compromises our moral obligations to those who
served. Not potential cost. Not missing medical records. Not bu-
reaucratic inertia. Not the lack of a single—theory of causation for
diffuse symptoms. Nothing can be allowed we will do our best to
make sure that nothing compromises our moral abrogation to those
who served.
When we send a truck or tank into battle and it comes back bro-
ken, we fix it. When we put men and women into hostile physical
and military environment and they come back sick, we should do
everj^hing in our power to heal the wounds caused by the war.
I welcome all our witnesses today and look forward to hearing
their testimony.
At this time, I'd like to call on Mr. Davis.
Mr. Davis. I will, so we can move on with the hearing, ask unan-
imous consent to insert my statement in the record.
We also have the statement of our colleague, Jim Walsh from
New York, and ask unanimous consent that his statement be put
in the record today.
We have Bill Gleason, one ofhis constituents, who will be before
us today.
[The prepared statement ofHon. James T. Walsh follows:]
Prepared StatementofHon. JamesT. Walsh, aRepresentative in Congress
FROMTHE State ofNewYork
I thank my colleague, Chairman Christopher Shays of Connecticut, for allowing
my statement to be entered into the record, and for hearing my constituent, Bill
Gleason, who was a Master Gunnery Sergeant serving with Bravo Company, 8th
Tank Bn., U.S. Marine Corps in Operation Desert Storm. Mr. Gleason brings com-
testimony before this hearing. He is unique because his unit served their
fa»setUitnhgree months amongst the oil f^es ofKuwait and he has managed to stay in
personal contactwith ninety eightpercentofthe tankers he served with.
I don't beheve there is any combat unit around today who can say that many
members have stayed in contact. This has been entirely through the efforts ofBill
Gleason. He has taken the time to survey the members of Bravo Company as to
whattheirailments are and whatsymptoms theyhave been experiencing since their
return from Operation Desert Storm. Many say these ailments are connected to
their exposure to chemical elements and environmental pollution during the war.
I don't know what the extent of the connection is, but personally I think there's
something there. Mr. Gleason has done an extraordinary amount of research and