A scientific panel has concluded that the Veterans Affairs Department should stop searching for links between environmental exposures in the 1991 Persian Gulf War and veterans’ illnesses and instead focus on monitoring and treating those who have health problems related to deploying 25 years ago.
In a report released Thursday, Institute of Medicine researchers said Gulf War veterans are at increased risk for developing some physical and psychological health conditions like post-traumatic stress, anxiety, Gulf War illness and chronic fatigue syndrome, but other diseases like cancer, respiratory illnesses and most neurodegenerative conditions do not appear to occur at higher rates in these former troops.
Without concrete information on each Gulf War veteran’s exposure and the unlikely prospect of ever having the data, VA should focus instead on following this group as members age and treat illnesses that develop, panelists said.
According to the report, the federal government has spent more than $500 million since 1994 to study Gulf War veterans' health but “there has been little substantial progress in our overall understanding of the health effects” from the 1990-1991 deployments.
Thus, “without definitive and verifiable individual veteran exposure information, further studies to determine cause-and-effect relationships between Gulf War exposures and health conditions in Gulf War veterans should not be undertaken,” wrote the panel of researchers, including experts in environmental health, epidemiology and medicine.
Future research, they added, should focus on personalized care for veterans, follow-up assessments and treatment.
The panel's top recommendation also said VA should thoroughly study the “mind-body” connection of disease.
"Any future studies of Gulf War illness should recognize the connections and complex relationships between brain and physical functioning and should not exclude any aspect of the illness with regard to improving its diagnosis and treatment,” panelists noted.
The new report has outraged advocates for veterans who suffer from illnesses stemming from their service in the 1990-1991 operation.
They argue the report reflects a bias among the panel toward VA and panelists were selective in choosing which studies they reviewed for the study, "Gulf War and Health, Volume 10: Update of Health Effects of Serving in the Gulf War, 2016."
"IOM committees should not be made up of former VA officials and their friends," said Rick Weidman, executive director for policy and governmental affairs for Vietnam Veterans of America. “It's outrageous that the VA under secretary from the 1990s who began the policy of minimizing Gulf War illness was on this committee or that the committee chair was on record before she was appointed saying you can't say what caused it.”
"The science is unequivocal, if viewed honestly and in its totality: Toxic exposures were responsible,” said Dr. Beatrice Golomb, a professor of medicine at the University of California-San Diego and former scientific director for the VA's Research Advisory Committee on Gulf War Illness. "But the IOM doesn't look at all relevant studies. This 'don't look, don't find' practice has been a consistent problem in IOM Gulf War reports.”
The report examined studies on myriad diseases and their prevalence in Gulf War veterans as well as those who did not deploy. The panel then categorized these illnesses on a spectrum ranging from the strongest link — "sufficient evidence of a causal relationship” — to "inadequate or insufficient evidence to determine an association.”
Post-traumatic stress disorder was the only condition the panel found to be caused by Gulf War deployment. The group also found sufficient evidence of an association for generalized anxiety disorder, depression, substance abuse, gastrointestinal symptoms, chronic fatigue syndrome and Gulf War illness, a catch-all term used to describe undiagnosed symptoms in Gulf War veterans.
According to the report, there also is "limited but suggestive" evidence that amyotrophic lateral sclerosis, or ALS, fibromalygia and chronic pain and self-reported sexual dysfunction are related to Gulf War deployment.
But it found little or no evidence that cancer, skin conditions, birth defects, musculoskeletal system diseases, multiple sclerosis and other illnesses were related.
“In spite of a thorough literature search, [this] committee found little evidence to warrant changes to the conclusions made by [a previous IOM] committee regarding the strength of the association between deployment to the Gulf War and adverse health outcomes," they wrote.
About a quarter of the war's 700,000 veterans developed symptoms after deployment that include chronic headaches, widespread pain, memory loss, persistent fatigue, gastrointestinal problems, skin conditions and mood disturbances.
Researchers have determined that environmental factors, such as chemical exposures in the region, including sarin gas, pesticides and anti-nerve-agent pills, may have played a role in development of diseases among some troops.
Anthony Hardie, a Gulf War veteran and director of Veterans for Common Sense, said the new report refutes earlier studies and is insulting to those who served as well as widows of those who have died from diseases like brain cancer and ALS.
“It’s the same old government theme from the 1990s to deny what happened and deny care and benefits — just when research to understand the illness and identify treatments is finally making real progress,” Hardie said.
Patricia Kime covers military and veterans’ health care and medicine for Military Times. She can be reached at pkime@militarytimes.com