ARTICLE: Injured Gulf War Veteran Uses VA Program to Lose Weight

Written by Kelli Grant, KELOLAND TV - Sioux Falls,SD,USA

(Sioux Falls, S.D.) - Members of the military are often in the best shape of their lives. Basic training can be strenuous and the muscle starts to build and the fat melts away. But as some veterans age, they begin to notice, like most of us, that their military physique ended with the war they were fighting in. But the Sioux Falls VA Medical Center has been working to change that and is giving veterans back the spring in their step.

When we first met Desert Storm Veteran Rodney Merfeld back in December, he had dropped more than 50 pounds.

After being injured during the war, his lifestyle changed. He became limited in what he could do...that is until he found the MOVE program at the Sioux Falls VA.

“The MOVE program keeps me accountable for that. If I'm accountable to somebody else that also helps me a lot,” Merfeld said.

The MOVE program, which stands for Managing Overweight or Obesity in Veterans Everywhere offers a well-rounded support system...including not only dieticians, but also psychologists, physical therapists, pharmacists and social workers.

And it's a program that's definitely needed.

“Three quarters of our veterans are overweight or obese,” said MOVE Program Coordinator Amy Eisenbeisz.

When Merfeld was in the Army, he weighed 275 pounds...he lifted weights daily and was a runner.

But as he aged, his weight crept up...and his heaviest day was when he reached 375 pounds. Now he's back down to 332...but it hasn't been an easy battle.

“I kind of fell off the wagon, I guess if you wanna put it that way..and I gained 20 pounds back,” Merfeld said.

That was after we met him last year...but thanks to the weight-loss program, he's lost almost every single pound he gained.

“It seems to be people are losing the weight and they're doing well and then it's easy to kind of fall off and make it so it's not as much of a priority,” said Eisenbeisz.

But the program is working.

Remember 72-year-old Arnie Tronson? When we met him in December he had already lost 113 pounds. He was almost wheelchair bound...and was on oxygen 100 percent of the time.

“I feel 100 percent better. The VA has been good to me,” Tronson said.

He feels better because that weight just keeps melting away. To date he's lost almost 150 pounds. He started at 444 and is now down to 296.

“Thing just changed my whole life kinda - instead of sitting around doing nothing,” Tronson said.

Now Tronson rarely uses his oxygen and gets around a lot easier.

“I'm volunteering four days a week. That makes me move more and I try to do some at home,” Tronson said.

Both Merfeld and Tronson are committed to the program - attending weekly meetings with other veterans.

“We sit and talk about how much we lost or how much we gained and we kind of give each other moral support with that,” said Merfeld.

Merfeld's goal weight is 291 pounds...it's a goal he's determined to meet and with the MOVE program he's confident he'll get there.

“I'm going to take it a couple pounds at a time. If I lose 2 or 3 pounds, maybe four pounds in a week, then that's good enough for me,” Merfeld said.

And at a celebration at the VA, the veterans were recognized for all of their hard work. The 200 to 250 veterans involved have lost more than 4 thousand pounds. Arnie Tronson was the biggest loser...losing 31 percent of his body weight.

Connecticut Gulf War veteran needs help

Written by Susan Campbell, July 2, 2009, The Hartford (Conn.) Courant

(Hartford, Conn.) From his time as a soldier/mechanic, veteran Carl MacLeod, of East Haven, has encephalopathy, also known as Gulf War Syndrome. He no longer can work at his old job as a plant maintenance manager, and he hasn't been been able to finish work on his fixer-upper in West Haven. His frail parents have moved in with the family, which includes wife Kristy and four of their six children.

The house needs to be accessible -- for his parents and, eventually, for Carl.

Carl still volunteers to help other disabled vets through Disabled American Veterans, and through his work there, the owner of a construction company heard about his plight.

So now Henry Racki, of Rockfall Construction, is stepping in.

"The system had abandoned" the family, said Racki, so he's setting up a renovation project, with a plot plan and master construction plan. He's also securing zoning variances and applying for building permits. It's lke an "Extreme Makeover: Home Edition," says Racki, but there are no television sponsors picking up the tab.

So Racki's looking for church groups, contractors, supply companies, and people who just want to help to donate time, talent, materials, and money to get this family into their home. Racki estimates the entire project will cost $40,000.

If you're interested, contact Racki at 860-790-6291, or at henry@rockfallco.com.

Lessons Learned from Gulf War Syndrome: The Millenium Cohort Study

Courtesy DoD Millenium Cohort website.

The Millennium Cohort Study is the largest prospective health project in military history. It is designed to evaluate the long-term health effects of military service, including deployments. The Department of Defense recognized after the 1991 Gulf War that there was a need to collect more information about the long-term health of service members. The Millennium Cohort Study was designed to address that critical need, and the study was launched by 2001.

Funded by the Department of Defense, and supported by military, Department of Veterans Affairs, and civilian researchers, almost 150,000 people are already participating in this groundbreaking study. As force health protection continues to be a priority for the future of the United States military, the Millennium Cohort Study will be providing critical information towards enhancing the long-term health of future generations of military members.

ARTICLE: From Gulf War Syndrome to Green Surf Boards

Written by Leslie Berliant, Celsias.

Todd Patterson was a Gulf War Veteran and competitive martial artist working in the entertainment industry. In 2002, he found himself getting sick all the time and in constant pain. The doctors couldn’t figure out what was wrong with him. “Here I was, this competitive go, go, go guy and I was bed ridden,” he tells me, “and I didn’t know why. It was the most suicidal I’ve ever been in my life.”

One day his wife met someone from the Veteran’s Administration and got to talking about her husband’s health issues. She came home sure that she finally knew what was wrong with Patterson; Gulf War Syndrome. “She ran down the list and every symptom described me,” Patterson says. Shortly after, he discovered on a vacation trip to Maui that the only activity he could enjoy pain free was scuba diving. When he got back to Los Angeles, his friend Greg Provance suggested he try surfing. “Greg took me out surfing and I was hooked,” Patterson says. “It saved me.”

Patterson was concerned about any additional exposure to toxins, though. And in researching surf boards, he discovered that most boards are made with toxic materials and processes and so-called eco-boards often address one of these processes but not all of them.

Along with Provance and another surf buddy, Trevor Watkins, he decided to start a company, Synergy Surfboards , that would make environmentally friendly short boards, the kind that professional surfers use. “High performance short boards are the biggest offenders,” Patterson says, “because they’re thrown away after a few uses. They’re not designed to last.”

It wasn’t an easy process making an eco-friendly board. The first challenge was replacing the fiberglass that coats conventional boards. “Fiberglass is the thing that will never be green,” Patterson tells me. “The amount of resources it takes is unbelievable. It has to be stored at temperatures that are higher than volcano lava and spun at a rate of 60 miles a minute.” They tried hemp, hemp silk and other renewable materials, but nothing worked.

“At times we thought about just using fiberglass,” Trevor Watkins, a partner in the company who also learned to surf from Greg Provance, tells me. “People said, ‘just do it the regular way and tell them you’re doing it green’.” But Patterson was adamant. “I’m suffering from toxic chemical poisoning, I don’t want to poison myself any further.”

Then one day, about three months ago, they stumbled on the answer; bamboo fabric. They didn’t have enough for the original demo board, so they pieced the material together. They also use plant based resins and recycled EPS foam for their boards. Professional surfers that have tried the board rank it among their favorites. And so, an eco surf board company was born.

Perhaps the most important aspect of Synergy Surfboards is that they want their boards to be price competitive with conventional boards. Most eco boards are in the $1500 range and out of reach for a lot of surfers.

“None of us are tree huggers,” Patterson explains, “but the more we’ve gone this direction, the more aware we become of our environmental impact and the more aware we want to be. Doing this has made me a greener person.”

“There’s no need to make new materials,” Watkins adds, sounding a lot like a tree hugger, “we’ve got plenty already.”

Synergy recently participated in the disabled vets surf camp organized by Operation Amped . And Watkins wants to do more, “I want to educate, volunteer in other countries and spread this knowledge that we have,” he tells me. “It’s not cool to not give away how much surfing has enhanced our lives,” Patterson adds.

LANSING ARTICLE: Family battles VA to get aid for ailing Gulf War vet

Written by John Schneider • Lansing State Journal • July 8, 2009

(Lansing, Mich.) The war chemicals and vaccinations Stephanie Harrist endured in Desert Storm, during the first Gulf War, may or may not have caused, or contributed to, her multiple sclerosis.

Harrist's stepmother, Karen Dunckel of Lansing, said Harrist's doctors have suggested a link. It's unlikely, it will ever be proven, one way or the other, she said.

But there is no disputing the fact that Harrist, a 39-year-old veteran of the U.S. Army, served her country for 10 years. For that alone, her family members argue, she deserves better treatment than she's getting from the U.S. Department of Veterans Affairs.

"It's very frustrating," Dunckel said. "These are the people who fight for our freedom. You hear about them being ignored (by the VA) when they come home. I'm living it."

In a nursing home

Harrist's disease has progressed to the point where she can't walk, feed herself or speak. Since December, she's been in a nursing home in Lowell, east of Grand Rapids.

Harrist's birth mother, Bath resident Brenda Bartkowiak, recently left me a voice-mail message pleading for intervention on behalf of her daughter.

The issue: a wheelchair.

Harrist has one, but it's useless to her because it doesn't provide the support she needs to remain upright in the chair.

"She slides off to the side and bumps her head," Bartkowiak said. "She can't hold her body up."

Approved - in theory

On April 15, after the standard period of bureaucratic delay, the VA authorized a customized rebuilding of the chair to suit Harrist's needs.

But that's where it ended - with an authorization and a promise.

Bartkowiak and Dunckel tell me they they've had dozens of conversations with the folks at the Battle Creek VA Medical Center. They hear about parts on order. They hear about somebody vital to the process being on vacation, or out sick or "dropping the ball."

"I think one department crosses the T's and another department dots the I's and they just can't get together," Bartkowiak said.

Meanwhile, Harrist is pretty much confined to a stationary reclining chair in her room at the nursing home.

My calls to the Battle Creek VA eventually led me to Public Affairs Officer Todd Greenman, who said privacy rules prevented him from discussing the particulars of Harrist's case. However, Greenman added: "We are looking into it. It will receive the appropriate attention."

Bartkowiak and Dunckel said they've heard that before - many times. But nothing ever happens.

"I'm afraid they're just waiting for her to die," Bartkowiak said.

Call John Schneider at 377-1175, send a fax to 377-1298 or e-mail jschneid@lsj.com.

BU TODAY: One in Four Gulf War Vets Suffers Gulf War Illness

Medical breakthroughs: BU experts own the science for landmark report

By Caleb Daniloff

Roberta White, a neuropsychologist and chair of environmental health at the School of Public Health, has been studying Gulf War syndrome in U.S. military veterans since 1991. Photo by Frank Curran

Medical stories transcend all boundaries because all of us — rich or poor, old or young, Mayflower descendant or recent arrival — hope for good health, and need care sooner or later. This week, we revisit some of our intriguing medical reports from the past school year; the insights and breakthroughs they reveal could well shape our lives going forward.

Effectively debunking years of government denials, Gulf War veterans suffering a host of neurological problems scored a huge victory last fall in their struggle to legitimize their medical claims — thanks in part to public health experts at BU.

Comprising leading scientists, medical experts, and military veterans, a congressionally mandated panel charged with shaping federal health research related to the 1991 Middle East conflict has concluded that Gulf War syndrome is a real medical condition and that it afflicts at least one in four of the 697,000 U.S. veterans who fought in Iraq, Kuwait, and Saudi Arabia. The landmark report, presented in November 2008 by the Research Advisory Committee on Gulf War Veterans’ Illnesses to Secretary of Veterans Affairs James Peake, calls on Congress to appropriate $60 million for treatment of Gulf War vets.

“Veterans of the first Gulf War have been plagued by symptoms of ill health, including fatigue, problems with thinking, skin lesions, and gastrointestinal upset, since their return 17 years ago,” says Roberta White, the committee’s scientific director and chair of the department of environmental health at BU’s School of Public Health. “Despite their persistence and severity, these symptoms have often led to no diagnosis in a substantial portion of the war’s veterans.”

The 450-page report, which was prepared under the leadership of Lea Steele, the committee's former scientific director, and released under White, brings together for the first time the full range of scientific research and government investigations on Gulf War illness. The report found that the condition fundamentally differs from stress-related syndromes seen after other wars and states that scientific evidence “leaves no question that Gulf War illness is a real condition.”

The report lays the blame for several health problems on the troops’ exposure to toxins, primarily in two self-inflicted contexts. In anticipation of a chemical attack, the drug pyridostigmine bromide was given to hundreds of thousands of troops. And to battle desert insects, living and dining areas, as well as tents and uniforms, were sprayed with pesticides.

The report also suggests that the U.S. demolition of an Iraqi munitions dump may have exposed 100,000 troops to nerve gas stored at the facility. Gulf War veterans have shown significantly higher rates of amyotrophic lateral sclerosis, a neurodegenerative disease also known as Lou Gehrig’s disease, than veterans of other wars. And troops that were stationed downwind from the demolitions have died from brain cancer at twice the rate of other Gulf War veterans.

For almost two decades, the government and the military have downplayed veterans’ complaints, often referring to it as another form of post-traumatic stress disorder (PTSD). For its report, the research committee evaluated hundreds of studies of Gulf War veterans, extensive research in other human populations, studies on toxic exposures in animals, and government investigations related to exposures in the Gulf War.

“The illness is probably controversial because it’s symptom-based and most veterans don’t have a common medical diagnosis that fits all of their symptoms,” White says. “It may also be controversial because people feel that it’s obvious that war is stressful and therefore stress must be causing the health symptoms, even though this has never been proven. In fact, it’s been discounted in quite a few studies.”

White has been studying Gulf War illnesses since 1993 and served as research director of one of the three initial VA-funded centers on Gulf War illness. Since the early 1990s the U.S. Department of Defense and Department of Veterans Affairs, among other federal entities, have funded SPH studies of Gulf War veterans and the effects of exposure to low-level sarin, pesticides, and pyridostigmine bromide.

The Research Advisory Committee on Gulf War Veterans’ Illnesses has been based at BU since last year.

Caleb Daniloff can be reached cdanilof@bu.edu.

This story originally ran December 3, 2008.

New Funding Focuses on Environmental Link to MS in Gulf War Veterans (2 articles)

Study Shows Link Between Gulf War Service and MS

Written by MICHAEL KUHNE, Johnstown, Penn. Daily American Correspondent

JOHNSTOWN, Pennsylvania — Local veterans and members of the National Multiple Sclerosis Society gathered in the Holiday Inn along Market Street Wednesday to recognize U.S. Rep. John Murtha for securing funds for medical research.

Approximately $5 million has been allocated to the society through the U.S. Department of Defense. Murtha secured the funding through the Congressionally Directed Medical Research Program.

“We’re here to thank Congressman Murtha and to talk about an important program in achieving funding for medical research,” said David Chatel, executive vice president of advocacy for the organization.

The funding has been the result of efforts by society members and veterans seeking more research to answer questions about the disease, board Chairman Robert Bernstein said.

The primary purpose of the event is to understand what MS is, how it affects people and what the society is doing to stop it, he said.

The National Multiple Sclerosis Society attempted to secure an appropriation for research in 2007, but did not. The organization was later recognized by Congress and added to the Congressionally Directed Medical Research Program.

“We recognize the tremendous need for MS research,” Pittsburgh division board member Geoff Kelly said. “We understand our activists have a vision of a world without MS; make no mistake, we will get there.”

Tom Caulfield of the Veterans Leadership Program of Western Pennsylvania stated during his speech that many cases of multiple sclerosis among veterans are linked to combat service. This link is most clear among Gulf War veterans and could be due to a neurotoxin, said Caulfield, who donated $500 to the organization.

National Multiple Sclerosis Society vice president of federal government relations Shawn O’Neail said this could be because there is more data available on veterans from the Gulf War than Vietnam War veterans.

O’Neail said a study of Kuwaiti residents shows the number of multiple sclerosis cases doubling in the last six years, indicating a possible environmental trigger for MS.

The event closed with an award ceremony for Murtha’s contribution and a short speech from activist Angela Gorzelsky, who suffers from the disease. Murtha was unable to attend to the event. The award was accepted by the congressman’s district director, Mark Critz.

“Everything we can do comes from everybody out there,” Gorzelsky said. “It really will make a difference.”

More information about the National Multiple Sclerosis Society can be found online at www.nationalMSsociety.org/PAX or by calling 1-800-FIGHT-MS.

============

Organizations work to raise awareness of MS risk for vets

Written by RANDY GRIFFITH, Johnstown (Penn.) Tribune-Democrat

George “Murph” Neelan of suburban Pittsburgh started losing control of his muscles

24 years ago, and the condition has gotten progressively worse.

Bill Taafe of Duncansville developed visual problems so severe he couldn’t drive and was virtually housebound for eight months in 1979, but he has had few problems since then.

The two men have two things in common: Both are veterans and both have multiple sclerosis.

And both were in Johnstown on Wednesday for a town hall meeting to raise awareness of the need for multiple sclerosis research and the possible threat to military veterans of combat.

“We have a strong indication of a link between combat-service veterans and MS,” said Tom Caulfield, regional coordinator for the Veterans Leadership Program of Western Pennsylvania and director of Veteran Community Initiatives in Cambria County.

Those who fought in the first Gulf War in particular have elevated rates for multiple sclerosis, he said.

About 28,000 veterans are receiving care for multiple sclerosis through the Veterans Adminstration, Caulfield said.

An estimated 5,300 cases are thought to be service-connected.

But only about one in three eligible veterans receives health care through the Veteran’s Adminstration, Caulfield said.

“Some of the research we want funded would find out who some of these other veterans are,” he said.

In the past few years, funding available for multiple sclerosis research has dropped even as the incidence of the disease has increased, David Chatel, National Multiple Sclerosis Society’s executive vice president for advocacy, told the audience at the meeting in Holiday Inn-Downtown, 250 Market St.

Backed by national veterans’ groups, the society was able to have $5 million for research added to the Defense Department’s budget.

The society is asking for $15 million next year.

Research is vital, Neelan said.

“I came here to give support,” he said. “These grants for research can help find a cure.”

The Multiple Sclerosis Society provides vital support for those dealing with the neurological disease, he said.

“I say am the luckiest man in the world because I have had so much help and support from the MS Society and my friends and family,” Neelan said.

Israeli Conference Focuses on Central Nervous System Damage by Chemicals

Coping with a toxic world

July 4, 2009
Written by JUDY SIEGEL-ITZKOVICH, The Jerusalem Post

There are some 80,000 man-made chemicals in the industrial environment, but only a handful of them - lead, mercury manganese, acrylamide, organophosphates, heavy metals and organic solvents - have been fully tested for potential health risks.

Prof. Donald Fox (left) of Houston and Prof. Yoram Finkelstein of Jerusalem.
Photo: Judy Siegel-Itzkovich

The realization that chemicals can damage the central nervous system is not very old, so there are not many specialists with extensive knowledge of both neurology and toxicology. Eighty of these interdisciplinary experts from 16 countries, including the US, Israel, Nigeria, Japan, Estonia, Poland, Spain, Italy, the UK, India and France met last month at the Kibbutz Ma'aleh Hahamisha Guest House outside Jerusalem to discuss the latest discoveries in the field. Few of the foreign participants had ever been here.

The five-day biennial meeting of the International Neurotoxicology Association (INA) focused on Gene-Environment Interactions in Neurotoxicology and was co-chaired by Prof. Yoram Finkelstein, director of the unit of neurology & toxicology at Jerusalem's Shaare Zedek Medical Center, and by Dr. William Boyes, INA's president. The chairman of the scientific advisory committee was Prof. Donald Fox, an expert in vision science, biology, biochemistry and pharmacology at the University of Houston in Texas.

The INA, with 300 paying members - including fewer than 10 Israelis - aims to promote science and communications among countries and foster the education of medical students. It was the 12th biennial conference, and the first outside the US or Europe.

The aim of the conference was to promote greater awareness of chemicals' adverse effects on the nervous system, update experts on the latest research and provide information to regulators. Over 70 papers were delivered on subjects ranging from how children's exposure to agricultural pesticides may be responsible for the increase in attention deficit to how chronic exposure to organic solvents can lead to schizophrenia and depression. They looked at interactions between genetic inheritance and exposure to toxins, policies to reduce exposure, and how to prevent damage to health.

FINKELSTEIN has worked a great deal on the effects of chemicals on the retina and brain, especially in animals during gestation and shortly after birth. Neurotoxicology, he said in an interview, "is a combination of two very different fields, so there aren't many who specialize in it. As far as I know, I am the only physician in Israel who deals with it."

He studied neurology at Haifa's Technion-Israel Institute of Technology's Rappaport Medical School, and went on to the Weizmann Instite of Science in Rehovot to study neurochemistry. Moving to the Rambam Medical Center, he worked at its National Poison Control Center, where experts receive calls from doctors and the general public - especially parents - who fear that someone was poisoned. Finkelstein later moved to Jerusalem and joined Shaare Zedek, where he has been for two decades.

Fox, who was born in Cleveland, went to California for his postdoctoral work, and then to Texas to conduct research. Unlike other foreigners at the conference, he has visited Israel four times.

Although pulverized asbestos in the air and other pollutants can cause disease in the lungs and other organs, Fox specializes in substances from chemical and pharmaceutical industries, and chronic damage rather than acute injury. "Half of all long-term, low-level toxicity is related to the body's neurological system, because it is much more complex and has more cell types, with every part of the system susceptible, but at even lower concentrations."

Fox said 900,000 inner-city children in Washington, DC were affected by lead. The use of lead paints in the US was prohibited in 1959, so lead poisoning of US slum children from paints on furniture and peeling walls is much less common now, but low-level lead poisoning from lead water pipes, industrial air pollution and other sources "is most insidious. About 80% of learning disabilities result from levels of lead the US government say are safe."

The element, which has a sweet taste and thus is happily chewed by children, doesn't decay. "It remains in the dust, in the air, in the water - especially in poor areas. It accumulates in the bones. And children who were exposed to lead have grown up and are having children now, and they too can be affected," Fox explained.

Fox also noted that for many years, there were toys painted with or containing lead. "It doesn't kill children, but it can cause irreversible sensory, motor and cognitive deficits. Acute toxicity of a variety of chemicals can cause death, but we are mostly interested in the effects of long-term low levels."

The trigger for damage can appear in the fetus if the mother is exposed to toxic chemicals, but the effect can also appear decades later, said Finkelstein.

Harmful heavy metals are mostly found in factories, he said, but can also be found in nature. Volcanoes such as Krakatoa in Indonesia spread toxic heavy metals by air currents. Yet man-made chemicals that can damage health go back to the beginning of human history. "In the time of the pharoahs, lead was used for making ceramics, and was also put into makeup," said Finkelstein.

Toxic chemicals can cause symptoms that usually occur in chronic disease, such as parkinsonian tremors. Fox notes that there were very few cases of Parkinson's before 1817, when it was named - largely because people died at much younger ages from pre-antibiotic infections. But exposure to manganese or chemical solvents can create Parkinson-like symptoms. The condition called "Gulf War syndrome" suffered by US soldiers in Iraq was due to chemical exposure there, he continued.

The expert from Texas said he would not bar the use of very toxic chemicals but regulate them to prevent exposure to at-risk populations such as pregnant women, young children, the elderly and people with chronic disease or weak immune systems.

"Individuals with such disorders have to be supervised and treated differently when exposed to pollutants."

Fox, who lives two kilometers from downtown Houston, said he was well aware of pollution's toll in most city centers. "Although gasoline is cleaner today, cars still produce sulphur dioxides, nitric oxides and other dangerous particles. When water hits them, it becomes a source of acid rain. The US authorities allow 50 parts per million of arsenic in the water, but legislators are working to bring it down."

POLLUTION in China and India, with their huge populations, increased industrialization and growth in gas-powered vehicles, is growing daily, Fox continued. "India's city of Bangalore alone has 20 million people, with 3,000 new cars registered daily and no pollution controls. Environments are usually not protected during the initial stages of capitalism, so developing countries do not require catalytic converters."

Both Finkelstein and Fox use animals for research, and the animals are "brainier" species like cats or dogs. Instead, neurotoxicologists often use flies, worms, rats and zebrafish - which are commonly found in aquariums and have black and white stripes. "The brain and eyes of this little fish and man's surprisingly have a very similar biology," said Fox. "We have a lot of data on zebrafish."

Finkelstein continued that neurotoxicologists do their best to test without animal models. "We have a very good relationship with anti-vivisectionist organizations, as we are on their side. Cosmetics are quite safe in Israel, and are no longer tested for toxins because risky substances in the industry are gone."

The effects of chemicals on people are not uniform, Fox continued. "African Americans metabolize certain drugs differently than Caucasians. Diet also influences interaction with chemicals. Low-level lead exposure produces delayed-onset obesity only in male animals, so reaching conclusions about the effects of chemicals is very complicated."

In Israel, pesticides were a serious problem. The Health Ministry used to issue bulletins regularly when bug killers were used in excessive doses for strawberries. But today, pesticide use has declined somewhat due to natural enemies of bugs, as well as increasing public demand for low levels of pesticides and more organic products. Knesset members are also more aware of the dangers, said Finkelstein.

In the US, concluded Fox, "there are federal laws that set priorities for the testing of chemicals. Everybody wants to be protected, but politics and big money often interfere with the legislative process."

Fox concluded that the INA is "pleased to have its conference in Israel for the first time. We want to collaborate with our Israeli counterparts to develop the field. We hope that more legislation to protect the public from chemicals will be passed and that individuals and institutions will become more aware of the long-term effects of low-level exposure."

Research Advisory Committee on Gulf War Veterans' Illnesses Finds Path Towards Possible Treatments for Gulf War Illness

Written by Anthony Hardie, 91outcomes

(91outcomes.blogspot.com) - Today, the federal government for the first time ever held a day-long session hearing scientific and medical presentation on treatments for Gulf War Illness, with extraordinary results.

The federal, Congressionally chartered Research Advisory Committee on Gulf War Veterans' Illnesses is meeting at the Boston University School of Public Health today and tomorrow to review scientific and medical information on this timely, pressing topic.

However, since no members of the media were interested enough in this issue, the only place you'll find news about the day's proceedings is 91 outcomes (http://91outcomes.blogspot.com), which today has eight new articles summarizing each of the day's presentations in plain, easy to understand language.



Please feel free to review, share, post, redistribute, link, republish, or otherwise spread this critically important news -- the goal of 91outcomes is simply to get accurate, timely, important information on Gulf War veterans' health out to the Gulf War veterans, their advocates, and their loved ones. If you do republish it, please just provide a link back to 91outcomes so interested parties can continue to get news on Gulf War veterans' health. If you want to link or otherwise provide direct access to 91outcomes from your organization or other website, this email constitutes specific and welcomed permission to do so -- Gulf War veterans aren't getting any news from VA about the issues that matter to them about their ongoing, disabling illness, so it's available here.

As you may know, 91 outcomes is neither a for-profit nor a non-profit enterprise -- it's simply a labor of love in order to fill a gaping void in news and information available to the 175,000 to 210,000, or about one-fourth of Gulf War veterans who have been ill and remain ill following our 1991 Gulf War service.

VA Notes Preliminary Research Success, Justifies Violation of Charter Requirements

Written by Anthony Hardie, 91outcomes

(Boston, Mass. - June 29, 2009) In a meeting of the Congressionally chartered Research Advisory Committee on Gulf War Veterans' Illnesses, Dr. William Goldberg of the federal VA's Office of Research and Development provided an overview of the VA's recent Request for Applications for research funding for Gulf war Illness Treatments.

He also noted the recent success small treatment trial for Gulf War Illness.

The VA-funded treatment trial involved the use of a Continuous Positive Airway Pressure (CPAP) machine in Gulf War veterans suffering from Gulf War Illness. While only "about four to eight veterans" participated in the study, the results were significant, albeit preliminary. The findings showed improved fatigue and cognition in Gulf War veterans suffering from Gulf War Illness.

Responding to a question from RAC Chair Jim Binns regarding why VA failed to adhere to the RAC's Charter, which requires that VA's research funding announcements must be provided to the RAC prior to issuance, Dr. Goldberg stated that the VA had to provide the Request for Applications quickly, and "literally wrote it in a matter of days."

According to the Charter of the Congressionally Chartered advisory committee, written consistent with the federal law creating the body,
Applications for the RFA are due July 15, 2009 and are accepted only from VA researchers. According to Dr. Goldberg, the VA therefore made the determination to make the RFA available only internally on the VA's Interanet, and not publicly on the Internet.

The RFA was made public on 91outcomes on June 25.

The Committee shall review all proposed [emphasis added] Federal research plans, initiatives, procurements, grant programs, and other activities in support of research projects on health consequences of military service in the Southwest Asia theater of operations during the 1990-1991 Gulf War. The Committee, consistent with law, shall have access to all VA documents and other sources of information it finds relevant to such review.

Improving the Quality of Life -- One Physician's Experiences in Treating the Symptoms of an Illness that has No Effective Treatments

Written by Anthony Hardie, 91outcomes

(Boston, Mass. - June 29, 2009) Dr. Meryl Nass, a practicing physician at the Mt. Desert Island Hospital, in Bar Harbor, Maine has learned through practice that since there is no recognized treatment or set of treatments for her Gulf War Illness patients, she has sought to find what works, focusing on treating the symptoms and trying treatments that treat similar illnesses known to work. Her goal is simple: improve the patient's quality of life.

In a study presented today in Boston before the federal Research Advisory Committee on Gulf War Veterans' Illnesses involving a records review of 20 of her Gulf War patients, 15 male and five female, Dr. Nass noted her findings included a host of diseases, illnesses, conditions, symptoms, and difficulty communicating.

Many other conditions were noted, including tinnitus, recurrent oral ulcers, and other firmly diagnosed conditions, rather than self-reported conditions.

She noted that the group of ill Gulf War veterans had an average of 13 diagnoses each, "which you don't see in other parts of the world," said Dr. Nass.

One-fourth had Type 2 diabetes, and many of them had hypertension. What struck Dr. Nass as unusual, however, was that those patients were mostly male, mostly non-obese, and were diagnosed with these conditions in their 30s -- all highly unusual for the conditions.

She found that central sleep apnea was common among her study group of ill Gulf War veterans.

Severe nausea, vomiting, or diarrhea was common in forty percent of her patients.

Dr. Nass noted that many of these veterans have Multiple Chemical Sensitivity, including to detergents, solvents, paints, glues, and many others. She has frequently seen food sensitivities in her patients with Multiple Chemical Sensitivities, which requires an elimination diet to determine what foods are impacting negatively on the patient.

Dr. Nass has found in her clinical practice that no one pharmaceutical or single group of pharmaceuticals has proved to be particularly useful for fibromyalgia, which she called, "a surrogate" for Gulf War Illness. However, while she said that treating fibromyalgia patients through a multi-system approach is often quite successful, she candidly noted that success in treating Gulf War Illness patients has been only about "30 to 40 percent" for whom quality of life was improved, though not enough so that they could go back to work.


Treating the Symptoms

In the absence of proven treatments for the underlying Gulf War Illness condition, Dr. Nass has seen "countless" Gulf War veterans suffering from Gulf War Illness. In seeking to improve their quality of life, Dr. Nass has combined a variety of approaches, using "patient-centered care", which she says is necessary because so many Gulf War Illness patients have difficulty remembering, particularly complex instructions.

She tries a comprehensive approach, including treating pain, sleep, nutrition, gastointestinal complaints, saying, "treat everything you can." Those treatmens include treating the symptoms of debilitating fatigue, cognitive issues, chronic pain, and respiratory, gastro-intestinal, and immunological problems among others.

Her methods also include having appointments that last longer than usual, providing handouts and writing exactly what care is needed, which is often complex -- necessary because of Gulf War Illness patient's significant cognitive issues.

She also uses a pain questionaire developed by the manufacturer of Oxycontin in order to assess the level of pain, which is a primary symptom for many veterans suffering from Gulf War Illness. She also creates a complete problem list that is used as a continuing guide to treatment.

And, Dr. Nass explains that it's important to test for conditions with similar symptoms, like Lyme Disease, Vitamin B-12 deficiency, thryoid function issues, and other problems unique to each patient.

"Every veteran is also emotionally wounded," says Dr. Nass, which requires especially compassionate care, a thorough review of the veteran's often extensive medical records, and geting a "good feel" for the patient and family.

She noted that she was surprised that while thyroid function appears normal in Gulf War Illness patients, prescribing thryoid hormone at about one-third the level normally produced by the thyroid has significantly reduced pain and some other symptoms in a number of her Gulf War Illness patients. She says it remains unclear why the veterans' thyroid hormones simply don't stop functioning.

During questions following her presentation, it was noted that the high levels of GERD (Gastro-esophageal Reflux Disease) in Gulf War Illness patients lead to the common prescription of proton pump inhibitors (PPIs), which can then result in a Vitamin B deficiency in Gulf War Illness patients. The Vitamin B deficiency then must also be treated.. Examples of PPIs include Prilosec, Prevacid, Aciphex, and Protonix.

She noted that sexual dysfunction in males with fibromyalgia has been successfully treated with biweekly testosterone injections. She has prescribed narcotic pain medications and ritalin -- usually used primarily for attention deficit -- with success in Gulf War Illness. She notes that she always addresses the psychological aspects of having a chronic multi-symptom illness like Gulf War Illness.

Dr. Nass stresses that she must write everything down for Gulf War Illness patients (but not fibromylagia patients) due to the memory loss and cognitive issues, and she retains a copy as the treating physician.


Limited but Important Successes

One Gulf War Illness patient Dr. Nass described from her Mt. Desert Island Hospital practice was still working, would overdo it, then stay several days in bed, then repeat the cycle.

While he's not able to return to the workforce, several of his symptoms have improved, he is now able to work physically two to four hours per day, he now has a good self-image, and his family life has improved -- in short, true to Dr. Nass's goal as a physician, his quality of life has improved.

Treatments may be ready for Gulf War Illness Treatment Trials

Written by Anthony Hardie, 91outcomes

(Boston, Mass. - June 29, 2009) Treatments for Gulf War Illness (GWI) may already be available and ready for testing in treatment trials, said Dr. Keith Kelley during a presentation today in Boston before the federal Research Advisory Committee on Gulf War Weterans' Illnesses.

Kelley is Professor of Immunophysiology in the Integrative Immunology and Behavior Program and Neuroscience Program and the Department of Animal Sciences at the University of Illinois at Urbana-Champaign.

During his presentation, entitled, The role of neuroinflammation in chronic illness, Dr. Kelley explained what it actually means "to be sick" from a scientific perspective, which includes increased temperature, decreased social and physical activity, and other effects, and noted that many of these correlate with key aspects of the current definition of Gulf War Illness, including affected learning and memory, mood changes, and unrelenting fatigue.

While there is currently a lack of treatments for Gulf War Illness, Dr. Kelley said he believes that the current neuroinflammation hypothesis of Gulf War Illness is worth testing because FDA-approved drugs to reduce neuroinflammation from pre-clinical animal studies are available. According to Dr. Kelley, neuroinflammation reduces appetite, motivation, increases exhaustive fatigue and sensitivity to pain, causes deficits in learning and memory, and induces depressive-like behaviors.

Dr. Kelley suggested that potential treatments that would be valuable to study with regards to the neuroinflammatory model of Gulf War Illness may include:

• Antibiotics
• New drugs for fibromyalgia
• Botanicals
• HMG-CoA reductase inhibitors
• Diet--soluable fiber (which increases Interleukin-1 (IL-1) expression in the brain)
• IDo Inhibitors now in Phase I clinical trials
• Exercise

According to Dr. Kelley's biography, his research interests include proinflammatory cytokines and hormones in the brain and in cancer and muscle cells:

"For the past 30 years, our laboratory has been involved in defining reciprocal systems of communication between the immune and central nervous systems. We currently are interested in defining receptor signaling pathways that occur following activation of receptors for both proinflammatory cytokines and growth factors in the brain and the periphery and the role of inflammation in mental health disorders. For the former, we have discovered the existence of intracellular crosstalk between receptors for proinflammatory cytokines (TNFalpha, IL-1beta) and hormones (IGF-I) in a variety of cells. This interaction reduces the ability of growth factor receptors to function in the presence of very low concentrations of proinflammatory cytokines.

"The result is that the biological response of cells to a growth factor, whether it is the proliferation of cancer cells or the differentiation of muscle progenitor cells, is reduced in the presence of proinflammatory cytokines. Collectively, these data show that the biological properties of a classical hormonal growth factor receptor are directly regulated by proinflammatory cytokines from the immune system. For the second major emphasis in our laboratory, major research projects are aimed at determining the actions of proinflammatory cytokine receptors that are involved in sickness behavior, depressive-like behavior and memory. Brain inflammation causes symptoms of sickness that are usually associated with microbial infections, which is likely to make an important contribution to the comorbid behavioral and psychological disturbances that occur in the elderly.

"We have shown that IL-1beta and TNFalpha serve as communication molecules between the immune and central nervous systems. In contrast, anti-inflammatory cytokines in the brain, such as IL-10 and IGF-I, reduce behavioral symptoms of sickness following infection. We now are exploring the influence of aging on development of depressive-like behaviors in mice because one in five individuals over the age of 65 suffer from depressive disorders. This is more than twice the prevalence found in the general population.

"A likely mechanism for the increased prevalence of depressive disorders during aging is a reduction in the synthesis of serotonin, a key neurotransmitter in the regulation of mood, caused by proinflammatory cytokines acting in the brain. This action is mediated by immune-induced activation of the tryptophan-degrading enzyme, indoleamine 2,3 dioxygenase (IDO). This process decreases the bioavailability of tryptophan for the synthesis of serotonin.

"We are measuring IDO enzymatic activity, tryptophan and its metabolism (serotonin, 5-HIAA, kynurenine) in discrete brain regions of aged mice given either LPS or BCG. The major health impact of our research is directed at cognitive function, affect and muscle wasting in AIDS, cancer and aging."

Immune System in Ill Gulf War Veterans "Remodeled", Research Shows

Written by Anthony Hardie, 91outcomes

(Boston, Mass. - June 29, 2009) Research findings show immune system "remodeling" in blood and saliva samples of ill Gulf War veterans, including clear abnormalities in their immune system function and response and neuroendocrine balance, said Dr. Gordon Broderick of the University of Alberta in a presentation today in Boston before the federal Research Advisory Committee on Gulf War Veterans' Illnesses.

Using highly detailed data and analyses, the study found that GWI subjects can be distinguished from healthy veterans (and from CFS) by their neuroendocrine-immune status, and that differences can be amplified by studying response to exercise by looking for diagnostic features and illness processes.

At the intracellular level, Interleukin-5 (IL-5), Tumor Necrosis Factor-alpha (TNFa), and IFN were substantially elevated, as was Interleukin-6 (IL-6) plasma in vivo. The level of cytokines as a broad sectrum response -- which are a marker of inflammation in the body -- is greatly increased in Gulf War veterans with GWI with relation to key immune system markers following exercise .

GWI subjects are distinct in their immune response to excercise, and most significant at rest. The findings note that cytokines in combination and across time are are entirely distinct between the GWI and control groups, leading to an ability to precisely identify those suffering from GWI using their immune system markers found in the blood.

At the cellular level of Gulf War veterans with GWI, the research found that their immune system does respond to an exercise challenge, but its response is significantly more diffuse and
disorganized than the immune response among healthy study controls.

The research suggests that the team may have developed a working model for diagnosing Gulf War illness through neuroendocrine-immune system markers in ill Gulf War veterans' blood and saliva. Dr. Broderick believes that his research will help lead to treatments for Gulf War veterans suffering from Gulf War Illness.

Dr. Broderick's current research on Gulf War Illness is funded by the U.S. Department of Defense Congressionally Directed Medical Research Program.

Gulf War veterans' blood shows illness worsens with exercise

Written by Anthony Hardie, 91outcomes

(Boston, Mass. - June 29, 2009) Research findings presented today in Boston to the federal Research Advisory Committee on Gulf War Veterans' Illnesses noted similarities between Gulf War Illness and Chronic Fatigue Syndrome. Most significantly, the research findings showed that following an exercise challenge, Gulf War veterans had genetic and other measurable biological markers showing not only significant abnormalities related to pain, sensory perception, and the functioning of the immune and endocrine systems, but that these abnormalities dramatically worsen following exercise.

Dr. Nancy Klimas, a distinguished researcher in Chronic Fatigue Syndrome (CFS/ME), Gulf War Illness, and related health issues who is at the Miami, Fla. VA Medical Center, today presented her team's research findings in a public presentation entitled, Impaired immune function in Gulf War Illness.

Her most recent study involved issues surrounding the study of multi-symptom illness with a multi-system pathogenesis, which are the same for GWI and CFS. The study involved an exercise stressor model, with sampling before, at peak, and four hours after an exercise challenge using an exercise bike and a VO2 submax challenge. Blood and saliva samples were taken throughout from the matched ill Gulf War veterans, Chronic Fatigue patients, and health controls. A comprehensive set of genomic and other data was developed from the samples.

CD26+ lymphocytes were found to be elevated in both CFS and GWI, with the highest level in GWI. The findings also showed a reduced sDPPIV/CD26 in blood plasma, even more reduced than in CFS, which is reduced from the healthy population.

Preliminary findings in new, ongoing research further suggest that in ill Gulf War veterans, hundreds of genes are abnormal at baseline, during an exercise challenge, and at four hours following exercise, with the abnormalities worsening to nearly double at rest following exercise. It is notable that these findings correspond with the reported experiences of ill Gulf Ware veterans. Pain, sensory perception, and numerous immunological, endocrinological and other processes were abnormal following the exercise challenge.

While these finding are only preliminary, they suggest that there are significant abnormalities in Gulf War veterans' inflammation, fatigue, and other symptoms, that they are much more abnormal than the abnormalities found in CFS patients. They also show that unlike CFS patients, whose abnormalities drop back nearer to normal after resting following exercise, Gulf War veterans get steadily worse.

Dr. Klimas bases her conclusions on the research finding, concluding that CFS and GWI are similar, but GWI patients are sicker. Perhaps most significantly, and unlike CFS patients, GWI patients "fail to recover" following an exercise challenge, instead dramatically worsening.

Dr. Klimas agreed that it is unclear whether the findings show the disease itself or the results of GWI. However, she believes that ongoing research will show the way to GWI treatments.

According to the official biography for Dr. Klimas:

Dr. Klimas, a director of the laboratory, is board certified in internal medicine and diagnostic laboratory immunology. She is also the director of the Allergy and Immunology Clinic, and is a
licensed laboratory director in Florida. Dr. Klimas is Director of Research for the Clinical AIDS/HIV Research at the Miami Veterans Affairs Medical Center.

A leader in the field of Chronic Fatigue Syndrome (CFS) research, Dr. Klimas is the current President of the International Association for Chronic Fatigue Syndrome. Dr. Klimas is the principal investigator of the National Institute of Health's (NIH) Center for Multidisciplinary Studies of CFS Pathophysiology at the University of Miami. Dr. Klimas has been appointed to the inter-agency CFS Coordinating Committee, chaired by the Surgeon General of the United States. She is the founding editor of the Journal of Chronic Fatigue Syndrome. Recent publications include 123 peer reviewed papers, 3 books and 19 invited chapters.

Minneapolis VA Study Shows Blood Abnormalities in Ill Gulf War Veterans

Written by Anthony Hardie, 91outcomes

(Boston, Mass. - June 29, 2009) Gulf War veterans have measurable blood abnormalities related to chronic inflammation and abnormal immune responses, according to a ongoing research finding presented by Dr. Ronald Bach, Ph.D, FAHA, of the Minneapolis VA Medical Center, at today's RAC meetings at the Boston University School of Public Health.

Dr. Bach noted that the unusual Tissue Factor findings, found while screening for biomarkers of illness in Gulf War veterans, are related to chronic inflammation and immune response abnormalities in Gulf War veterans. According to Dr. Bach's ongoing research, there are notable abnormalities in tissue factor and chronic coagulopathies, suggesting the possibility of a hyperactive coagulation in the blood of ill Gulf War veterans.

Earlier research included a review of chronic symptoms and medical records of study participants, and sowed significantly increased blood levels showing higher coagulatory measures in ill Gulf War veterans, concluding that there was indirect evidence of coagulation system activation in Gulf War veterans and direct evidence of significant abnormalities.

Dr. Bach stated that his research finding are "unprecedented," with most Gulf War veteran subjects enrolled in the study had abnormally high levels of thrombin-antithrombin complex, high levels of thrombin-antithrombin complex, D-dimer, and factor VII antigen, resulting in a hypercoagular state. Dr. Bach concluded that these unusual findings may represent a heretofore unknown state of blood coagulation among ill Gulf War veterans, and may serve as a diagnostic biomarker for ill gulf War veterans.

His ongoing research goals are to be able to diagnose Gulf War Illnesss with blood tests, and to evaluate potential therapies that would help ill Gulf War veterans.

Dr. Debra Buchwald, Professor of the University of Washington Department of Medicine, Director of the Center for Clinical and Epidemiologicl Research, and a newly appointed member of the panel, noted concerns about the definition and concerns that some veterans with other veinous, thrombotic and related conditions might be misdiagnosed with these biomarkers. Dr. Bach responded that only one tissue factor "jumped out," that the Gulf War veterans he studied were not suffering from these conditions, and and that the Gulf War veterans in the study are a different kind of chronic "compensatory" process whereby the factors being measured are perpetually increased to compensate for something unique in ill Gulf War veterans.

Dr. Bach noted that his funding for new research, funded though a scientist- and Gulf War veteran-reviewed research funding process of the U.S. Department of Defense Congressionally Directed Medical Research Program, begins on July 1st, and his further studies are expected to reveal more about these "significant" abnormal findings in the blood markers in ill Gulf War veterans.

Dr. Meryl Nass, an attendee at the advisory committee review, noted her concerns about one of the measured factors, D-dimers. However, Dr. Bach responded that while he shares this concern, that the other measurable abnormalities are "significant".

Dr. Bach and his reasearch team continue to seek additional Gulf War veterans near Minneapolis, Minn. for the ongoing research. Dr. Bach can be contacted at ronald.bach@med.va.gov.

Harvard Study Shows Increased Symptoms in Kuwaitis that Mirror Gulf War veterans' symptoms

Written by Anglico.
Monday, June 29, 2009.

(Boston, Mass. - June 29, 2009) University Professor Dr. Douglas Dockery of the Harvard University School of Public Health kicked off the RAC's morning presentations with a presentation on Harvard's Kuwaiti oil well fire studies.

Beginning in 1991, Harvard researchers on the ground were measuring environmental impacts of the Kuwait oilwell fires. Later that year, Harvard organized an international conference on the
health effects of the oil well fires and environmental contamination.

The first Kuwait oil well fire was on February 10, 1991, about two-thirds of the way through the 1991 Persian Gulf War, which began in the early morning hours of January 17 of that year and
ended on February 27. Most of the oil well fires were ignited by Iraqi forces in late February 1991, as they retreated in advance The last of the oil well fires were finally extinguished on
November 6, 1991.

Dr. Dockery noted several unique characteristics, including that Kuwait keeps a complete registry of Kuwaitis from birth to death, which were carried safely out of the country at the time of the invasion and that Kuwait paid a stipend to Kuwaitis who remained in country during the invasion and occupation, thereby allowing for easy identification of those who were thus exposed to Gulf War environmental hazards during the war.

According to Dr. Dockery, who serves as Chair of Harvard's Department of Environmental Health, and Professor of Environmental Epidemiology, 37 percent of the 576,861 Kuwaitis received a stipend for having stayed in Kuwait during the invasion and occupation showing which Kuwaitis were remained in Kuwait and had Gulf War exposures. Most of that population centered in Kuwait City and along the coast. About two-thirds of the Kuwaiti population were non-nationals, and most left during the war.

Harvard conducted a public health study, including face-to-face interviews at home between December 3, 2003 and January 29, 2005, with interviews of next of kin for those who were
deceased or unable to answer. The extensive survey included the location of residence during the invasion and occupation, what their experiences were during that time, medical symptoms
before and after the invasion, and date of death for those deceased, and a comprehensive health history.

The study noted symptoms related to trauma and stress, including increased rates of heart attacks, colitis, and Post-Traumatic Stress Disorder (PTSD) symptoms. Increased rates of Chronic Obstructive Pulmonary Disease (COPD) were also noted among those with high Gulf War trauma and stress.

The study showed a host of increased health conditions and symptoms, unrelated to trauma and stress, in the Kuwaiti population who remained during the invasion and occupation. The highest rate of symptoms included fatigue, including severe fatigue, headaches, joint pain, and moodiness. Other conditions that were ranked high included sleep problems, unwellness after exercise, feeling not rested, muscle and body pain, dizziness, light sensitivity, breathing trouble, problems concentrating, memory problems, depression, irritability, anxiety, sinus problems, hand-shoulder and arm or leg pain, back problems, and gas.

It was noted by a member of the RAC that nearly all of these symptoms and conditions are among those most commonly reported among Gulf War veterans.

Anthony Hardie, a Gulf War veteran member of the panel, noted that he and "countless other Gulf War veterans" in Kuwait following the war experienced oil well fire smoke so thick it could be seen "in front of [his] hand" as it wafted by. He noted that his location was near the Kuwaiti International Airport in heavily populated Kuwait City, and that all the symptoms ranked as high were virtually the same as experienced by him and countless other ill Gulf War veterans.

According to Dr. Dockery's Harvard University School of Public Health biography:

Dr. Dockery and his colleagues have studied the health effects of air pollution exposures in populations who have been followed for up to twenty-five years. That research has increasingly
pointed to combustion-related particles as being causally linked to increased morbidity and mortality even at the relatively low concentrations observed in developed countries today. Dr.
Dockery and his colleagues have reported that episodes of particulate air pollution are consistently associated with increased daily mortality, increased hospital admissions and emergency room visits, exacerbation of asthma, increased respiratory symptoms and lower lung function. Long-term follow-up studies have shown particulate air pollution is associated with shortened life expectancy in adults and increased chronic respiratory illness and lower lung function in children. This research has led to the current debate on the role of particulate air pollution in producing adverse effect effects and to the re-evaluation of air quality standards both nationally and internationally.

Dr. Dockery's current research is attempting to more specifically identify the chemical and physical characteristics of those particles responsible for the observed adverse health effects. Current studies also are attempting to understand the pathways of acute cardiovascular events associated with air pollution exposure and to link these epidemiologic finding with toxicologic studies of particle effects. He also is assessing the health benefits of air pollution controls.

In addition, the methods developed to assess air pollution health effects epidemiologically are being applied to other environmental hazards including contamination of water supplies.