VA Ups Focus on Gulf War Illness

As thousands of soldiers from the war in Iraq stream home reporting myriad health problems, the government is now refocusing its research on illnesses among veterans from the first Persian Gulf War, over a decade ago.

Among the recent changes, the Department of Veterans Affairs (search) announced it will be putting $15 million over the next year into defining and treating maladies that could have been caused by exposure to dangerous neurotoxins in the 1991 war.

Gulf War veteran Steve Robinson, who sat on the panel that made the recent recommendations to the VA that resulted in the added research dollars, said this development will also help to ensure that current Iraq veterans will not have to wait so long to get the attention they need.

"There are thousands of soldiers coming home sick," Robinson said. "But we are smarter today than in 1991 about what those illnesses are. Back then, when we came home they thought that the illnesses were all in our heads."

According to the Department of Defense, as of Nov. 22, 21 percent of the 361,226 active duty soldiers who have deployed and returned from service in Iraq and Afghanistan since January 2003 have reported medical concerns. The top five concerns include dental, orthopedic, mental health, dermatological and pulmonary ailments. Twelve percent said they were concerned by some of the environmental exposures they experienced in the field.

As for the 190,569 reserve and National Guard veterans who have returned, 37 percent reported medical problems, with 21 percent of those reporting concerns of exposures.

According to VA statistics reported in July, about 16 percent of the soldiers returning from Afghanistan and Iraq had sought treatment since they left active duty service.

Of those, 21 percent were suffering from "symptoms, signs and ill-defined conditions," but most were complaining of back and joint pain, mental health issues and diseases of the digestive system. Also high on the list were problems related to the nervous and respiratory systems.

Meanwhile, thousands of soldiers from the first Gulf War are still suffering from severe symptoms that have been linked to what is now known as Gulf War illness (search), say veterans advocates. The recent move to shift money into finding out what it is many of the 697,000 troops from the war were exposed to — as opposed to linking their symptoms to combat stress — marks a shift that took nearly a decade.

"It is very significant in that the department not only plans to increase the research but will focus its research on developing treatments and no longer fund research for stress-related theories for Gulf War illness," said Jim Binns, a former Defense Department official and chairman of the Research Advisory Committee on Gulf War Veterans' Illnesses (search).

Binns' panel reported this month that it had found a probable link between Gulf War illness and the exposure of soldiers to a number of environmental factors, particularly neurotoxins (search), which can include everything from the nerve gas dispersed when troops destroyed Iraqi chemical weapons bunkers to the pesticides and inoculations given to soldiers to prevent them from getting sick.

The panel, which was appointed by VA Secretary Anthony Principi (search) in 2002, consists of four Gulf War veterans, seven scientists and Binns, who is a Vietnam War veteran. They concluded in their report that little evidence supports the theory that the chronic symptoms veterans have been reporting since the war ended in 1991 — everything from fatigue and memory loss to chronic joint pain and a rare form of Lou Gehrig's disease — are due to combat stress, which many earlier studies have suggested.

Rather, the panel found that many of the soldiers who served in the war, most of which took place in the desert and highways of Kuwait, are probably suffering from exposure to one or more dangerous environmental factors, which also include, according to the 143-page report, air around oil fires and depleted uranium dispersed from U.S. tank ammunition.

"Multiple exposures on individuals — and all of us have a different genetic make-up — have combined to make a deleterious effect on soldiers," said Robinson, who is also the director of the National Gulf War Resource Center (search).

Dr. Lea Steele, an epidemiologist with Kansas State University and the director of science for the committee, said the panel's mission was to sift through recent research and to make some sense of it. Panel members believe they did that, and are happy to see that the VA is reacting quickly.

"Our mission was to consider all of the evidence and that's how we came up with our report," she said. "Previous government studies had a disproportionate focus on stress and that's why we hadn't made as much progress as some veterans would have liked."

But Joyce Riley, a Gulf War veteran and spokeswoman for the American Gulf War Veterans Association (search), said the research has gone on long enough, and the government has just been avoiding taking responsibility for the sick veterans and giving them easier access to benefits and health care.

"This is atrocious, 14 years after the war we have nothing more than research dollars," she said. "This is the biggest farce that we have seen — making these veterans think they are getting help."

The number of Gulf War veterans who suffer from Gulf War illness is difficult to grasp. Robinson and other advocates say they believe that many of the 330,000 Gulf War veterans who have sought medical treatment from the VA since the war — and 179,000 who are collecting some level of disability benefits — are suffering from one or more of the symptoms. But no hard and fast numbers are available, said Robinson, partly because soldiers grew tired of trying to prove their exposure to Pentagon officials and gave up seeking assistance from the military.

"There has been such a pattern of obfuscation on the part of the DoD that soldiers have stopped going to VA," he said, pointing to the "drip drip" of admissions over the years by the Pentagon of when and how soldiers might have been exposed to neurotoxins.

Not all scientists agree with the latest findings, and some urge caution when linking exposure to sickness.

"I was very concerned when they started talking about 'compelling' evidence because in my mind, they had no accepted method of looking at the evidence to call it compelling," said Dr. Hal Sox, editor of the Annals of Internal Medicine and chairman of an early study commissioned by the Institute of Medicine (search) in 2000.

He said there is no way to measure the existence of the exposures — to chemicals or oil fires, for example — in order to say what kind of effect it could have had on the soldiers in question. He, like others in the scientific community, said he believes that stress has more of an effect than the advisory committee would like to believe.

"Given the difficulty of this mystery of understanding the Gulf War illness, we should not be ignoring any plausible theory and in my opinion, combat-related stress is still a plausible theory."

Dr. Stephen Fhin, the acting director for research and development at the VA, said he is aware of the ongoing controversy.

"At this point we are still lacking the definitive evidence," he said. "If there is still controversy, then more research is warranted."