e: http://www.nytimes.com/2001/12/11/health/anatomy/11GULF.html
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December 11, 2001 U.S. Reports Disease Link to Gulf War
By SHERYL GAY STOLBERG
The joint announcement by the Defense and Veterans Affairs Departments was
based on the preliminary findings of a study of more than 2.5 million
veterans. Officials said they would immediately offer disability and survivor
benefits to affected patients and families. Forty cases have been identified
so far. "The hazards of the modern-day battlefield are more than bullet
wounds and saber cuts," Veterans Affairs Secretary Anthony J. Principi
said in releasing the results of the study. "We have to be conscious of
that and act accordingly." Some scientists said the decision might be premature because the research
had not been subjected to the analysis of peer review. An epidemiologic
analysis, the study tracks patterns of disease, and does not prove that gulf
war service was the cause of the disorder, formally called amyotrophic
lateral sclerosis, or A.L.S. The authors did not offer theories on why gulf war veterans would be at
increased risk. Nor did they say what the odds were that the finding occurred
by chance. Conducted at a veterans' hospital in Durham, N.C., the study has
been submitted for publication in an academic journal. Officials would not
identify it. Veterans' groups, who have long argued that their members are afflicted by
unexplained illnesses collectively called Gulf War syndrome, were ecstatic.
So were patients' advocates, who said the study might yield important clues
about the cause of the disease. More than 100,000 American service members sent to the region in 1990 and
1991 have reported a range of maladies including fatigue, muscle pain, memory
loss and sleep disorders. But studies have found no definitive links,
although several have suggested that the ailments may stem from to chemical
exposure, stress or prophylactic medicines given to soldiers. "This may give some insight into an environmental exposure that would
have something to do with A.L.S.," Mike Havlicek, president of the ALS
Association, which represents the 30,000 Americans with the disease, said
about the new study. "We are very supportive of the effort to get to the
bottom of this." A.L.S. is extremely rare, and the risk for soldiers is small. Of nearly
700,000 who fought in the yearlong gulf conflict, the study identified 40
with A.L.S. About half have died. In a comparison group of 1.8 million people
who served in the military at the same time but were not in the region, 67
developed A.L.S. The study found that among the nearly 700,000 soldiers sent to the gulf
from August 1990 to July 1991, the risk of contracting A.L.S was 6.7 per
million. Among the 1.8 million who were not deployed, the risk was 3.5 per
million. Though the overall risk was twice as high among those deployed, it was not
consistent across the services. Air Force veterans were 2.7 times more likely
to develop A.L.S. than those not deployed. Army soldiers faced twice the
risk. But Navy and Marine Corps veterans did not show rates of disease that
were statistically higher than those not deployed. The epidemiologist who led the research, Dr. Ron Horner, said he and his
colleagues drew on military records, appealed to veterans and patients'
groups and made other efforts to identify veterans who had received diagnoses
of A.L.S. in the 10 years since the war. He said his team had interviewed
veterans with A.L.S. and their doctors and studied medical records and death
certificates of those who had died. Pentagon and veterans' officials said that the Durham study might be the
largest of its kind and that they were confident of the results. "The
risk is elevated, and the risk is statistically significant," said Dr.
John R. Feussner, chief of research and development for the Veterans Affairs
Department. He and Secretary Principi promised to pursue research that would help
identify the cause of the illnesses. They said they could not wait for a
complete scientific review before informing patients of the results. Dr. Feussner said the results were presented today at meeting of
researchers. "Our first order of business," he said, "is to
take care of our patients." The announcement was a startling turnabout for the military, and it is
quite likely to renew focus on gulf veterans' health problems. "It's just a shame it has taken so long," said Representative Christopher
Shays, a Connecticut Republican who has held hearings on veterans' health
problems. "There has been an incredible reluctance on the part of the
Defense Department to acknowledge any gulf war illness. So I consider this a
huge announcement." The Pentagon assistant secretary for health affairs, Dr. William
Winkenwerder, described the shift as a result of "an evolving thought
process" about the risks of combat. "The science," said Richard J. Santos, national commander of the
American Legion, "is sound and the evidence is clear — U.S. troops were
exposed to something in the Persian Gulf that accounts for an increased rate
of A.L.S." We applaud the administration for deciding to award just
compensation and benefits immediately." A.L.S., which causes severe muscle wasting, is typically fatal in two to
five years. Scientists have identified two genes connected with the A.L.S.,
which came to public attention when Lou Gehrig of the Yankees contracted it.
The inherited version accounts for 15 percent of all cases. The rest are
classified as sporadic. "The fact that we have been able to find a higher incidence in gulf
war veterans is a big step forward to, maybe, getting at the cause,"
said Sharon Hesterlee, chief of research and development for the Muscular Dystrophy
Association, which pays for A.L.S. research. Reports of A.L.S. among young veterans were particularly disturbing, Dr.
Hesterlee said, because the disease typically afflicts people 45 and older.
Two other studies had failed to show a link to gulf war service. The $1.3 million study began in March 2000, and the next step, Dr.
Feussner said, is for scientists to "look to see if there is any cluster
or anything these soldiers have in common that might give us a clue as to
what the cause is." |
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