Gulf war symptoms do not constitute a syndrome

The unexplained symptoms that afflict thousands of veterans of the Gulf war do not constitute a syndrome, a study from the US Institute of Medicine, published on 12 September, has found.​found.

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Figure 1

US experts say that veterans, such as Major Randy Hebert, seen here testifying to Congress, suffered ill health but their symptoms did not amount to a syndrome

Credit: DENNIS COOK/AP/EMPICS

At the behest of Congress, the US Department of Veterans Affairs commissioned the Institute of Medicine to do the study.

The Institute of Medicine chose 850 potentially relevant epidemiological studies from more than 4000 references, and decided to base its conclusions on only peer reviewed published literature.

Almost 700 000 US soldiers, along with troops from 34 other countries, took part in the Gulf war. In the Persian Gulf, these soldiers were exposed to a wide variety of toxins and other health hazards, including pesticides, depleted uranium ammunition, and smoke from hundreds of burning oil wells.

The 13 member committee of the institute was chaired by Lynn Goldman, professor of occupational and environmental health at Johns Hopkins University, Baltimore, who said, “Gulf war veterans consistently report experiencing a wide range of symptoms.

“But because the symptoms vary greatly among individuals, they do not point to a syndrome unique to these veterans. Unfortunately, because of the lack of objective pre-deployment health information, we do not have the baseline data needed to draw more definitive conclusions about many aspects of these veterans' long term health.”

Almost 30% of personnel who served in the war in 1991, whether from the United States or other countries, have reported symptoms, compared with 16% of personnel who served elsewhere.

The report found that veterans of the Gulf war had increased chances of experiencing a psychological disorder such as depression, anxiety, or post-traumatic stress disorder. It also found a possible association between Gulf war service and amyotrophic lateral sclerosis, a rare disorder that occurs in five of every 100 000 people in the general population.

Simon Wessely, professor of epidemiological and liaison psychiatry at the Institute of Psychiatry, King's College London, and director of the King's Centre for Military Health Research, London, said, “This is a very impressive review of what we know. It is now clear there is no specific condition called `Gulf war syndrome' but it is equally clear that service in the Gulf war did adversely affect health in some personnel.”

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Longer versions of these articles are on bmj.com