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Review says chemicals caused Gulf War illness

A scientist’s review of Gulf War illness studies shows that many of the symptoms — including chronic fatigue, pain and cognitive problems — can be explained by similar chemicals used in pesticides, sarin gas and anti-nerve-agent pills.

“These findings do not imply that all illness in Gulf War veterans or illness in all Gulf War veterans is the result of [the chemicals],” Beatrice Golomb wrote in a report in the March 18 edition of the Proceedings of the National Academies of Sciences. “However, mounting evidence suggests that [chemical] exposure may account for some or perhaps much of the excess illness seen in Gulf War veterans.”

Golomb, professor of internal medicine at the University of California, San Diego School of Medicine, wrote that veterans who were unable to process those chemicals quickly were also at higher risk for symptoms of Gulf War illness.

About 30 percent of the 700,000 troops who deployed to the Middle East during the 1991 Persian Gulf War have reported chronic health problems, but in the past, stress or mental health issues have been blamed for physical health problems.

Golomb questioned why Gulf War veterans would have more stress-related issues related when the ground war lasted only a few days, and when veterans from other wars or deployments were not having the same issues. One problem that stood out to her were the many musculoskeletal problems among Gulf War vets that did not appear in other combat veterans.

Stress and psychological issues “are inadequate to account for excess illness in Gulf War veterans,” Golomb wrote.

So she concentrated on the environmental factors that were different: anti-nerve-agent pills, pesticides and nerve agents. All these chemicals are acetylcholinesterase inhibitors, which overstimulate muscles by inhibiting acetylcholinesterase, a chemical that signals muscles to stop moving. The tongue, being a big muscle, eventually cuts off a person’s ability to breathe if it is overstimulated.

The Defense Department estimates 100,000 people may have been exposed to sarin when U.S. forces blew up an Iraqi military chemical weapons dump in Khamisiyah shortly after the war ended, sending a plume of smoke wafting over a large swath of the country. Paul Sullivan of Veterans for Common Sense said he filed Freedom of Information Act requests in 1994 and found that as many as 300,000 troops may have been exposed to the cloud.

In large enough amounts, PB, or anti-nerve-agent pills, is harmful, but in small doses, it acts to prevent nerve agents from overstimulating muscles, and the effects of PB itself are temporary and reversible. An estimated 250,000 troops took PB.

Pesticides use the same chemical in much smaller doses to kill bugs; the Defense Department has estimated 41,000 people may have been overexposed to pesticides, Golomb wrote.

Golomb realized that many of the symptoms of Gulf War illness — fatigue, musculoskeletal, cognitive, gastrointestinal, sleep and skin problems — could be caused by the acetylcholinesterase inhibitors, and wrote about that connection for the Rand Corp.

In her recent report, she cited 72 studies of Gulf War veterans. She found that those who took more anti-nerve-agent pills “had significantly worse reported health state than those citing fewer PB pills.”

Another recent study showed that service members who may have been exposed to the Khamisiyah sarin plume had “significantly worse neuropsychological function,” along with lower volumes of white brain matter.

She also found evidence that some service members could break down sarin and process it out of their systems, while the sick veterans were more likely to have a genetic variation of an enzyme — paraoxonase — that could be less efficient at breaking down sarin. However, Golomb wrote that those connections need to be looked at more closely in people who are not Gulf War vets because it is impossible to know if the veterans had difficulty breaking down the chemicals before they were exposed or if that difficulty is part of another issue.

Another enzyme charged with a similar chemical-cleaning role — butyrylcholinesterase — also appeared differently in 45 ill Gulf War veterans. Again, the sick veterans had the version of the enzyme that was not good at breaking down sarin and other inhibitors. Another study showed that those with both a poor enzyme system and exposure to the anti-nerve-agent pills had a “40-fold excess risk of reported chronic health problems.”

After looking at the Gulf War studies, Golomb looked at individuals with lesser enzyme systems who were exposed to similar chemicals in agricultural situations.

“They more commonly report multiple symptoms, and prominent symptoms appear to match those of Gulf War veterans,” she wrote.

Then she looked at studies of people exposed to sarin in attacks on trains in Japan. They also have symptoms similar to those with Gulf War Syndrome.

“The character of clinical findings reported after exposure in each of these settings appears similar,” Golomb said, despite the fact that the incidents involved different exposure amounts over different periods of time.

While doing her research, Golomb found one more connection: Parkinson’s disease and amyotrophic lateral sclerosis, or Lou Gerhig’s disease, have been linked to pesticide exposure, as well as to the enzyme issues. The number of service members with ALS is higher than the general population and is increasing, she wrote, adding that testing Gulf War veterans for Parkinson’s also “may be prudent.”

The connection between the inhibitors and their affect on people who can’t process low-level doses out of their systems is significant not only for Gulf War veterans, Golomb wrote.

“It has implications for current and future deployments, and for homeland defense,” she wrote. “[It] may be relevant to a subset of civilians with chronic multisymptom complaints that are currently unexplained.”

Related reading: Sarin at root of Gulf War syndrome, study says