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As part of a longitudinal surveillance program, 35 members of a larger dynamic cohort of 79 Gulf War I veterans exposed to depleted uranium (DU) during combat underwent clinical evaluation at the Baltimore Veterans Administration Medical Center. Health outcomes and biomonitoring results were obtained to assess effects of DU exposure and determine the need for additional medical intervention. Clinical evaluation included medical and exposure histories, physical examination, and laboratory studies including biomarkers of uranium (U) exposure. Urine collections were obtained for U analysis and to measure renal function parameters. Other laboratory measures included basic hematology and chemistry parameters, blood and plasma U concentrations, and markers of bone metabolism. Urine U (uU) excretion remained above normal in participants with embedded DU fragments, with urine U concentrations ranging from 0.006 to 1.88 μg U/g creatinine. Biomarkers of renal effects showed no apparent evidence of renal functional changes or cellular toxicity related to U body burden. No marked differences in markers of bone formation or bone resorption were observed; however, a statistically significant decrease in levels of serum intact parathyroid hormone and significant increases in urinary calcium and sodium excretion were seen in the high versus the low uU groups. Eighteen years after first exposure, members of this cohort with DU fragments continue to excrete elevated concentrations of uU. No significant evidence of clinically important changes was observed in kidney or bone, the two principal target organs of U. Continued surveillance is prudent, however, due to the ongoing mobilization of uranium from fragment depots. [ABSTRACT FROM AUTHOR]

Veterans of the 1990–1991 Gulf War have been reported to have an increased incidence of amyotrophic lateral sclerosis (ALS) compared to personnel who were not deployed. An excess of ALS cases was diagnosed in Gulf War veterans younger than 45 years of age. Increased ALS among Gulf War veterans appears to be an outbreak time-limited to the decade following the Gulf War. Seeking to identify biologically plausible environmental exposures, we have focused on inhalation of cyanobacteria and cyanotoxins carried by dust in the Gulf region, particularly Qatar. Cyanobacterial crusts and mats are widespread in the deserts of Qatar, occupying up to 56% of the available area in some microhabitats. These cyanobacterial crusts, which help bind the desert sands, are dormant throughout most of the year, but during brief spring rains actively photosynthesize. When disturbed by vehicular traffic or other military activities, the dried crusts and mats can produce significant dust. Using HPLC/FD, an amino acid analyzer, UPLC/MS, and triple quadrupole LC/MS/MS we find that the dried crusts and mats contain neurotoxic cyanobacterial toxins, including β-N-methylamino-L-alanine (BMAA) and 2,4 diaminobutyric acid (DAB). If dust containing cyanobacteria is inhaled, significant exposure to BMAA and other cyanotoxins may occur. We suggest that inhalation of BMAA, DAB, and other aerosolized cyanotoxins may constitute a significant risk factor for the development of ALS and other neurodegenerative diseases. [ABSTRACT FROM AUTHOR]

As part of a longitudinal surveillance program, 35 members of a larger cohort of 77 Gulf War I veterans who were victims of depleted uranium (DU) “friendly fire” during combat underwent a 3-day clinical assessment at the Baltimore Veterans Administration Medical Center (VAMC). The assessment included a detailed medical history, exposure history, physical examination, and laboratory studies. Spot and 24-h urine collections were obtained for renal function parameters and for urine uranium (U) measures. Blood U measures were also performed. Urine U excretion was significantly associated with DU retained shrapnel burden (8.821 μg U/g creatinine [creat.] vs. 0.005 μg U/g creat., p = .04). Blood as a U sampling matrix revealed satisfactory results for measures of total U with a high correlation with urine U results (r = .84) when urine U concentrations were ≥0.1 μg/g creatinine. However, isotopic results in blood detected DU in only half of the subcohort who had isotopic signatures for DU detectable in urine. After stratifying the cohort based on urine U concentration, the high-U group showed a trend toward higher concentrations of urine β2 microglobulin compared to the low-U group (81.7 v. 69.0 μg/g creat.; p = .11 respectively) and retinol binding protein (48.1 vs. 31.0 μg/g creat.; p = .07 respectively). Bone metabolism parameters showed only subtle differences between groups. Sixteen years after first exposure, this cohort continues to excrete elevated concentrations of urine U as a function of DU shrapnel burden. Although subtle trends emerge in renal proximal tubular function and bone formation, the cohort exhibits few clinically significant U-related health effects. [ABSTRACT FROM AUTHOR]

The existence of Gulf War Syndrome is a topic of much controversy. Many highly respected scientists initially concluded that no single disease or unique condition affected the veterans of the Gulf War. More recent studies have concluded that there is evidence that some of the conditions suffered by many Gulf War veterans are more common among those who served in the Gulf and are, quite likely, a result of exposure to toxins, whether man-made or naturally occurring, that were present in the area of the Gulf War. This article provides general information on Gulf War Syndrome, controversy surrounding the syndrome, and challenges faced in determining whether the syndrome exists. A bibliography of selected Internet resources provides additional information on the syndrome. [ABSTRACT FROM AUTHOR]

A previous symptom-based survey of veterans of the 1990-1991 Persian Gulf War suggested a neurological syndrome (blurred vision, loss of balance/dizziness, tremors/shaking, and speech difficulty). The authors conducted the present study to determine whether specific findings could indicate an organic basis for this possible syndrome. They completed an extensive clinical and laboratory evaluation on Gulf War veterans with all 4 symptoms, using 3 comparison groups. A single clinically based neurological syndrome could not be identified. No deployment-related exposure appeared to explain the pattern of symptoms, but this evaluation suggested comorbidities and possibly multiple vaccines as important contributors. Many of the neurological symptoms reported by the studied veterans appear to have an organic basis, but comorbidities must be excluded before researchers can conclude that a definitive syndrome exists. [ABSTRACT FROM AUTHOR]

Veterans of the Gulf War present various symptoms and maladies. Reports by governmental and private entities have yielded mixed results and have been fraught with criticisms of biased research design. The vast majority of these studies have focused on U.S. veterans, with a much smaller number focusing upon British veterans. Very few have examined Iraqi Gulf War veterans. Our study involves administering a health issues questionnaire to a sample of Iraqi Gulf War veteran refugees in the U.S. Results indicate relationships between Post-Traumatic Stress Disorder (PTSD) scores and health outcome measures of chronic fatigue, tibromyalgia, functional status, quality of life, and health care utilization in terms of frequency and level of intensity. Implications for further inquiry are presented. [ABSTRACT FROM AUTHOR]

In this study, we identified deployment-related and demographic predictors of several factors of posttraumatic growth in a sample of combat-exposed Gulf War I veterans. Participants were obtained via a Veterans Administration registry of Gulf War I veterans and were mailed a survey containing a number of scales assessing predeployment, deployment, and postdeployment factors from the Deployment Risk and Resilience Inventory and the Posttraumatic Growth Inventory. Military status and perceived threat were significant predictors of appreciation of life. Relating to others, personal strength, and posttraumatic growth as a whole were best predicted by the postdeployment variable of social support. Minority status was the only significant predictor of new possibilities, with ethnic minorities reporting more new possibilities postdeployment. Limitations and suggestions for future research are discussed. [ABSTRACT FROM AUTHOR]

Objectives. Our objective was to describe fatal motor vehicle crashes (MVC) among veterans of the 1991 Gulf War era and to compare the distribution of crash and individual characteristics between those deployed to the Gulf War (GWV) and those not deployed (NDV). Methods. We compared individual characteristics, crash mechanisms, and crash circumstances between 765 GWV and 553 NDV who died from MVC within the first five years of the war, between May 1991 and December 1995. Results. Overall, GWV and NDV who died from a MVC were more likely to be enlisted males (97%), 21–30 years old (72%), have a high school education or less (91%), drive a passenger car (52%), and not use restraints (60%). The overall annual rate of motor vehicle fatalities for GWV (23.6 per 100,000; 95% confidence interval: 21.9–25.3) was significantly greater than the rate for NDV (15.9, 95% CI: 14.6–17.3). GWV with the highest motor vehicle fatality rates include males (24.8, 95% CI: 23.0–26.6), 17–20 year olds (105.0, 95% CI: 78.2–138.1), and those not married (27.3, 95% CI: 25.1–30.1). Adjusting for differences in age distribution across GWV and NDV did not account for the difference in rates. Characteristics of MVC fatalities that were over-represented among GWV include serving as regular active duty (p = 0.001), having a high school education or less (p = 0.01), being involved in a single-vehicle crash (p = 0.008), and dying within the first hour following the crash (p = 0.004). Also, we identified a greater proportion of alcohol-related crashes among GWV during the late night and early morning hours. Conclusions. The highest rates of motor vehicle fatality among young, single males in the military mirror the experience of the general population. Further research is necessary to determine modifiable risk factors that can be targeted for specific interventions and whether the elevated late night alcohol-related crash rate among GWV is an effect of deployment or an inherent population bias among those selected for operational deployments. [ABSTRACT FROM AUTHOR]

This study examined the effectiveness of the Impact of Event Scale (IES; Horowitz, Wilner, & Alvarez, 1979) variables in detecting posttraumatic stress and physical symptoms in relevant groups of Gulf War veterans. A large sample of Gulf War veterans were administered the the IES, a semi-structured interview (PSS-I; Foa, Riggs, Dancu, & Rothbaum, 1993) on DSM-IV (American Psychiatric Association, 1994) criteria for posttraumatic stress disorder (PTSD), and a Physical Symptom Questionnaire from the National Center for PTSD Patient Medical Information Checklist (1993). This study utilized four groups of veterans: 1) a reserve control group of participants who were in a reserve unit during the Gulf War but not deployed to the Gulf; 2) a Gulf War control group of veterans who were deployed to the Gulf War but did not report any symptoms of PTSD; 3) a subclinical group of Gulf War veterans who reported 1–5 DSM-IV criteria for PTSD; and 4) a group of Gulf War veterans who met DSM-IV criteria for PTSD. Group contrasts supported the hypothesis that IES scores would be significantly different in the expected clinical direction. Analyses also demonstrated significant relationships between IES scores and the number of DSM-IV symptoms of PTSD as well as the number of physical problems reported by these veterans. [ABSTRACT FROM AUTHOR]

From September 1990 to June 1991, the UK deployed 53,462 military personnel in the Gulf War. In 1993 reports began to surface in the UK about unexplained health problems occurring amongst Gulf War veterans. This paper considers the way sufferers of Gulf War Syndrome (GWS) came to label their condition in this way. Unlike other research into this illness, this work focuses on sufferers' own accounts to better understand the way GWS is perceived by those it affects. Based on 14 months of ethnographic fieldwork in the UK, data for this paper were collected mainly by in-depth semi-structured interviews with GWS sufferers, their family members, doctors and scientists, as well as Gulf veterans. Findings suggest that GWS narratives provide a template to make sense of life events and illness. Investigating the way veterans came to ascribe to GWS as an explanation of their suffering, it became clear that contact with other sufferers was central to this process. Through participation in the veterans group and by assimilating the stories of other sufferers, a culturally specific narrative form is learned. This provides a framework for the reflexive re-interpretation of one's past and helps to construct a narrative of GWS. Unlike most work on narrative which focuses on the individual, this interpretation suggests that the collective aspect is central. In the absence of a diagnostic test and a coherence of symptoms, it is the concordance between the individual and collective narrative that is persuasive. [ABSTRACT FROM AUTHOR]

Presents a study to describe the frequency and clinical characteristics of chronic fatigue syndrome in Gulf War veterans in the U.S. Impact of symptoms on quality of life of veterans; Need to provide treatment to veterans to reduce the impact on their quality of life.

Recent contributions to social movement theory have emphasized the importance of cultural and political opportunities in shaping movement growth and development While most of that work focuses on how these factors facilitate social movement efforts, we examine a case in which cultural and political factors have constrained the efforts of a social movement. Analyzing data from in depth interviews with 55 respondents, we examine the organizing efforts of Gulf War veterans claiming illnesses connected to environmental exposures in the Persian Gulf Despite the claims of many veterans that exposure to hazardous conditions resulted in illness, they have been unsuccessful in legitimating Gulf War illness to the government or to the public. This article contributes to the social movement literature by analyzing ways in which both cultural and political institutions may hamper the efforts of a contemporary social movement. [ABSTRACT FROM AUTHOR]

ABSTRACT. To identify a syndrome unique to Gulf War veterans, the authors applied an exploratory factor analysis to the 47-symptom correlation matrix of 10,423 Gulf War and 8,960 non-Gulf War veteran respondents. A separate factor analysis was performed for Gulf War and non-Gulf War veterans, and the resulting 6 factors were compared between the 2 groups. Five of the factors were very similar in the 2 groups; however, 1 of the factors in the Gulf War group, but not the non-Gulf War group, contained a cluster of symptoms consistent with neurological impairment. Symptoms specific to this factor were blurred vision, loss of balance/dizziness, tremors/shaking, and speech difficulty. The Gulf War veterans who had all of the aforementioned symptoms (n = 277) also reported exposures to several putative risk factors at a rate 3 or more times higher than other Gulf War veterans. This finding suggests a possible syndrome related to Gulf War deployment, which requires objective supporting clinical evidence. [ABSTRACT FROM AUTHOR]

A comprehensive neuropsychological battery was administered to 48 veterans with Gulf War Illness (GWI) characterized by severe fatigue (GV-F) and 39 healthy veterans (GV-H). Subjects were matched on intelligence and did not differ on age, gender, race, and alcohol consumption. Compared to GVs-H, GVs-F were significantly impaired on four tasks: three attention, concentration, information processing tasks and one measure of abstraction and conceptualization. After considering the presence of post-war Axis I psychopathology, GWI remained a significant predictor of cognitive performance on one of the attention, concentration, and information processing tasks and one abstraction and conceptualization measure. Performance on the remaining two attention, concentration, and information processing tasks was only significantly predicted by Axis I psychopathology with post-war onset. The results suggest that Gulf War Illness is associated with some aspects of cognitive dysfunction in Gulf Veterans, over and above the contribution of psychopathology. [ABSTRACT FROM AUTHOR]

ABSTRACT. More than 68 000 of the 700 000 veterans of the Gulf War have become members of the Veteran Affairs' Gulf War Registry. In 1995, we undertook a questionnaire study of the symptoms and medical histories reported by a randomly selected subsample of 1 935 of these veterans to characterize their complaints. All results reported were based on questionnaire responses without face-to-face evaluation or physical examinations. Inasmuch as initial registry symptoms overlapped those of Chronic Fatigue Syndrome and Multiple Chemical Sensitivities, we also included standard questions for these syndromes in the questionnaire. A total of 1 161 (60%) individuals responded, and there were no major demographic biases; therefore, 15.7% of registry veterans qualified for Chronic Fatigue Syndrome in accordance with the 1994 Centers for Disease Control definition. In addition, 13.1% qualified for multiple chemical sensitivities in accordance with a widely used definition, and 3.3% of the respondents had both conditions. There were no effects of gender, race, branch, duty status (active or reserve), or rank, although Multiple Chemical Sensitivities was somewhat more prevalent in women and African Americans. The data gleaned in this study suggested that the unexplained symptom syndromes of Chronic Fatigue and Multiple Chemical Sensitivities may characterize an appreciable portion of the complaints of those who volunteered for the Veterans Affairs' Gulf War Registry, and further investigation is warranted. [ABSTRACT FROM AUTHOR]

Discusses the implications of the Gulf War Syndrome. Description of the victims of the Gulf War syndrome; Evidence for psychological causes; Reexamination of American military's practices and preparations for sending soldiers to war.

Profiles the Gulf War syndrome of 1991. Failure of studies to identify a discrete syndrome; Review of American participation in the Gulf War and medical threats and exposures considered by the US Armed Forces; Assessment of American government's approach to investigating the complaints of returning servicemen.

Presents the results from the examination of the Technology Assessment Workshop on the illnesses reported to the panel by Persian Gulf War veterans. Effect of the environment on the health of veterans; Presence of multiple diseases with overlapping symptoms and causes; Need for a collaborative government-supported program for the evaluation of illnesses.

This paper presents a description of the objectives, planning, observations, and reports of a Department of Veteran's Affairs Social Work Outreach Team's efforts to work with soldiers returning from Operation Desert Storm. The soldiers reported experiences with discrimination, low morale, sexual harassment, and fear. [ABSTRACT FROM AUTHOR]

Editorial. Focuses on the confusion about symptom-based illnesses such as Chronic Fatigue Syndrome, fibromyalgia, and Multiple Chemical Sensitivity Syndrome. Lifestyle modifications in patients with chemical sensitivity; Relation between chronic fatigue and chemical sensitivity; Reference to a study on the self-reported prevalence of symptom-based illnesses in Gulf War veterans.

Editorial. States that the aliphatic chlorinated hydrocarbon pesticide known as permethrin has the potential to explain Gulf War syndrome. Findings of studies on the use of permethrin-treated uniforms as a protective agent against insect-borne diseases; Mode of action of dichloro-dyphenyl-triachloroanthane and permethrin; Background information on the Gulf War syndrome.