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Eight years after the Gulf War ended, the first evidence of what could have caused so many to fall ill afterwards may be emerging. An American study says a chemical given to military personnel to protect them against attack by nerve gas may have contributed to the range of symptoms known as Gulf War syndrome.
But the report also shows there may be many other causes. In some respects, the most horrifying conclusion from the study is that chemicals were liberally used on humans when the forces had little knowledge of the side-effects.
The Rand Corporation study for the Pentagon examines pyridostigmine bromide (PB), which was given to soldiers to protect them against soman nerve gas. It says that despite earlier reports ruling out PB as a cause, it could in some circumstances have caused later illness.
"This does not imply that it is necessarily a causal factor, only that the possibility cannot be dismissed," says the paper. The study concluded that stress may have changed the physiology of the servicemen and women, "allowing PB to enter the brain, producing effects of PB that would not normally occur, or would occur only at far higher doses". It also noted: "Different individuals have physiological variations that result in marked individual differences in processing of, and susceptibility to, PB."
And: "Interactions between PB and other chemicals to which veterans may have been exposed may result in toxic effects occurring at far lower doses than if exposures had occurred separately." More than 300,000 troops were given PB during the Gulf war.
A British study in the The Lancet earlier this year said: "A specific mechanism may link vaccination against biological warfare agents and later ill-health," and identified PB as a possible culprit. But it also said: "The risks of illness must be considered against the protection of servicemen." A previous Ministry of Defence study said: "This drug has been used in medical practice since the 1950s in very much larger doses than those used [in the Gulf War]. If there were long-term effects consequent upon its use, it is very likely these would have been noted by now."
Other reports are due from Rand, including reviews of chemical and biological warfare agents, depleted uranium, pesticides, oil well fires, immunisations, infectious diseases, and stress, all areas which have been identified as possible causes of illness. Depleted uranium is a radioactive metal used in ammunition during the Gulf War and in Kosovo.
Despite wide research, there is still no agreement on whether Gulf War syndrome exists. "It is not yet clear the extent to which veterans are experiencing either higher than expected rates of identifiable illnesses with known etiologies or any other illnesses from as yet unidentified origins," says the Rand paper.