Greater Study Needed To Understand Gulf War Illnesses, Special Report Says

Wednesday, August 16, 2000

MAYO CLINIC CONTACT: John Murphy 507-538-1385 (days) 507-284-2511 (evenings) email: newsbureau@mayo.edu

To contact study author, Dr. Jeffrey Sartin, call 316-663-9183.

For Immediate Release

ROCHESTER, MINN. — A researcher whose findings are published in the current edition of Mayo Clinic Proceedings reports that despite much attention to the so called "Gulf War syndrome" in the scientific and popular literature, the illnesses suffered by troops remain poorly understood.

The conclusions of the report, authored by Jeffrey Sartin, M.D., from Internal Medicine Specialists in Hutchinson, Kan., are the results of his review of the available scientific literature and government reports, as well as numerous lay press accounts of illnesses. His special article appears in the August issue of Mayo Clinic Proceedings. Dr. Sartin is formerly a lieutenant colonel in the U.S. Air Force, Landstuhl Regional Medical Center, 2nd General Hospital, Landstuhl, Germany.

"The various illnesses that have been identified in Gulf War veterans with complaints represent normal illnesses for any large group," Dr. Sartin writes. Regardless of whether toxic or other physical factors are eventually found to contribute to the illnesses, the perception that the various illnesses constitute a syndrome has been shaped by societal influences. These include a strong belief in hidden causes for perplexing occurrences; a basic mistrust of official responses to questions raised by Gulf War illnesses; and an overemphasis on unsupported hypotheses.

However, Dr. Sartin says, "Personal experience and anecdotal evidence suggest that a small number of unusual cases have objective findings that lack obvious explanations. There seem to be enough legitimate questions raised by sensible researchers to warrant investigating many aspects of Gulf War illnesses furthers, as the 85 or so ongoing projects are expected to do."

Dr. Sartin's review determined that the results of the various studies were inconclusive, the stated conclusions were not supported by the data presented. "Thus, Gulf War illnesses join other ambiguous conditions, such as chronic fatigue syndrome and fibromyalgia, which are controversial and frustrating to define scientifically."

The conflict began with the Iraqi invasion of Kuwait on Aug. 2, 1990. Soon, the United States led a multi-country effort to stop the Iraqi forces. There were 148 combat deaths and 145 deaths to other causes among the 697,000 U.S. troops deployed. Injury and illness rates were extremely low. Numerous studies investigating the Gulf War illnesses have documented that although Gulf War veterans are more likely to seek medical treatment and disability retirement than their non-Gulf War counterparts, they are no more likely to die or be hospitalized.

"On the 10th anniversary of the Gulf War deployment, we are still trying to determine the consequences," says an accompanying editorial. The editorial is signed by U.S. Air Force Lt. Col. James Riddle of the Department of Defense, Capt. Kenneth Hyams of the Naval Medical Research Center, Frances Murphy, M.D., of the U.S. Department of Veterans Affairs, and John Mazzuchi, Ph.D., of the U.S Department of Defense. The editorial also acknowledged that, for fiscal years 1994-1999, the U.S. Departments of Defense, Veterans Affairs, and Health and Human Services are projecting research expenditures of more than $159 million to fund more than 150 clinical basic science, and epidemiological research projects on illnesses among Gulf War veterans. "To date, more than 100,000 of the 750,000 Gulf War veterans from the United States, Canada and the United Kingdom have been evaluated and are included in four clinical registries."

Based on available data, "something more than a biological or psychological explanation will be needed to understand and care for the problems experienced by Gulf War veterans and their families," write the editorialists. They add, "there is ample historical precedent for the importance of nonbiological influences on veterans' health. The question of a unique war-related disease has arisen repeatedly in widely diverse circumstances." Examples include "irritable heart" among American Civil War soldiers and "effort syndrome" among both World War I and II troops. Both were major scientific and political controversies. "More recently, there have been questions about possible 'Balkan War syndrome' among military peacekeepers."

Although the authors are affiliated with military and governmental offices, their views are not official positions of those groups or reflective of their organizations' stances.

Mayo Clinic Proceedings is a peer-reviewed and indexed general/internal medicine journal, published for 75 years by Mayo Foundation, with a circulation of 120,000 nationally and internationally.

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