WASHINGTON, D.C.--U.S. soldiers who served in the Persian Gulf in 1990 are just as healthy on average as those who stayed home, say two new reports involving medical records of nearly all 700,000 Gulf War veterans. The findings, published in the 14 November issue of the New England Journal of Medicine, are perhaps the strongest evidence so far that reported health problems among Gulf War vets are stress-related illnesses unrelated to the war.
Since the Gulf War ended nearly 6 years ago, many veterans have complained of symptoms such as headaches, muscle pain, and trouble sleeping. Veterans groups have blamed these disparate symptoms, collectively known as Gulf War syndrome, on battlefield exposure to toxicants such as chemical weapons, smoke from oil fires, pesticides, or drugs to protect against nerve gas. But many experts--including a presidential advisory panel whose draft report was leaked to the press earlier this week--have discounted the existence of the syndrome.
Nevertheless, considerable doubt has lingered about whether Gulf War vets are sicker on average than soldiers at home or in other war theaters. To find out, a team led by Gregory Gray of the Naval Health Research Center in San Diego looked at hospital records through September 1993 for 547,076 Gulf War veterans and a control group of vets. They found slightly more hospitalizations among Gulf War vets for some illnesses, such as tumors (mostly benign), anemia, and mental disorders. Gray's team suggests that the increases are probably due to a number of factors: a tendency among vets to wait until after a war to seek treatment for problems, a postwar baby boom, and the stress of war.
In a similar study, Han Kang and Tim Bullman of the Department of Veterans Affairs (VA) in Washington, D.C., examined death records of 1765 U.S. fatalities culled from records on 695,516 Gulf War vets, and compared these to fatalities in a group of non-Gulf vets roughly equal in size. Records showed that the fatality rate among Gulf vets was 9% higher. But the extra deaths were due to more accidents, not to disease. Such a trend has also been observed in vets of other wars, and may reflect the fact that war survivors tend to take more risks, the authors say.
The findings are "a dose of reality," says Harvard Medical School internist Edward Campion, an NEJM editor. Doctors examining the vets, he says, "should be objective and stick to what they know and not try to diagnose a disease that doesn't exist."
But the findings are likely to be hotly contested by veterans' groups that have in the past criticized the government's handling of their complaints. Nor do the results exclude the possibility that certain ailments might be linked to the Gulf War. For instance, the VA study says nothing about illnesses that didn't require hospitalization, and it may have overlooked disease clusters resulting from toxic exposures if the nonexposed Gulf War vets were healthier than controls. These studies are unlikely to lead to a cease-fire in the battle over Gulf War syndrome.