Science Policy For All

Because science policy affects everyone.

Holes in Veterans’ Health

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By: Danielle Daee

In 2006, the independent, non-profit Institute of Medicine (IOM) Committee on Gulf War and Health published their findings based on a literature review of Gulf War veterans’ health.  This committee, consisting of scientists and health professionals, was charged by the US Department of Veterans Affairs (VA) to examine available data from studies (largely those funded by the VA) to (1) reveal any consensus conclusions and (2) make recommendations for future studies.  In their report, the committee revealed many shortfalls by the VA and the Department of Defense (DoD) in recording medical and combat histories of veterans.  In addition, the committee described that Gulf War veterans generally report more overall symptoms compared to controls.  Several multiple symptom disorders (e.g. fibromyalgia, chronic fatigue syndrome) also were diagnosed more often in Gulf War veterans.  Despite this increase in symptoms, the committee could not identify a unique set of symptoms that could be defined as a specific Gulf War Syndrome.

The inability to define a syndrome has generated a public controversy among some veterans, scientists, and physicians who feel that a syndrome designation could aid in diagnosis, treatment, and benefit procurement.  As a result the congressionally appointed Research Advisory Committee on Gulf War Veterans’ Illnesses (RAC), staffed by independent scientists and veterans, undertook their own investigation.  Their report, published in 2008, contradicts the IOM findings and asserts that there is sufficient evidence to suggest the existence of a multisymptom Gulf War Illness caused by neurotoxic exposures.  The disparate findings triggered congressional hearings in an attempt to establish a clear consensus.

According to the IOM committee chair Dr. Lynn Goldman, the two studies fundamentally differed in their treatment of the available data.  Goldman asserted that the IOM’s rigorous review of published studies revealed errors in many study designs that undermined the conclusions of the authors.  As a result, the IOM could not conclude that a unique subset of symptoms comprised a Gulf War Syndrome.  Goldman also contended that the results of some studies and the poor quality of veteran exposure data could not allow the committee to conclude that a specific exposure triggered the increased symptoms reported in veterans.  Goldman held fast to the reality that Gulf War veterans are sicker and report more symptoms than non-deployed veterans.  Consequently, she fully supported the congressional provision for “undiagnosed illnesses” to be compensated for veterans.  In addition, Goldman highlighted the IOM’s recommendation to the VA to standardize the criteria for veterans to receive healthcare and benefits.  This measure was intended to alleviate the bureaucratic obstacles that often hindered a veteran’s benefit procurement.

From an outsider’s perspective, it seems clear that much of this debate could have been avoided if the VA and DoD kept better records of veterans’ health prior to deployment (including vaccinations), health post-deployment, deployment locations, and field exposures.  With this information, perhaps a consensus conclusion would have been likely between the two committees.  Additionally, a clear picture of every veteran’s health prior to and after deployment would ease the burden on the VA to validate service-related illnesses.  Moving forward, these records may improve provided that the IOM’s recommendations to the VA and DoD are implemented.

IOM report: http://www.nap.edu/openbook.php?record_id=11729&page=1

RAC report: http://www1.va.gov/RAC-GWVI/

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Written by danidaee

March 14, 2012 at 4:57 pm

One Response

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  1. It would have also been beneficial if the military had not destroyed all medical records for service members in the Gulf War because they claim they didn’t have enough room or capability to bring them home.

    The IOM to this day, as witnessed by the speeches given at their recent public hearing, still leans on the asinine assumption that gulf war illness is caused by stress and is a somatic illness. In other words, they stuck their head in the sand and ignored all the relevant data.

    Its been 21 years since the Gulf War. Millions of dollars have been spent in research to find a cause and treatments. Much headway has been made in the last few years and it has become clear that the cause of Gulf War Illness (GWI) comes primarily from a combination of toxic exposures. There are also a couple of studies that show promising treatments for some parts of the illness, particularly the chronic fatigue. Yet not a single one of my VA doctors has any idea about any of this research which would go a long way in treating my own symptoms of GWI. Some doctors have even told me that they don’t even know if GWI even exists despite the page on the VA’s web site that clearly states that they admit it does exist.

    The VA and the IOM have wasted years that could have been put to good use in monitoring ill Gulf War Veteran’s (GWV’s) and feeding their complaints, medical findings and treatments into a national data base. All that data that could have been collected directly from professional sources has gone to waste.

    So 21 years later, GWV’s are finding that this illness increases in severity over time, that our doctors are ignorant of the medical research and the rest of the world just thinks we are crazy.

    Its difficult, at best, to get compensation for our illnesses from the VA for the same reasons: ignorance of the facts.

    The IOM needs a kick in the pants so they can wake up and see the real picture. The whole “wait long enough and they’ll all die off” crap needs to stop now.

    Pete

    March 20, 2012 at 4:54 pm


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