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thedrifter
03-11-08, 05:48 AM
Chemicals, pesticides may be at root of Gulf War illnesses

By Cheryl Clark
UNION-TRIBUNE STAFF WRITER

5:03 p.m. March 10, 2008

SAN DIEGO – A class of chemicals that includes nerve agents, pesticides and an anti-nerve gas drug may be causing the chronic fatigue, severe muscle pain, memory loss and other illnesses that about 250,000 Persian Gulf War veterans are experiencing, a San Diego researcher reported Monday.

“Enough studies have been conducted and the results shared to be able to say with considerable confidence that there is a link between chemical exposure” and those ailments, said Dr. Beatrice Golomb, the report's author and an associate professor at the UCSD School of Medicine.

Her research was published Monday in the Proceedings of the National Academy of Sciences.

Golomb said the veterans' vulnerability to such symptoms might be amplified by genetic mutations that reduced their ability to process pyridostigmine bromide, or PB, a drug intended to neutralize or suppress the effects of nerve agents.

“It doesn't matter whether they were exposed to the pills, the nerve agent itself or the pesticides. People with any of these exposures showed increased rates of health problems,” she said.

About 700,000 troops were deployed for the Persian Gulf War, which lasted from August 1990 through February 1991. Many may have been exposed to pesticides used to kill sand flies in Kuwait and Iraq, nerve gas and chemicals released after U.S. planes blew up a munitions bunker in Khamisiyah, Iraq.

Since the early 1990s, researchers worldwide have conducted hundreds of studies to determine whether a link exists between chemicals and the group of illnesses that many veterans have labeled as Gulf War syndrome.

Their conclusions are mixed, and the syndrome remains a topic of intense debate in military and scientific circles.

Officials for the Pentagon and the Department of Veterans Affairs did not return calls seeking comment on Golomb's new report.

Golomb is among the scientists who see a connection between the chemicals and health problems. Her report analyzed findings from more than two dozen studies of thousands of Persian Gulf War veterans from the United States, Australia and Europe who were exposed to a class of chemicals called acetylcholinesterase inhibitors and organophosphates. The class includes nerve gases such as sarin.

Even outside military settings, Golomb said, studies show a link between exposure to pesticides used in agricultural settings and similar complaints of illness among farm workers. These pesticides include those used to kill parasites in sheep.

A greater percentage of those agricultural workers with symptoms had reduced levels or variations of the enzyme that is supposed to detoxify those compounds, compared to those workers without symptoms, Golomb reported.

“These findings add to evidence for concern about health effects of pesticide exposure,” Golomb said.

She suggested that pesticide use be limited to settings “where there is a clear public health necessity.”

The federal government and various researchers said there is no set of symptoms that can be defined as a “syndrome” resulting from service in the Persian Gulf War. Complaints include debilitating fatigue, muscle and joint pain, rashes, memory lapses, cognitive difficulties, gastrointestinal problems and sleep disturbances.

Although they acknowledge that U.S. and foreign veterans who served there have real health complaints, there is no unique pattern because the symptoms described vary so greatly among individuals.

Golomb said that doesn't matter because with any disease or condition, the way it will manifest in the patient varies. “There's no condition or disease where the symptoms don't vary to some extent,” she said.

When asked how the federal government's studies derive different conclusions, she replied, “There is a culture in the field that has tried to reinforce a different view.”

An estimated 250,000 personnel in Operation Desert Shield/Desert Storm were given the drug pyridostigmine bromide because it was thought to confer protection in the event of nerve agent attack. As many as 41,000 may have been overexposed to pesticides in the same family. Those compounds were used to control insects such as sand flies.

And 100,000 may have been exposed to some levels of nerve agents, such as sarin or cyclosarin, such as near the Khamisiyah munitions depot bunker destruction in 1991.

Some of the studies about Gulf War syndrome focused on veterans with certain genetic mutations that left them without the enzymes necessary to process those chemicals. These individuals reported medical problems that were more severe than troops without the mutations.

In previous studies of similar symptoms in Gulf War veterans, Golomb said, variations in the genes responsible for producing certain enzymes also are associated with increased rates of some neurological diseases, including Parkinson's disease, and amyotrophic lateral sclerosis, also known as Lou Gehrig's disease.

Golomb was among the first U.S. researchers to report the “strong biologic plausibility” that the array of Gulf War illnesses could be connected to the compounds used in these drugs, pesticides and toxins.

Her Rand Corp. report in 1999 found that pyridostigmine bromide (PB) pills might actually amplify veterans' vulnerability to nerve gas attacks other than soman. Subsequently, the military stopped dispensing these pills. Today, Golomb said, military personnel are instructed to take the pills only in the event of a threat of attack from one specific nerve agent, soman.

Cheryl Clark: (619) 542-4573; cheryl.clark@uniontrib.com

Ellie