After nearly 30 years of trying to prove a theory, new research shows that sarin nerve gas was the cause of Gulf War Illness.
More than one-third of all people who deployed after the Gulf War reported unexplained chronic symptoms such as fatigue, gastrointestinal and digestive issues, brain and muscle and joint pain. The idea that troops may have been exposed to chemical agents was dismissed by federal agencies.
A study published last week in the journal Environmental Health Perspectives found that US service members who were exposed to sarin were more likely to develop Gulf War Illness.
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Haley, director of the Division of Epidemiology in the Internal Medicine Department at University of Texas Southwestern Medical Center, said that their findings prove that Gulf War illness was caused by sarin, which was released when we bombed Iraqi chemical weapons storage and production facilities.
There are still more than 100,000 Gulf War veterans who are not getting help for this illness and our hope is that these findings will accelerate the search for better treatment.
The chemical weapon sarin was developed as a pesticide and was used by Iraqi President Saddam Hussein before and after the Persian Gulf War. The synthetic nerve agent attacks the central nervous system and brain, killing victims by triggering an overreaction of neurotransmitters that causes convulsions and asphyxiation.
Thousands of coalition troops were exposed to sarin and cyclosarin when the U.S. destroyed a chemical weapons cache in southern Iraq. Some may have been exposed to low levels of contaminants, as troops frequently reported that chemical weapons alarms went off in the absence of an attack.
After the war, veterans who sought medical help at the Department of Veterans Affairs were sent to psychiatrists for mental health treatment. In the early 2010s, the VA conducted health surveys for Gulf War veterans that focused on questions about psychological and psychiatric symptoms.
The VA hid or obscured research findings that linked physical ailments to military service in order to deny veterans health care and benefits.
The charges were confirmed by an email sent to staff from the former Undersecretary for Benefits.
Haley and colleagues randomly selected 1,116 veterans who completed the U.S. Military Health Survey, including many who deployed and developed Gulf War Illness. They asked the veterans if they heard nerve gas alarms during their deployment, and if so, how often.
The researchers found a variant of the PON1 gene that helps the body metabolize pesticides. Some people have a variant of this gene that is more effective in breaking down sarin, while others have a variant that is less efficient against sarin.
The study found that people who reported hearing nerve agent alarms and had the least robust form of the gene had a nine-fold chance of having Gulf War Illness. Those with a mix of the two variant had more than four times the chance of having Gulf War Illness, while those who just heard nerve agent alarms raised the chance of developing the condition by nearly four times.
The data leads to a high degree of confidence that sarin is a cause of Gulf War Illness.
Our hypothesis was that if you have a strong form of the gene, you will be able to destroy sarin in your blood. Haley said in an interview with Military.com that if you have the weak form of the gene, it goes through your blood into your brain and you get sick. That is true if you are dealing with a gene-environment interaction.
The mysterious symptoms experienced by thousands of service members, which came to be known as Gulf War Syndrome and, later, Gulf War Illness, generated hypotheses of the possible cause, including an anti-nerve agent given to troops.
The Departments of Defense and Veterans Affairs had little interest in finding a cause and blamed the symptoms on stress or other mental health disorders, according to a congressional investigation in 1997.
The Committee on Government Reform and Oversight found that the Department of Defense and the VA were plagued by arrogant incuriosity and a lack of evidence that the illness did not exist.
When it comes to diagnosis, treatment and research for Gulf War veterans, the Federal Government often has a closed mind and a tin ear.
As Congress investigated the issue, Haley was studying possible causes, funded by Ross Perot, the Texas billionaire and Navy veteran known for donating to veterans charities and resources, including efforts to help U.S. prisoners of war in Vietnam.
The medical body of the National Academies of Sciences, Engineering and Medicine found Haley's studies to be insufficient in size and suffering from call bias, even though his early work pointed to sarin as a possible cause.
Haley said the new research cannot be explained away by errors in recalling the environmental exposure or other biases in the data.
Others agree. The study makes a strong case for a link, according to an editorial by a professor at the Harvard T.H. Chan School of Public Health and a research associate professor at the Boston University School of Public Health.
They wrote in their opinion piece that there is a strong argument that there is a true causality between presumed nerve agent exposure and the PON1 gene.
The VA has established a service connection for Gulf War veterans who have unexplained symptoms.
Those who served in the 1990-1991 conflict and have certain symptoms, such as chronic fatigue syndrome, can receive benefits even if they don't have a service connection.
The VA has been strict in determining service connection. The VA denied over 100,000 claims for Gulf War Illness between 1994 and 2015.
Haley said the research could lead to more veterans being able to access health care and benefits. Once scientists figure out how sarin works, the symptoms may be treated.
Haley said that they could come up with treatments to reverse it. This is not a loss of brain cells like a stroke or something like that.
Paul Sullivan, a Persian Gulf War veteran who works as director of veteran outreach at the law firm Bergmann & Moore, deployed to Iraq as an Army cavalry scout with the 1st Armored Division in 1991, and is excited about the new study.
The results show that affected veterans need to get care from the VA.
Sullivan said the landmark study provided a clear path for the VA to presume sarin exposure for all 1991 Gulf War veterans.
Haley said he has received letters from veterans asking if they could get tested for the different types of the PON1 gene and if it would be helpful. He said that a diagnostic test that would provide peace of mind to veterans is a possibility.
Thousands of studies on Gulf War Illness have been funded by the Department of Defense and the VA despite long-standing skepticism.
This is the scientific process. Nobody is bad. Nobody is good. People have theories. Skepticism is the name of the game. Haley said that it makes it fun.
The person can be reached at military.com. You can follow her on social media.
30 Years After the Gulf War: Veterans and the Legacy of Toxic Wounds is a book.
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