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Gulf War Syndrome or Gulf lore mythology?

Article Excerpt
ONE-FOURTH OF THE VETERANS OF THE 1990-91 Gulf War complain of persistent memory and concentration problems, chronic headaches, widespread pain, gastrointestinal problems, and other chronic abnormalities not explained by well-established diagnoses. Treatments are ineffective and symptoms do not improve over time. Gulf War Syndrome or Gulf War Illness (GWI) is a controversial diagnosis, and some have questioned whether it really exists.

Now a new report from the Research Advisory Committee on Gulf War Veterans' Illnesses has concluded that Gulf War Illness is real and that it is probably attributable to pyridostigmine bromide (PB), a prophylactic for nerve gas poisoning and pesticide exposures. Its major conclusions:

Gulf War illness is a serious condition that affects at least one fourth of the 697,000 U.S. veterans who served in the 1990-1991 Gulf War. Gulf War illness fundamentally differs from trauma and stress-related syndromes described after other wars. Evidence strongly and consistently indicates that two Gulf War neurotoxic exposures are causally associated with Gulf War illness: 1) use of pyridostigmine bromide (PB) pills, given to protect troops from effects of nerve agents, and 2) pesticide use during deployment.

The Research Advisory Committee on Gulf War Veterans' Illnesses was mandated by Congress and appointed in 2002. The report, published November 17, 2008, is an exhaustive review of all available data, including some that is unpublished. It runs to 454 pages, has multiple authors and consultants, lists 1840 references and has multiple appendices. I can't pretend to have mastered all the information, but I have read enough to understand the basis of their conclusions. They are based on good evidence and logic, but they leave me with some doubts.

Evidence Suggesting GWI Isn't Real

Skeptics have pointed out that ill-defined syndromes are often reported after wars, attributed to everything from shell shock (World War I) to Agent Orange (Vietnam). Two 1996 articles in the New England Journal of Medicine found no difference in hospitalizations or in death rates from illness in Gulf War veterans. A 1998 study found that Gulf War veterans were less likely to be hospitalized for unexplained illnesses and were healthier overall than veterans who were not deployed. In a...

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