Summary

Many of the 700,000 Gulf War veterans have complained of mysterious illnesses since the war's end in 1991. Some believe that their chronic, disabling conditions are a result of wartime exposure to a host of potentially hazardous substances, including drugs used to protect against chemical warfare, fuel in shower water, depleted uranium, and smoke from oil-well fires. The Pentagon acknowledged last year that some veterans may have been exposed to the nerve agent sarin following the postwar demolition of Iraqi ammunition facilities. GAO found that nearly six years after the end of the Gulf War, little is known about the causes of illnesses among returning veterans. Neither the Defense Department nor the Department of Veterans' Affairs has systematically attempted to determine whether ill Gulf War veterans are any better or worse today than when they were first examined. Ongoing epidemiological research should provide descriptive data on veterans' illnesses, but formidable methodological problems are likely to prevent researchers from pinpointing the causes of veterans' illnesses. GAO questions the Pentagon's decision to attribute veterans' symptoms to stress or parasites while discounting chemical agents as a contributing factor. In a related testimony (GAO/T-HEHS-97-158, June 19, 1997), GAO discusses the views of Gulf War veterans on the care they have received from the Department of Veterans Affairs.

GAO noted that: (1) over 100,000 Gulf War veterans have participated in DOD and VA health examination programs; (2) of those veterans examined by DOD and VA, nearly 90 percent reported a wide array of health complaints and disabling conditions; (3) although efforts have been made to diagnose veterans' problems and care has been provided to many eligible veterans, neither DOD or VA has systematically attempted to determine whether ill Gulf War veterans are any better or worse today than when they were first examined; (4) federal research on Gulf War veterans' illnesses and factors that might have caused their problems has not been pursued proactively; (5) the majority of the research has focused on the epidemiological study of the prevalence and cause of Gulf War illnesses rather than the diagnosis, treatment, and prevention of them; (6) while this epidemiological research will provide descriptive data on veterans' illnesses, methodological problems are likely to prevent researchers from providing precise, accurate, and conclusive answers regarding the causes of veterans' illnesses; (7) ongoing epidemiological federal research suffered from two methodological problems: a lack of case definition, and absence of accurate exposure data; (8) without valid and reliable data on exposures and the multiplicity of agents to which the veterans were exposed, researchers will likely continue to find it difficult to detect relatively subtle effects and to eliminate alternative explanations for Gulf War veterans' illnesses; and (9) support for some official conclusions regarding stress, leishmaniasis (a parasitic infection), and exposure to chemical agents was weak or subject to alternative interpretations.