Analysts have based their conclusions on the likely consequences of exposure to PM on the contaminants of concern (silica or soot) and do not take into account the possible synergistic effect of other toxic compounds (e.g., volatile and semi-volatile organic compounds, metals, etc.) that may be present. Further research is required to develop an understanding of the dose-response mechanisms associated with these types of exposure.

Medical diagnoses for respiratory distress complaints during the Gulf War typically cited non-specific causes and did not relate symptoms to exposures to PM. To differentiate between the various potential causes of respiratory distress, especially when US forces are deployed to dusty regions, health care professionals may need to revise diagnosis procedures to better account for causes originating from environmental factors such as PM exposure.

Information about the mechanisms of toxicity and the synergistic effect of multiple compounds present in association with PM is limited. In general, there is not a clear relationship between the individual toxic components of airborne PM and adverse health symptoms or indicators, such as respiratory and cardiovascular ailments. Nor is there toxicological evidence suggesting plausible biological mechanisms to explain the toxic effects attributed to PM in epidemiological studies, or to determine how the populations at risk are exposed to these components. Additional detailed information on the physical, chemical, and biological properties of the various components of PM that might cause the adverse health effects is needed to fill these information gaps.

The USACHPPM continues its collaborative efforts with the NOAA/Air Resources Laboratory to reconstruct daily PM levels for the KTO. This effort will provide additional information on PM exposure levels in the KTO in relation to daily troop unit locations and provide unit commanders with information to implement actions to reduce exposures that may otherwise result in acute symptoms.

It should be noted that the limitations in the data and the need for additional research are not unique to the Gulf War; the limitations apply more generally to our knowledge of PM exposures.

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