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The authors administered surveys to the 249 participants
in the study above, using standardized booklets to record self-reported
GW exposures to 19 suspected risk factors for illness during the war.
Syndrome 1 (see above two studies) was more common in veterans who reported
having worn pet flea-and-tick collars during the war and in veterans whose
main job during the GW involved security. Syndrome 2 was more common in
veterans who reported having experienced a likely chemical weapons attack
and in veterans who were located in "Sector 7" in northeastern
Saudi Arabia on January 20, 1991. Syndrome 3 was more common in veterans
who used more insect repellent on their skin and in those with more adverse
effects from pyridostigmine. The three syndromes were not associated with
any of the other suspected risk factors. The authors conclude that they
have demonstrated associations between specific risk factors (especially
cholinesterase-inhibiting compounds) and systematically defined syndromes
in GW veterans. They liken the syndromes to variants of organophosphate-induced
delayed polyneuropathy (OPIDP). The article’s discussion elaborates
on the mechanism of OPIDP and the related scientific evidence which is
compatible with their hypothesis. They discuss at length the controversy
about whether or not chemical agents which do not cause acute symptoms
can cause delayed neurological effects. Limitations of the study are some
of those described for the above two studies, recall bias in this repeatedly
examined group, the speculative nature of reported exposures to chemical
weapons, and the paucity of data which would permit extrapolation from
animal studies to GW veterans. |
