In January 1995 the Institute of Medicine released a preliminary report containing initial findings and recommendations on the federal government's response to reports by some veterans and their families that they were suffering from illnesses related to military service in the Persian Gulf War.

The committee was asked to review the government's means of collecting and maintaining information for assessing the health consequences of military service and to recommend improvements and epidemiological studies if warranted. This new volume reflects an additional year of study by the committee and the full results of its three-year effort.

Contents

• COMMITTEE TO REVIEW THE HEALTH CONSEQUENCES OF SERVICE DURING THE PERSIAN GULF WAR
• Preface
• Executive Summary
  • Recommendations
• 1. Introduction
  • An Emerging Problem
  • Panels and Committees
  • Conclusions
  • Charge to the Committee
  • Research and Data Issues
• 2. Charge to the Committee: Its Findings and Recommendations
  • Overview
  • The Committee's Charge
  • Findings and Recommendations
• 3. Environment and Exposures
  • Overview
  • Natural Environment
  • Man-Made Environment
  • Psychosocial Exposures
  • DVA Environmental Hazards Research Centers
• 4. Health Outcomes
  • Overview
  • Mortality Studies
  • Hospitalization Studies
  • Diagnosed Diseases in PG Veterans
  • Studies of Self-Reported Symptoms
  • Adverse Reproductive Outcome Studies
  • Mental Health Studies
  • Women's Health Studies
• 5. Some Hypotheses Regarding Illnesses in Persian Gulf War Veterans
  • Overview
  • Chronic Fatigue Syndrome
  • Multiple Chemical Sensitivity
  • Oxidative Phosphorylation Disorder
  • Dental Amalgams
  • Bacterial Illness
  • Mycoplasma and Chronic Fatigue
  • Skeletal Muscle Bioenergetics
  • Sarcoidosis and Lingual Abnormalities
  • Brainstem Dysregulation Syndrome
  • Microsporidia Infection
  • Organophosphate-Induced Delayed Neurotoxicity
  • Chemically Induced Porphyria
  • Fibromyalgia
  • Somatization Disorder
  • Summary
• 6. Information Systems
  • Overview
  • Criteria For a Research-Oriented Health Information System
  • Persian Gulf War Health Information Systems
  • Health Information Systems For the Future
  • Conclusions
• References
• Appendixes
  • A Relevant Sections of Public Law: 102-585
  • B Statement of Task
  • C Committee Meetings and Individuals Providing Information
  • D Invited Presentations
  • E Other Groups Reviewing Persian Gulf War Veteran Health Issues
  • F Research and Related Activities on Health Problems of Persian Gulf War Veterans
  • G Selected DoD, Army, Navy, Air Force, and DVA Databases
• Acronyms

Support for this study was provided equally by the Department of Veterans Affairs and the Department of Defense (Contract No. V101(93)P-1417).

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competencies and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.