Chemical Warfare
Project Summary

Title: Persian Gulf Veterans Health Tracking System
Synopsis: A study to describe all potential health consequences of Gulf War veterans related to possible environmental and occupational exposures e.g. oil fires, vaccines, chemical/biological warfare agents, pesticides, pyridostigmine bromide (PB), etc.
Overall Project Objective: Characterize all potential exposures (e.g., oil fires, vaccines, chemical/biological warfare agents, pesticides, pyridostigmine bromide, etc) to U.S. military personnel participating in Operation Desert Storm, and to assess the potential health consequences of those exposures. This responds to Public Law 102-585 (Section 702: Scientific research using Troop Health Registry).
Status/Results to Date: Since the March 1996 updates, we have received official confirmation from MEDCOM to proceed with this project. From July 1995 to April 1996, the CHPPM had developed a conceptual protocol for this project. This conceptual protocol integrates all potential environmental exposure and medical outcome databases for Operation Desert Storm. During this period of time, we had also reassessed the exposure databases which will be integrated into the Persian Gulf Veterans' Health Tracking System GIS. This reassessment was based on several requests from the Persian Gulf War Veterans' Illness Investigative Team (now the Office of the Special Assistant for Gulf War Illnesses [OSAGWI]) and the Assistant Secretary of Defense for Health Affairs Office, to concentrate on those environmental exposures deemed most critical to Gulf War Veterans' illnesses. These environmental databases include low-level chemical and biological exposure (from coalition bombings and munitions storage bunker detonations) and pesticide usage and their possible interaction. Other environmental exposure data sets/databases include regional particulate matter concentrations for the Operation Desert Storm theater of operations; regional depleted uraniurn (DU) air concentrations for the Operation Desert Storm theater of operations and Botulinum Toxoid and anthrax vaccinations. In addition, taskings were received which required integration of the CCEP database into the GIS from which medical outcome and exposure relationships can be investigated. To date, this project is ongoing. We have integrated the CCEP database into the GIS. Space and time analyses are being performed on the possible low-level chemical agent exposure from the munitions storage bunker detonations at Khamisiyah and air war attacks on other sites. The soldiers and Units identified in the CCEP, the U.S. Armed Services Center for Research of Unit Records Troop Unit Movement Database, and the Defense Manpower Data Center Operation Desert Storm personnel roster are being mapped with respect to their proximity to these sites. Exposure analyses are being performed with dispersion modeling results from the Central Intelligence Agency, Defense Threat Reduction Agency, and Naval Surface Warfare Center. We are planning to integrate the chemical detection network data into the 018 for additional low-level chemical agent analyses. In addition, other environmental exposure data sets/databases to include scud sites, tent heaters, microwaves, and dust suppression are being collected and assessed. This year additional exposure data on chemical agents, DU, particulate matter, botulinum toxoid, anthrax vaccinations, and oil well fires was added to the system databases, in addition to improved troop unit movement data. The system is being used to support various VA and university researchers assessing Persian Gulf veterans' exposures and the impact on their current health. Support of a joint VA, DoD, HHS, and multi-university study of ALS (VA-61/DoD-118) among Gulf War Veterans is also being provided as well as support of a joint analysis of the combined VA and DoD (CCEP) clinical registries (DoD-94). A new study, in conjunction the Uniformed Services University of the Health Sciences, studying fatal motor vehicle crashes among Gulf War and non-deployed veterans is also underway (DoD-102). We are also collaborating with the new VA Center for the Study of War Related Illnesses in Washington D.C. on a number of issues.
Agency:Department Of Defense
Location:US Army Center for Health Promotion and Preventive Medicine
P.I. Name:Jack M Heller, Ph. D.
Research Type:Development
Research Focus:Environmental Toxicology
Focus Category:Chemical Warfare
Study Start Date:April 15,1995
Estimated Completion Date:December 31,2003
Specific Aims: The site-specific Kuwait Oil Fire Health Risk Assessment and the Troop Exposure Assessment Model (TEAM) address the potential risks to U.S. military personnel from potential exposure to airborne contaminants from oil well fires. This study attempts to characterize other potential exposures experienced by U.S. military personnel during Operation Desert Storm and to assess the potential health risks/consequences of those potential exposures.
Methodology: The Persian Gulf Veterans Health Tracking System uses a geographical information system (GIS) to assess potential exposures and medical outcomes for U.S. military personnel who participated in Operation Desert Storm. Once troop locations are determined and mapped (from the Troop Location Registry data), the GIS can help determine potential troop exposure to any number of different chemicals environmental threats, or other materials. When troop locations and potential exposures have been determined, the potential health risks resulting from the potential exposures can be determined. In addition to examining potential exposure, databases on medical outcomes (e.g., Comprehensive Clinical Evaluation Program (CCEP), the Veterans Administration Mortality Study, etc.) can be evaluated by studying potential exposures, locations, movements, and relationships of the troops in these databases for epidemiological significance.
Most Recent Publications:

Smith TC, Heller JM, Hooper TI, Gackstetter GD, Gray G. Are Gulf War veterans experiencing illness due to exposure to smoke from Kuwaiti oil well fires? Examination of Department of Defense hospitalization data. American Journal of Epidemiology, 155(10):908-917. May 2002. Abstract

Draxler RR, Gillette DR, Kirkpatrick JS, Heller JM. Estimating PB-10 Air Concentrations from Dust Storms in Iraq, Kuwait and Saudi Arabia Atomospheric Environment, 35:4315-4330, 2001. Article

Lange JL, Schwartz DA, Doebbeling BN, Heller JM, Thorne PS. Exposures to the Kuwait oil fires and their association with asthma and bronchitis among gulf war veterans. Environmental Health Perspectives, 110(11):1141-1146. Nov 2002. Abstract

Gray GC, Smith TC, Knoke JD, Heller JM. The postwar hospitalization experience of Gulf War veterans possibly exposed to chemical munitions destruction at Khamisiyah, Iraq. American Journal of Epidemiology, 150 (5) 532-40, Sep 1999. Abstract