OFFICE OF THE SECRETARY OF DEFENSE WASHINGTON, D.C. 20301-3140

DEFENSE SCIENCE BOARD

MEMORANDUM FOR CHAIRMAN, DEFENSE SCIENCE BOARD

SUBJECT: Report of the Defense Science Board (DSB) Task Force on Persian Gulf War Health Effects

• all available intelligence and reports of chemical or biological agent detection or exposure during the Persian Gulf War

• scientific and medical evidence relating to exposure to nerve agents at low levels and possible long term effects

• other potential health consequences resulting from low level chemical exposure, environmental pollutants, Kuwaiti oil fires, endemic biologics or other health hazards attributed to Persian Gulf service

In this report, we confine ourselves to conclusions for which there is substantial supporting evidence. There is a substantial hiatus between the imaginable and the plausible and the proven.

On the order of 1 per thousand or less of the troops deployed in Operation Desert Shield/Storm (ODS) have reported symptoms and complaints for which there is not a conventional medical diagnosis and explanation. Many conjectures could be entertained, and would be hard to prove or disprove, about exposures and consequences at this level of outcome; ODS was not conducted as a controlled clinical experiment for our analytical convenience. It might take many years of further investigation to run every conjecture to ground beyond any remote possibility of doubt. In our proceedings, we relied on the veracity of reports briefed to us by the analysts from the Department of Defense, the intelligence community, and other government agencies. In our view, we had unstinting cooperation from all of these; but beyond our examination for face consistency, and an effort to get corroboration from primary records, e.g. log books, we had no resources or procedure to challenge that veracity.

Accordingly, our conclusions are as follows:

• There is no persuasive evidence that any of the proposed etiologies caused chronic illness on a significant scale in the absence of acute injury at initial exposure. In fact, the overall health experience of US troops in ODS was favorable beyond previous military precedent, with regard to non-combat as well as combat-related disease. This remarkably low background has probably put into relief the residual health problems that have instigated this inquiry.

• The Task Force found no evidence that either chemical or biological warfare was deployed at any level against us, or that there were any exposures of US service members to chemical or biological warfare agents in Kuwait or Saudi Arabia. We are aware of one soldier who was blistered, plausibly from mustard gas, after entering a bunker in Iraq during the post-war period.

• The Task Force felt that there is insufficient epidemiological evidence at this time to support the concept of any coherent "syndrome". We do recognize that veterans numbering in the hundreds have complained of a range of symptoms not yet explained by any clearcut diagnosis -- a number of cases in many respects resemble the "Chronic Fatigue Syndrome"; it would be advantageous to coordinate further research on veterans' illness in this category with ongoing studies of"CFS" in the civilian population. This is not to deny the possibility of service-connectedness, as severe stress, infection and trauma may well be precipitating causes of"CFS".

• Much further work is needed, even to verify whether the incidence of symptomatic events, beyond the reports of complaints that can be elicited by wide publicity, is associated with any specific aspects of ODS experience, or indeed is provably different among ODS veterans compared to other armed forces or the civilian population. This remark is not to be read as denying service-connectedness, but simply a reflection of the tenuous state of the available epidemiological data in the absence of controlled surveys and studies.

• The Department of Defense needs substantial improvements in pre and post-deployment medical assessments and data handling. These must obviously be coordinated between DoD and DoVA.

• The appropriate Service medical facilities should ensure that clinical treatment, absent a proven etiology, is managed on a case-by-case basis, directed at the symptoms presented. Carefully controlled treatment protocols might assist in carving out specific syndromes from the broad range of symptoms noted.

• The Task Force advises that high-tech, low-casualty campaigns in exotic places will engender a preoccupation with residual health effects as a fact of life for the foreseeable future. If chemical or biological weapons are ever actually employed, there will be a gross multiplication of those residuals (on top of obvious acute physical and psychological casualties), and further research is needed on long-term consequences of exposure.

Joshua Lederberg
Chairman

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