I. OVERVIEW

• 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

Dr. Joshua Lederberg          The Rockefeller University
Dr. George M. Whitesides      Harvard University
Dr. Paul Doty                 Professor Emeritus, Harvard University
Dr. Abba I. Terr              Stanford University Medical Center
Dr. Joseph Bunnett            University of California, Santa Cruz
Dr. John D. Baldeschweiler    California Institute of Technology
Dr. Margaret Hamburg          NYC Commissioner of Public Health
Major General Phil Russen,    Johns Hopkins University School of Medicine
US Army (retired)

The following Government and special advisors assisted the Task Force:

Government Advisors          Agency

Dr. Ruth Etzel               Centers for Disease Control, Department 
                             of Health & Human Services
                             
Dr. Susan Mather             Department of Veterans Affairs

Dr. Ann Norwood              Uniformed Services University 
                             of the Health Services, 
                             Department of Defense


Special Advisors             Agency 

Dr. Richard Miller           Institute of Medicine, 
                             National Academy of Sciences
                             
Dr. Graham Pearson           Director General, Chemical & 
                             Biological Defense Establishment, 
                             United Kingdom

Administrative and research support was provided by Colonel Frank Cox and Major Ben Hagar, Office of the Assistant to the Secretary of Defense (Atomic Energy).

Following a series of fact-finding meetings (Appendix A) the Task Force - developed the following principal conclusions and recommendations:

A. Conclusions

• 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 Operation Desert Storm (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.

• There is no scientific or medical evidence that either chemical or biological warfare was deployed at any level against us, nor 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 postwar period.

• The epidemiological evidence is insufficient 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 clear-cut diagnosis -- a number of cases in many respects resemble the a 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 and 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 with the Department of Veterans Affairs.

• Clinical treatment, absent a proven etiology, must be 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.

• We advise that high-tech, low-casualty military 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. The Department of Defense must plainly sustain its historic commitment to providing the highest quality of health care to those who serve the nation in their military missions.

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