Tuesday, 20 September 2011

The legacy of Desert Storm

This post represents a little bit of a departure from the my normal autism research-related musings. The topic however is something that has cropped up during the course of my career on several occasions. Read on and see more.

Having recently commemorated the shocking events of 10 years ago on that fateful Tuesday morning September 11th 2001, the repercussions of those atrocities continue to reverberate across the globe. Whilst Afghanistan remains an active theatre of operations, the memory is still fresh from Operation Iraqi Freedom and the whys and wherefores of that conflict that left so many families devoid of loved ones. Casting your mind back further to the early 1990s, and in particular the conflict known as Operation Desert Storm, some interesting questions still remain outstanding on the health implications to military and civilian populations alike as a result of the 'Video Game War'. A recent paper by Lea Steele and colleagues* published in the journal Environmental Health Perspectives provides further evidence (adding to a growing body of research) suggesting that deployed military personnel experienced various illnesses potentially as a result of several exposures on and off the battlefield.

It is perhaps important to make a few points before proceeding. As well as being the first modern action to be broadcast live to the masses, remembering all those picture of Tomahawk cruise missiles being deployed from the coaliton battlegroup, the 1990 Persian Gulf War has been described as one of the most toxic wars in history. Saddam Hussein and his followers were known to use chemical weapons on their own population as exemplified by the Halabja attack; an attack which is thought to have used various chemical agents including mustard gas and the nerve agents sarin and VX. Although the picture is still fuzzy about whether such agents were deployed against coalition troops, the environment was always going to be a hostile one for lots of other reasons such as burning oil fields and various depleted uranium tipped munitions employed on top of the various other hurdles posed by a pretty inhospitable natural environment. Although the subject of some debate in a dwindling number of quarters, it does appear that many deployed personnel returned from the conflict in a pretty poor state of health; indeed even 10 years after, their health was still the cause of some concern. Termed, 'Gulf War Illness' or 'Gulf War Syndrome', the US Department of Veteran Affairs website carries quite a lot of information about what the syndrome includes. I am going to stop there on the background data because the research base to the condition is huge and could take up a whole blog in itself.

Back to the Steele paper. Their findings based on 144 veterans who met author specified criteria for Gulf War Illness suggested that several different factors and scenarios might have been instrumental to their symptoms depending on whether personnel were in active theatre or not. For forward deployed troops, reported proximity to SCUD missile explosions and the use of pyridostigmine bromide (PB) pills, also called NAPS (anti-nerve agents), were associated with illness. For support personnel not seeing front line action, the use of pesticides on clothing or skin were associated with illness.

Bearing in mind various limitations of this paper, the results are complex yet interesting. I have previously touched upon pesticide exposure in relation to autism and what the various classes of pesticides might be capable of so won't give much more space to this factor aside from what is already known about the health effects of DEET and lindane. PB pills have long been the source of speculation in terms of their potential health effects. Professor Mohamed Abu Donia has published extensively on the 'interacting' effects of pesticides and PB medication. As for the SCUD explosions, I don't know. It does perhaps make you wonder what the payload might have been in these missile particularly when you see what was potentially hosted at some Iraqi munitions dumps.

I mentioned at the start of this post about how Gulf War illness is something not unfamiliar to my time in autism research. One of the questions that has been asked over the years concerns what happened to the offspring of those veterans who were conceived after their service. Did those environmental exposures (and possibly others) so detrimental to the health of many of them have any effects on their children? How about concentrations of toxic trace elements and autism as discussed by this study** by Fido and Al-Saad based in Kuwait? Relevant or not?

* Steele L. et al. Complex factors in the etiology of Gulf War Illness: wartime exposures and risk factors in veteran subgroups. Environmental Health Perspectives. September 2011.
** Fido A. & Al-Saad S. Toxic trace elements in the hair of children with autism. Autism. August 2005.