Papers p 290

By the end of the Gulf War in February 1991 US, British, and Canadian forces had deployed about 697 000, 53 000, and 4500military personnel, respectively, to south west Asia. The conflict required rapid mobilisation of coalition combat troops, and massive numbers of casualties were expected.1 An extensive medical infrastructure and preventive medicine effort was deployed to support the troops. 2 3 During the operation service personnel were exposed to a wide variety of known and potential health hazards. These exposures included smoke from oil well fires, extremes of hot and cold weather, petroleum products and fumes, depleted uranium, pesticides, endemic infectious diseases, and other physical and psychological stressors. The preparations for war included training in chemical warfare, immunisation against certain biological warfare agents, and use of the nerve agent protection pill, pyridostigmine bromide.

Despite the arduous conditions, morbidity rates among US troops were lower than in previous wars. 4 5 Mortality was also much lower than expected. Altogether 372 deployed US troops died in 1990-1: 40% from combat, 52% from accidents (primarily related to training and motor vehicles), and 8% from illness.6 Illnesses in Gulf War veterans have been a source of intense controversy on both sides of the Atlantic. Since 1991 many veterans and their families have voiced concerns about possible health consequences of their service, and many have complained of being unwell, reporting a wide array …