US links motor neurone disease with Gulf war service

BMJ 2002; 324 doi: (Published 12 January 2002) Cite this as: BMJ 2002;324:65
  1. Fred Charatan
  1. Florida

    US secretary of veterans affairs Anthony Principi has declared that motor neurone disease is connected with service in the Gulf war.

    He is the first to connect a specific illness with service in the Gulf war, and his decision will lead to full disability and survivor benefits for those with the disease, the cause of which is unknown.

    Last month the Department of Veterans Affairs described preliminary results of a government sponsored study involving 2.5 million US servicemen and servicewomen. The study was carried out at Duke University and the Veterans Administration Hospital in Durham, North Carolina, and was directed by Dr Ronald Horner, director of epidemiological research at the Veterans Administration Center in Durham. It found that of 700 000 US veterans who served in the Gulf from August 1990 to July 1991, 40 had motor neurone disease (known in the United States as amyotrophic lateral sclerosis), a case rate of 6.7 per million. Of 1.8 million US veterans in the same period who were not deployed, 67 developed motor neurone disease, a case rate of 3.5 per million.

    Dr Horner said, “We hope to have the manuscript describing the study and its findings published sooner rather than later. However, I cannot provide details as to a journal or publication date.”

    Since the Gulf war, more than 100 000 US veterans have complained of a wide range of symptoms that have collectively been labelled the “Gulf war syndrome” (BMJ 2001;323:473). The government has so far spent $155m (£111m; €173m) on 193 research projects to investigate their complaints. The studies have found no definitive links, although several have suggested that stress, exposure to chemicals, or prophylactic medicines given to soldiers may be factors. Motor neurone disease usually affects people in middle age, but the cases among Gulf war veterans have affected a much younger population. The cause is unknown, and no curative treatment exists.

    A spokeswoman for the UK Ministry of Defence said that they were aware of the study but await peer review of the findings. About 40 000 British troops served in the Gulf war.

    Embedded Image

    Gulf war veteran 42 year old Major Michael Donnelly, former fighter pilot in the US air force, who is now totally incapacitated by motor neurone disease, testifies before Congress

    (Credit: DENNIS COOK/AP)

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