Science and soldiers' stress

To veterans it is a cruel mystery: Which of the countless pesticides, pollutants, microbes and poisons they encountered during the Persian Gulf War has left one in seven of them sick with a debilitating and persistent illness?

On Capitol Hill it is an outrage: Why, after spending more than $200 million on hundreds of studies, can't the Pentagon and the Department of Veterans Affairs determine what pollutant or microbe is causing the panoply of symptoms known as Gulf War illness?

Most scientists who have studied the chronic health problems of Gulf War veterans say they have answers to both questions: There is no environmental toxin or infectious agent to blame. A decade of research overwhelmingly points to another cause -- stress.

Yet many veterans don't believe it.

"I know a lot of people who are sick, and stress is not what's killing them," said Stephen Robinson, who served in special forces during the Gulf War and now heads the National Gulf War Resource Center, an advocacy group for ill veterans.

Searching for answers

Data show that Gulf War veterans are no more likely to die or be hospitalized than their peers who never served in the region. Their rates of cancer and other serious diseases are no higher than expected in 700,000 people of their age and background.

The VA did announce in December that Gulf War veterans are twice as likely to suffer from Lou Gehrig's disease as their peers, but many experts question the finding because no scientific paper has been published to back it up.

Even if it is borne out, says University of Iowa epidemiologist Gregory Gray, the Lou Gehrig's disease finding does not topple stress as the most likely cause of Gulf War illness because it applies to only a few dozen people. There could always be a small subset of veterans with a single well-defined disease that was caused by an infectious or toxic exposure during the Gulf War. But that would not explain what is making thousands of other veterans sick.

Still, no one disputes that Gulf War illness is real.

Researchers have verified that veterans of the Persian Gulf war are more likely to suffer from a range of chronic symptoms including memory and thinking problems, fatigue, joint pain, depression, anxiety, insomnia, headaches and rashes.

But why? In the 11 years since the Gulf War, myriad possibilities have been advanced, investigated and found wanting.

Government, university and independent investigators have looked at pesticides, parasites, insect repellents and pills the troops took to protect themselves from chemical attack. Also examined: Contaminated vaccines, infectious bacteria, depleted uranium ammunition and smoke billowing from oil wells that were set alight by retreating Iraqi troops.

Those who have proposed such agents as the cause of Gulf War illness have run up against a major obstacle: the estimated 100,000 victims have no single thing in common except that they all became ill after serving in the same war. Symptoms have been reported by veterans who were stationed thousands of miles apart and who performed widely differing duties. Experts say it would have been virtually impossible for such a wide cross-section of troops to have been exposed to the same thing.

Congress marches on

Unconvinced by stress arguments, members of Congress continue to approve funds for research into other theories. Sometimes they circumvent the normal scientific peer review process through which panels of government scientists decide how to allocate federal research money.

For example, Rep. Robert Livingston, R-La., now retired, attached $3.4 million to the 1996 defense budget to investigate the theory that Gulf War illness is caused by infectious bacteria.

Sen. Kay Bailey Hutchison, R-Texas, has earmarked a total of $10 million in the last two defense budgets to establish an independent research institute at the University of Texas Southwestern Medical Center so that the theory on toxic chemicals can continue to be studied.

The search for alternate explanations is certain to continue. In January the Secretary of Veterans Affairs, Anthony J. Principi, appointed yet another committee on Gulf War illness. Its job is to advise the government on the direction of future research.