Loading ...
Sorry, an error occurred while loading the content.
 

Complete Executive Summary: Gulf War and Health: Volume 3

Expand Messages
  • Kirt Love
    It took me a few hours to put this much together, but this is the only part of the report we all need to know. As usual I wont get credit for this, I never do.
    Message 1 of 1 , Dec 20, 2004
      It took me a few hours to put this much together,
      but this is the only part of the report we all need
      to know.
       
      As usual I wont get credit for this, I never do. But,
      at least others will have this to work with.
       
                                                          Sincerely
                                                          Kirt P. Love
                                                          Director, DSBR
       

      Gulf War and Health: Volume 3. Fuels, Combustion Products, and Propellants
      EXECUTIVE SUMMARY
       
      SUMMARY OF FINDINGS
       
      Although Table ES-1 provides a summary of all the committee's conclusions, the committee wishes to note that the starting point for any health outcome before study is, of course, the category of inadequate or insufficient evidence of an association. Of all the health outcomes on which any evidence was culled from the epidemiologic literature, none was found to be associated in even a limited or suggestive fashion with the uncombusted fuels that veterans may have been exposed to during the Gulf War (with the exception of benzene, a component of fuels, which was reviewed by a previous IOM committee and not reassessed in this report).
       
      The strongest finding was that there is sufficient evidence of an association between combustion products and lung cancer. The committee also found limited or suggestive evidence of an association between combustion-product exposure and cancers at several other sites (oral, nasal, laryngeal, and bladder), incident asthma, and two reproductive outcomes after exposure during pregnancy: preterm birth and low birthweight or intrauterine growth retardation. For the propellant components of Scuds, only hydrazines were found to have a suggestive association with lung cancer.
       
      Finally, it should be repeated that the committee was charged with reviewing the scientific data, not with making recommendations regarding the Department of Veterans Affairs policy; therefore, conclusions are not intended to imply or suggest policy decisions. Furthermore, the conclusions are related to associations between exposure to the agents under study and health outcomes in human populations, not to the likelihood that any one person's health problem is associated with or caused by exposure to the agents.
       
      TABLE ES.1 Summary of Findings Regarding the Association Between Exposure to Fuels, Combustion Products, Hydrazines, and Nitric Acid and Specific Health Outcomes
       
      Sufficient Evidence of a Causal Relationship
      Evidence is sufficient to conclude that there is a causal association between exposure to a specific agent and a specific health outcome in humans. The evidence is supported by experimental data and fulfills the guidelines for sufficient evidence of an association (below). The evidence must be biologically plausible and satisfy several of the guidelines used to assess causality, such as: strength of association, dose­response relationship, consistency of association, and a temporal relationship.
      o No conclusions
       
      Sufficient Evidence of an Association
      Evidence is sufficient to conclude that there is a positive association. That is, a consistent positive association has been observed between exposure to a specific agent and a specific health outcome in human studies in which chance and bias, including confounding, could be ruled out with reasonable confidence. For example, several high-quality studies report consistent positive associations, and the studies are sufficiently free of bias, including adequate control for confounding.
      Combustion products and lung cancer

      Limited/Suggestive Evidence of an Association
      Evidence is suggestive of an association between exposure to a specific agent and a specific health outcome, but the body of evidence is limited by the inability to rule out chance and bias, including confounding, with confidence. For example, at least one high-quality study reports a positive association that is sufficiently free of bias, including adequate control for confounding. Other corroborating studies provide support for the association, but they were not sufficiently free of bias, including confounding. Alternatively, several studies of lower quality show consistent positive associations, and the results are probably not due to bias, including confounding.
       
      Cancers ·
      Combustion products and
      o Cancers of the nasal cavity and nasopharynx
      o Cancers of the oral cavity and oropharynx
      o Laryngeal cancer
      o Bladder cancer ·
      Hydrazines and lung cancer
       
      Reproductive Effects ·
      Combustion products and
      o Low birthweight/intrauterine growth retardation and exposure during pregnancy
      o Preterm birth and exposure during pregnancy
       
      Respiratory Effects ·
      Combustion products and incident asthma
       
      Inadequate/Insufficient Evidence
      Evidence is of insufficient quantity, quality, or consistency to permit a conclusion regarding the existence of an association between exposure to a specific agent and a specific health outcome in humans.
      Cancers ·
       
      Fuels and
      o Cancers of the oral cavity and oropharynx
      o Cancers of the nasal cavity and nasopharynx
      o Esophageal cancer
      o Stomach cancer
      o Colon cancer
      o Rectal cancer
      o Hepatic cancer
      o Pancreatic cancer
      o Laryngeal cancer
      o Lung cancer
      o Melanoma
      o Nonmelanoma skin cancer
      o Female breast cancer
      o Male breast cancer
      o Female genital cancers (cervical, endometrial, uterine, and ovarian cancers)
      o Prostatic cancer
      o Testicular cancer
      o Nervous system cancers
      o Kidney cancer
      o Bladder cancer
      o Hodgkin's disease
      o Non-Hodgkin's lymphoma
      o Multiple myeloma
      o Myelodysplastic syndromes ·
       
      Combustion products and
      o Esophageal cancer
      o Stomach cancer
      o Colon cancer
      o Rectal cancer
      o Hepatic cancer
      o Pancreatic cancer
      o Melanoma
      o Female breast cancer
      o Male breast cancer
      o Female genital cancers (cervical, endometrial, uterine, and ovarian cancers)
      o Prostatic cancer
      o Testicular cancer
      o Nervous system cancers
      o Ocular melanoma
      o Kidney cancer
      o Non-Hodgkin's lymphoma
      o Hodgkin's disease
      o Multiple myeloma
      o Leukemia
      o Myelodysplastic syndromes ·
       
      Hydrazines and
      o Hematopoietic and lymphopoietic cancers
      o Digestive tract cancers
      o Pancreatic cancer
      o Bladder cancer
      o Kidney cancer ·
       
      Nitric acid and:
      o Stomach cancer
      o Melanoma
      o Lymphopoietic cancers
      o Pancreatic cancer
      o Laryngeal cancer
      o Lung cancer
      o Bladder cancer
      o Multiple myeloma
       
      Reproductive Effects ·
      Fuels and adverse reproductive or developmental outcomes (including infertility, spontaneous abortion, childhood leukemia, CNS tumors, neuroblastoma, and Prader-Willi syndrome) ·
       
      Combustion products and
      o Preterm births and exposure during any specific time period during pregnancy (for example, the first trimester)
      o Low birth weight and intrauterine growth retardation and exposure before gestation or during any specific period during pregnancy (for example, the first trimester)
      o Specific birth defects, including cardiac effects, and exposure before conception (maternal and paternal) or during early pregnancy (maternal)
      o All childhood cancers identified, including acute lymphocytic leukemia, leukemia, neuroblastoma, and brain cancer
       
      Neurologic Effects ·
      Fuels and
      o Peripheral neuropathy
      o Neurobehavioral effects
      o Multiple Chemical Sensitivity symptoms ·
       
      Combustion products and
      o Neurobehavioral effects
      o Posttraumatic stress disorder
      o Nervous system subgroupings (or individual nervous system diseases)
      o Multiple Chemical Sensitivity symptoms Respiratory Effects ·
       
      Fuels and
      o Nonmalignant respiratory disease
      o Chronic bronchitis
      o Asthma
      o Emphysema ·
       
      Combustion products and:
      o Chronic bronchitis (less than1 year of exposure)
      o Emphysema
      o Chronic obstructive pulmonary disease ·
      Hydrazines and emphysema
       
      Cardiovascular Effects:
      Combustion products and ischemic heart disease or myocardial infarction (less than 2 years of exposure) ·
       
      Hydrazines and ischemic heart disease or myocardial infarction · Nitric acid and cardiovascular diseases
       
      Dermal Effects:
      Fuels and dermatitis--irritant and allergic ·
      Combustion products and dermatitis--irritant and allergic
      Other Health Effects:
      Fuels and sarcoidosis
      Combustion products and sarcoidosis
      Hydrazines and hepatic disease
       
      Limited/Suggestive Evidence of No Association
      Evidence is consistent in not showing a positive association between exposure to a specific agent and a specific health outcome after exposure of any magnitude. A conclusion of no association is inevitably limited to the conditions, magnitudes of exposure, and length of observation in the available studies. The possibility of a very small increase in risk after exposure studied cannot be excluded. ·
      No conclusions
       

       
    Your message has been successfully submitted and would be delivered to recipients shortly.