Memorandum submitted by Professor Malcolm
Hooper, Scientific Advisor to the Gulf Veterans' Association
TABLE OF CONTENTS
| Summary and Abstract |
28 |
| Preface | 29 |
| Introduction | 30 |
| Nerve Agent Protection Sets, NAPS, Pyridostigmine Bromide, PB
| 34 |
| Vaccinations | 36 |
| Pesticides and DEET | 40 |
| Chemical Weapons | 41 |
| Depleted Uranium | 44 |
| Biological Weapons | 47 |
| Oil, Smoke, Fuels and Solvents | 47
|
| Summary of Gulf Exposures on Biological Systems/Organs
| 49 |
| Natural Hazards | 49 |
| Post Traumatic Stress Disorder, PTSD | 50
|
| Diagnosis and Treatment | 50
|
| Immediate and Future Actions | 53
|
| MOD, MAP and Independent Panel | 53
|
| References | 56 |
SUMMARY AND ABSTRACT
There is compelling evidence that Gulf War Veterans, GWVs
suffered extensive exposures to chemical and biological insults—
(a) IN PREPARATION FOR THE WAR
(i) Pyridostigmine Bromide, PB, NAPS tablets.
(ii) Vaccinations in large numbers and of varied types.
(b) IN THE THEATRE OF OPERATIONS
(i) Further vaccinations.
(ii) Exposure to varieties of pesticides of different chemical
classes, and DEET.
(iii) Depleted Uranium, DU, particularly as a ceramic dust.
(iv) Chemical Warfare Agents.
(v) Some Biological Warfare Agents.
(vi) Extensive exposures to Crude Oil and Smoke from the Oil
Well fires.
These exposures can be linked directly to the chronic illnesses
Gulf War Veterans are experiencing. They impact on many different
systems in the body causing multi-symptom, multi-organ, and multi-system
adverse effects.
There has been a massive assault on:
1. The nervous system, particularly the cholinergic system.
The neuroendocrineimmune paradigm provides a framework within
which the research data currently available can be understood
and new studies constructed.
Both the MOD and MAP have failed to listen to the GWVs and
have denied information, rejected pleas, and temporised in a continual
attempt to avoid facing the truth of the Gulf War. They have,
not provided justice. They have sought to disguise and cloak truth,
and practised deception. They have shown no compassion.
Both MAP and the Independent Panel provide alibis for not
addressing directly the health needs of the GWVs.
"A tin ear, cold heart and a closed mind" (Burton
1997) mark all their dealings.
Almost 10 years after the Gulf War no Government Agency has
effectively addressed the burning issue of the health of GWVs
who are dying at the rate of one per week.
The MOD and its associated bodies have now lost the trust
of the Veterans.
The Burton Committee in the States found that the official
Government and Military bodies in the States.
"After 19 months of investigation and hearings, the subcommittee
find the status of efforts on the Gulf War issues by the DOD,
VA, CIA and FDA to be irreparably flawed. We find these efforts
hobbled by institutional inertia that mistakes motion for progress.
We find those efforts plagued by arrogant incuriosity and a pervasive
myopia that sees lack of evidence as proof. As a result, we find
current approaches to research, diagnosis, and treatment unlikely
to yield answers to veterans `life-or-death' questions in the
foreseeable, or even far distant future." (Burton 1997)
This comprehensive catalogue of failures applies fully to
the MOD who still refuse to acknowledge facts conceded by the
Government and Military in the USA.
This has greatly hampered research in the UK. GWVs have sought
help from other sources in addressing their illnesses. A number
of extensive and varied studies have been carried out in the States,
where UK veterans have sent samples for examination and analysis.
The data from these studies and from the small amount of
UK work has never been investigated or assessed by any group associated
with the MOD.
It is clear that—
the prophylactic treatment with PB and the use of
aldoximes to aid recovery from nerve agent attack is FATALLY flawed.
The massive vaccination programme has involved the
use of unauthorised vaccines which did not work and was delivered
without informed consent. It has laid the foundation for profound
disturbances of the immune system which have led to chronic illnesses.
Pesticides were used excessively and with little
or no protection to the operatives. Some of these have reinforced
the cholinergic insults provided by PB and nerve agents. All are
known to produce adverse effects which are synergistic.
There is very strong evidence of chemical weapons
exposure.
There was an admitted colossal failure in providing
chemical detection equipment. Production, storage, training and
use were all deficient and left our troops unprotected. This totally
invalidates and renders hollow the repeated MOD assertions that
there was no exposure to chemical warfare agents.
Depleted uranium has been found in the urine of
GWVs indicating a prolonged radiological exposure from the inhalation
of DU dust over nine years ago. The extent and consequences of
such a cumulative radiotoxic dose is probably considerable.
Oil and smoke exposure has not been seen as a major
health threat although there is clear evidence of the adverse
effects of such exposures.
New methods of diagnosis are known and some treatments
have proved effective in improving the health of GWVs. These have
not been examined.
New research programmes, independent of the MOD,
MAP, and the Independent Panel, must be initiated as a matter
of urgency. Suggestions are made for developing such programmes.
The Gulf War was unique in the annals of Western Military
History. It was the first war in which the Coalition Forces were
faced by both chemical, CW, and biological BW, weapons. The knowledge
that Iraq has already used these weapons in vanquishing the Iranian
army and those fighting for an independent Kurdistan made it clear,
beyond any doubt that such weapons would be used, against the
Coalition Forces. Very high casualties are known to be associated
with the use of these weapons, Maynard 1992, and were expected
during the Gulf conflict.
The facts behind Iraq acquiring and developing these weapons
are slowly becoming known much to the embarrassment of the Governments
of the USA and the UK. It is now established that Iraq was supplied
with biological cultures and growth media, biological toxins,
chemical intermediates, and munitions by USA and UK with Government
approval. Reigle 1994; Burton 1997; Thomas, 1998; Keen letter
1995. All the technology for creating weapons of mass destruction
was provided to a regime which would use them against our own
troops. We armed the enemy.
The preparations for the Gulf War were made in full cognisance
of these facts.
The UK Gulf War Veterans, GWVs, were exposed to the following
hazards.
(1) Pyridostigmine bromide—administered prophylactically
as an experimental and unproven protection against the nerve agent
soman and other nerve agents.
(2) Mass Vaccinations—with the established Health
and Hygiene vaccines plus vaccines designed to counteract anthrax,
plague and botulism. Pertussis was given as an unproven and experimental
adjuvant. A number of unspecified vaccines were also given, perhaps
as many as six.
(3) Excessive Levels of Pesticides of different categories—these
included organophosphates, OPs, carbamates, CBs, pyrethroids,
and lindane.
(4) Excessive quantities of DEET, an insect repellant.
(5) Chemical Weapons exposures at low levels. These included
Nerve Agents (sarin, VX, soman), lewisite, mustard gas, hydrogen
cyanide, and possibly other agents.
(6) Biological Weapons—these included, anthrax,
plague, botulinum toxins, tricothecene mycotoxins, aflatoxin,
and possibly ricin.
(7) Depleted Uranium, DU, particularly dangerous as very
small particles of ceramic DU which could be inhaled and lodge
in the lungs, posing both a radiological and toxic metal hazard.
(8) Oil and Smoke from the oil well fires. This provided
a deadly brew of potent and damaging chemicals, including potent
carcinogens. Other solvents and fuels also contributed to this
hazard.
(9) Natural Hazards—these included the very fine
sand in parts of the region and natural endemic diseases.
The troops were supplied with very inadequate detection devices
for chemical weapons. These were of different types but would
respond rapidly to any exposure. There were no effective and efficient
devices for the rapid detection of any biological weapons according
to an MOD spokesman.
I will address each of these hazards in turn after a brief
introductory chapter on essential biological terminology.
I will then consider the work of the MOD, the Independent
Panel and MAP, and examine the questions of diagnosis and treatment,
before making recommendations about immediate and future actions.
INTRODUCTION
The Nervous System
The nervous system can be regarded as made up of three sub-systems,
the central, peripheral, and autonomic nervous systems. Further
divisions are usually made on the basis of the key chemicals,
neurotransmitters, involved in the transmission of nerve impulses
to other nerves, organs and glands.
The Cholinergic System is that part of the nervous system
which uses Acetylcholine as its neurotransmitter molecule. Cholinergic
nerves form part of the central, peripheral and autonomic nervous
systems. The cholinergic system is further sub-divided into nicotinic
and muscarinic branches depending on whether the action of acetylcholine
is mimicked by nicotine or muscarine. There are further sub-divisions
which need not concern us here.
Other major neurotransmitters are adrenaline, noradrenaline,
dopamine, 5-hydroxytryptamine (serotonin), a variety of neuropeptides,
including opioid peptides, cholecystokinins, neurotensins etc.
The different systems mutually interact and influence each
other so that changes in one system will cause changes in another.
Although many of these interactions are now well understood there
remains much to discover particularly about the workings of the
central nervous system.
THE BLOOD
BRAIN BARRIER
This is the membrane surrounding most of the central nervous
system which prevents the entry of many compounds into the brain
and spinal cord. However it can be made much more permeable by
inflammation arising from infection or some chemical exposures.
It is not complete and is penetrated by the olfactory tract
which allows direct intra-neural transport into the brain, particularly
the limbic system and thereby affecting the hypothalamus and pituitary,
Ashford and Miller, 1991, 1998. Many chemicals which are inhaled
will therefore have uninterrupted access to the brain. This mechanism
is thought to play a major part in developing chemical sensitivities.
The brain stem is also less protected than other areas of the
brain, Goodman and Gilman, 1980.
THE NEUROENDOCRINEIMMUNE
(PSYCHONEUROIMMUNE, PNI) PARADIGM
It is now clear that there is also considerable "cross
talk" between the nervous system, the immune system, and
the endocrine system Alder, 1991. Many neurotransmitters, including
acetylcholine, exert direct effects on the immune and endocrine
systems.
The immune system deals with infection by viruses, bacteria
and other micro-organisms, scavenging of cancers cells, inflamation,
allergy and sensitisation reactions. The impact of vaccines on
the immune system provides the basis of protection offered by
vaccines.
The endocrine system provides the central control mechanisms
for stress responses, growth, sexual and reproductive functions,
etc. The hypothalamus and pituitary gland are part of the brain.
Any major disturbance of any one of these systems will result
in disturbances in the other systems which may have serious consequences.
Gulf War Veterans, GWVs, show damage in all three of these
areas. The consequences of such damage will not necessarily be
limited to the area first affected by the chemical or biological
insult.
Electrical stimulation of the nerve results in the release
of acetylcholine, Ach, which travels through the narrow gap between
the nerve and the receiving cell, which may be another nerve,
a gland, smooth or voluntary muscle etc. Following binding to
a cholinergic receptor (cholinoceptor) the response in the receiving
tissue is evoked. Acetylcholine is rapidly broken down by a specific
enzyme, acetylcholinesterase, AchE, which restores the resting
state of the whole system.
Binding of the inhibitor to AchE prevents the binding and
breakdown of Ach resulting in an initial excessive stimulation
of the receiving cell which then rapidly fails to function. Pyridostigmine,
PB, Organophosphate, OPs, (malathion, parathion, chlorpyrifos,
etc) and Carbamate (Carbaryl, Aldicarb etc) insecticides, Nerve
Agents (Sarin, Soman, VX etc) all inhibit AchE.
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