Chapter 20 - GULF WAR VETERANS

20.1 What kinds of hazards may Gulf War veterans have been exposed to?

According to the Department of Defense (DOD) the approximately
690,000 American servicemen and women who served in the Gulf War may
have been exposed to many hazards such as:

* oil and other petrochemical agents

* smoke from the sabotage of Kuwaiti oil wells by retreating Iraqi
forces

* leishmaniasis (Sand flies)

* pyridostigmine bromide, malaria prophylaxis and other prophylactic
drug treatments

* depleted uranium (DU)

* inoculations (Anthrax, botulism, etc.)

pesticides

* diesel and jet fuels and other petrochemicals and solvents

* chemical agent resistant compound (CARC) paint

* chemical and/or biological warfare agents

* contaminated food and water obtained in the Persian Gulf

air pollutants (carbon monoxide, sulfur oxide, hydrocarbons,
particulate matter, and nitrogen oxide)

* psychological stressors

20.2 What is unique about examinations of Gulf War veterans?

Gulf War veterans may claim, and require an examination for, any
condition resulting from a disease or injury that was incurred in or
aggravated by military service, as other veterans do. In such cases,
the regional office may request an examination of one or more
specific conditions, e.g., residuals of a knee injury, and will refer
to the appropriate worksheet(s).



However, what is unique about Gulf War veterans is that some veterans
will need instead, or in addition, a comprehensive examination that
will allow the examiner to distinguish between a clearly diagnosable
condition (like asthma) and an "undiagnosed illness" (like a cough
that cannot be attributed to a specific diagnosis). An undiagnosed
illness is established when findings are present that cannot be
attributed to a known, clearly defined diagnosis, after all likely
diagnostic possibilities for such abnormalities have been ruled out.



Examiners should follow the worksheet titled "Guidelines for
Disability Examination in Gulf War Veterans," which provides detailed
instructions for examinations in Gulf War veterans.



20.3 What are the some signs and symptoms that may be manifestations
of undiagnosed illnesses in Gulf War veterans? (38 CFR 3.317)

* fatigue

* signs or symptoms involving the skin

*headache

*muscle pain

*joint pain

*neurologic signs and symptoms

*neuropsychological signs and symptoms

*signs or symptoms involving the respiratory system (upper or lower)

*sleep disturbances

*gastrointestinal signs or symptoms

*cardiovascular signs or symptoms

*abnormal weight loss

*menstrual disorders