Gulf War studies may be too late

2019-02-27 02:17:06

By Michael Day SHODDY record keeping and the difficulty of tracking down veterans of the Gulf War almost six years later could scupper belated attempts by the British government to understand the illnesses that have struck down hundreds of people. The British government first rejected calls to study Gulf War syndrome three years ago, and as recently as 1995, armed forces minister Nicholas Soames dismissed large epidemiological studies as “unnecessary”. But last week, the Ministry of Defence (MoD) launched two studies costing £1.3 million, after being forced to admit that it had misled Parliament over the extent to which veterans of the war were exposed to organophosphate insecticides. Patricia Doyle of the London School of Hygiene and Tropical Medicine, who heads the first study, plans to focus on reproductive health. Her team will send a questionnaire to each of the 50 000 British veterans to gather data on infertility, miscarriages and stillbirths. Doyle will also study low birth weight and congenital abnormalities among veterans’ children. Veterans’ responses will be compared with those of 50 000 military personnel who did not serve in the Gulf War. The second study, led by Nicola Cherry of the University of Manchester, will check whether there is any excess ill health in 6000 veterans compared with 6000 controls. If the researchers find evidence of Gulf War syndrome, they will do detailed clinical studies on affected individuals. But both projects could be jeopardised by the state of military records. “The whole problem is that the medical record taking is so atrocious that the epidemiology will be extremely difficult,” says one official familiar with the planned studies who asked not to be identified. “The standard of record taking is not going to make this any easier,” confirms Doyle. One problem is that there is little information on the doses of anti-nerve gas tablets taken by British soldiers. The MoD is now talking with its US counterpart about developing electronic dog tags to allow doses to be recorded automatically. “The records kept on the Gulf War were not up to the standards that modern technology allows,” concedes an MoD spokesman. Many paper records are thought to have been lost or damaged. Similar glitches have blighted efforts to investigate Gulf War syndrome in the US (This Week, 19 October, p 8). Doyle’s study faces severe logistical problems. Congenital abnormalities among veterans’ children are likely to be very rare events, she says. “So we need big numbers to respond.” Doyle admits that her study will probably not produce any reliable conclusions unless more than 80 per cent of the veterans reply. Response rates for posted questionnaires are rarely this high. “Even with interested groups you wouldn’t expect to get anywhere near 80 per cent responding,” says a spokeswoman for the market research group MORI. The MoD could in theory compel its employees to fill in the questionnaires. But if it did this, Doyle believes veterans might not give full and frank answers for fear that their job prospects would suffer. There is still the danger that only those who believe themselves affected by Gulf War syndrome will respond, which would distort the results. Finally, it may be difficult to trace the 30 per cent of veterans who have since left the armed forces. “It would have been easier to start this three years ago,