At the root of the controversy over Gulf War Syndrome are a few scientific, medical and factual questions.
FRONTLINE sponsored a debate between two leading experts with different perspectives on the issues: Jim Tuite III, former lead investigator of a U.S. Senate committee's inquiry into Gulf War Syndrome, who points to Iraqi nerve agents as the explanation for many veterans' sickness; and Jim Ware, environmental statistician at the Harvard University School of Public Health, who tilts toward battlefield stress as a more likely cause.
An edited transcript of their in-depth discussion on Dec. 18, 1996, is printed below, covering five principal areas.
Also available are excerpts of Real-Audio exchanges from the debate between Ware and Tuite.
I certainly believe that the pyridostigmine bromide is an issue that we need to look at in conjunction with some of the other exposures. There are several reasons why I say that. One is that pyridostimine bromide does exactly the same thing that nerve gas does. It's called an esterase inhibitor. It does it, ostensibly, in a reversible fashion. Theoretically, it doesn't penetrate the blood-brain barrier. But a recent study by some Israeli doctors has found that, at least in laboratory animals under stress - in this case, physiological stress - that, in fact, the pyridostigmine can penetrate the blood-brain barrier.
It's true that you can't rule
it out. I don't regard it myself as one of the more likely factors.
I don't believe that, in the dosages that it was used, it
would have the kinds of health effects that people report.
Again, looking at it in isolated
cases, are there five or six soldiers who were in an area where
pesticides were misused, and they might have symptoms very similar
to what we're seeing here as a result of those exposures? Certainly
that's possible. Do we have the kind of global use of pesticides
that would explain this phenomenon? I don't think we have the
global exposure to anything except for the oil smoke and to the
fall-out from the nerve agents if, in fact, one ascribes to that
particular exposure. So I think that, yes, you cannot exclude
it as a suspect, but I don't think it will end up being
the answer to what's causing Gulf War Syndrome.
The kinds of exposures you're
talking about now are ones for which there's very poor data.
Who actually used pyridostigmine bromide? Who used Deet (insect
repellent)? How much Deet did they use? Where were the pesticides
sprayed? Who got exposed to those pesticides? These are things
we'll probably never know. And, so, only over time will we be
able to discover whether epidemiologic research can, in fact,
untangle and come to any firm conclusion.
Yes, with the exception of the
vaccines. And I'm not talking about anthrax or botulinum toxin.
I'm talking about other vaccines that may have been administered
in this dynamic. I think that you will see clusters of individuals
or groups of individuals who, for example, have leishmaniasis.
I think there are 35 or so individuals who have been diagnosed
with leishmaniasis. Some hydrogen sulfide was detected by the
Fox vehicles during the oil fires, and certainly there are some
people who might have been particularly susceptible and may be
ill as a result of that. And depleted uranium dust, again, you're
going to see clusters. People who were in areas where this stuff
was used. I mean, if you're going to see depleted uranium, it
will be among the tankers who were using it, upclose and personal
and then climbing over the Iraqi tanks. But that phenomena should
not be manifesting itself yet. Most medical research says that
inhalation of radioactive particles or radioactive dust usually
takes anywhere from eight to ten years to cause the kind of chronic
illnesses that we're seeing in the soldiers.
Syndrome? || Chemical Weapons? || Vaccines? || Stress? || Cover-up?