Testimony of Lea Steele, Ph.D.
before the Subcommittee on National Security,
Veterans Affairs, and International Relations
U.S. House Committee on Government Reform
January 24, 2002
Good afternoon Mr. Chairman and members of the committee. My name is Dr. Lea Steele. I'm an epidemiologist and Senior Health Researcher at the Kansas Health Institute. I've conducted studies on the health of Gulf War veterans for the state of Kansas since 1997.
Like veterans from other states and countries, Kansas veterans have reported anomalous health problems since returning from Desert Storm. In 1997, the Kansas legislature funded a state program to look into these concerns. Our first objective was to find out if Gulf veterans had more or different health problems than veterans who did not serve in the war. In 1998, we launched a population-based study of over 2,000 Kansas Gulf War-era veterans. Study results were published about a year ago in The American Journal of Epidemiology.
The key findings from our research are as follows:
A pattern of chronic symptoms, "Gulf War illness," was identified. Overall, about a third of Kansas Gulf veterans reported a pattern of chronic symptoms that include joint pain, respiratory problems, neurocognitive difficulties, diarrhea, skin rashes, and fatigue. Although individually, some of these symptoms might occur in anyone from time to time, veterans with Gulf War illness experience a distinct pattern of multiple symptom types together that can persist for years. These conditions range in severity from relatively mild to severe and disabling.Gulf War Illness occurs in clearly identifiable patterns. For example, Army veterans are affected at a much higher rate than Air Force veterans, and enlisted personnel more than officers. Most importantly, illness rates differ by where and when veterans served in the Persian Gulf area.
Veterans who served primarily on board ship during the war had a relatively low rate of illness. The highest rate&endash;about 42%&endash; was seen in veterans who entered either Iraq or Kuwait, countries where the ground war and coalition air strikes took place. To be clear, what I am saying is that, overall, more than 40% of veterans who entered Iraq or Kuwait had this pattern of chronic symptoms we are calling Gulf War illness.
But more than half the Gulf veterans in our study were never in Iraq or Kuwait&endash;they remained in support areas during their deployment. We found another striking pattern in this group. Veterans who were in theater only during Desert Shield, but left before the air strikes began, had a very low rate of illness&endash;only about 9%. There was a somewhat higher rate for veterans present during Desert Storm, who left by March of 1991, just after the cease fire. But the highest rates were found in veterans who stayed in the region at least 4 or 5 months after the war ended. Again, I'm talking about veterans who served only in support areas, never in battlefield areas.
Veterans who did not deploy to the Persian Gulf, but reported getting vaccines from the military during the war, may have some of the same health problems as Gulf War veterans. Preliminary data from our study indicate that about 12% of Kansas veterans who did not serve in the Gulf, but said they received vaccines during that time, had symptoms of Gulf War illness. By comparison, less than 4% of Gulf-era veterans who did not receive vaccines had these symptoms. Again, to be clear, in veterans who never served in the Gulf region, the rate of Gulf War illness symptoms was 3 times higher for those who said they received vaccines during the war, than for those who did not.
So, what does all of this mean? It means, first, that Gulf War veterans are affected by excess health problems and that these conditions are connected to their experiences during the war. The patterns we described can not be explained by chance, by veteran overreporting, or by stress. Second, it suggests that veterans are affected by a number of different problems caused by a number of different exposures. Veterans who were in a position to experience more exposures have the highest rates of illness.
It appears that Gulf veterans may be dealing with a number of pathologies&emdash;illnesses that may have been caused by different combinations of different things in different people. In turn, these problems show up as different combinations of overlapping symptoms in different people. From a health scientist's perspective, the scenario is quite complex.
But I believe the take-home message from our research is that these complexities are not insurmountable, that questions about these health problems can be answered. We should not accept the view that methodologic difficulties mean that we can never really know if or why these men and women are ill. Our major finding may actually be that we had clear findings. In the context of the many millions of dollars in federal research expenditures, our Kansas study consumed relatively little time and few resources--2 years, about $150,000 and yet was able to make significant progress.
I actually view our research as very basic, but essential--the kind of first step that epidemiologists must take in approaching any unexplained health problem. It can be followed by further refinement of the process until we identify the most likely causes of the problem. As I said, these questions are complex but not unanswerable.
As a final comment, let me say that the majority of Gulf War veterans interviewed for our study reported specific symptoms only because we asked about them. Most have never come forward to the VA to request medical care or disability compensation. Among the thousands of veterans I have met or interviewed, many are suspicious of the government, many tell me they don't want benefits. They want their health back, and they want answers. It should go without saying that their service demands that we exert our best efforts in finding the answers to which they are entitled.
Lea Steele, Ph.D., is Senior Health Researcher with The Kansas Health Institute in Topeka, Kansas. From 1997-2001, Dr. Steele served as Director of The Kansas Persian Gulf War Veterans Health Initiative for the Kansas Commission on Veterans Affairs, and Principal Investigator of the Kansas Gulf War Veterans Health Study.
Return to Witness Testimony List | Statements submitted for the Record