Date: Sat, 18 Jun 1994 23:05:37 -0400 (EDT) From: Competitive Enterprise Institute Subject: CEI LIST - MEDIA TRIGGERS SCARE OF THE WEEK To: Jeff Chan MEDIA TRIGGERS SCARE OF THE WEEK By Michael Fumento, CEI's Warren Brookes Fellow in Environmental Journalism appeared in *Insight*, 4/18/94 Is it Saddam's revenge? More than two years after the end of the Persian Gulf war, newspapers and airwaves are filled with stories about Desert Storm veterans falling to a variety of perplexing illnesses. No fewer than 11 television programs, including *Nightline*, have focused on the phenomenon. This has prompted federal lawmakers to hold several hearings in which they have blasted military authorities. "The Pentagon just doesn't get it," said Rep. Lane Evans, an Illinois Democrat and chairman of the Veterans Affairs subcommittee on oversight and investigations. "Thousands of veterans are suffering without knowing what ails them." But maybe the Pentagon does get it. Maybe it sees that this alleged syndrome has "scare of the week" written all over it. What has been dubbed the Gulf war Syndrome, or GWS, comprises a number of ailments that have been diagnosed in some of the 650,000 men and women assigned to the Gulf region in 1990 and 1991. Among the symptoms attributed to the syndrome are aching muscles, irritability, fatigue, thick saliva, weight loss and gain, hair loss, sore gums, diarrhea, nausea, swelling, memory loss, labored breathing and headaches. If the definition of the syndrome is murky, the cause hardly is more clear. Theories about the specific cause or causes of the illnesses range from the use of depleted uranium in American shells to fumes from burning oil fires. But the depleted uranium is just that -- depleted of almost all radioactivity. At any rate, few soldiers got anywhere near it. As to the fires, Ruth Etzel of the national Centers for Disease Control and Prevention in Atlanta conducted a study on the health effects of the Kuwaiti oil-field fires and concluded that the only people with significant exposures to fires were firefighters. Soldiers were much too far away for exposure and even among firefighters there were no health problems, she said. That would seem to leave Iraqi use of chemical agents. *USA Today* went so far as to headline an article, "Trail of Symptoms Suggests Chem-arms." Much of the attention has been focused on a single unit, the reserve 24th Naval Construction Battalion stationed in Columbus, Ga., and the doctor in charge of investigating their complaints, Charles Jackson of the Tuskegee VA Medical Center in Huntsville, Ala. At one time Jackson was using GWS and exposure to chemical-biological warfare as a diagnosis. He has since backed away from it, though presumably under pressure. Jackson has called the alleged syndrome "one of the great mysteries of the century." Treating a diagnosing physician as an expert in fields in which he has no training is common to scares of the week. And the more outrageous the physician's pronouncements, the more likely he is to get quoted in *USA Today*. Toxicology experts, conversely, say there is no evidence of chemical warfare exposure. Neither Americans nor their allies reported suffering from chemical weapons at the time of the conflict, although some of Jackson's patients now are saying that in retrospect they remember suffering a burning sensation in their lungs after a Scud missile attack. Jackson admitted as much, yet he told *USA Today* something different: "But suppose they'd developed something that was insidious so they didn't need to incapacitate in the field; something that would get you when you got home." That would indicate incredible stupidity on the part of Saddam Hussein. One needn't have graduated from the War College to know that a weapon that doesn't work until two years after the war has ended is pretty useless. The Defense Department has said there is no evidence that Americans were exposed to enemy chemical agents. A spokesman said at a news conference that Czechoslovak chemical agent-detection teams had found evidence of low-level chemical agents that they attributed to allied bombing of an Iraqi chemical weapons facility in northern Iraq. But northern Iraq was on the other side of the country from allied soldiers and was downwind that day, according to the Pentagon. The spokesman added that U.S. forces used about 13,000 chemical-agent detectors during the war and that none showed any harmful concentrations. According to Evans, "The commonality of experiences that [Gulf veterans] faced seems to be fairly convincing that they are suffering serious problems." But what commonality? Headaches and thick saliva? Weight loss and weight gain? If these things don't sound related, it's because they're not. The list of symptoms is huge and diverse, quite the opposite of what one would expect if they had a single cause. The net has been cast so wide as to include even medical problems of soldiers' spouses. One soldier speaking at a congressional hearing described how his wife is "beginning to suffer pains in her joints." Indeed, it appears that any sickness, soreness or condition experienced by a Gulf war veteran qualifies as part of the syndrome. If you have a sore throat and didn't serve in the Gulf, it's just a sore throat. If you did serve in the Gulf, you're another victim of GWS. Dr. Barry Rumack, a toxicology expert who is a clinical professor at the University of Colorado School of Medicine and director emeritus of the Rocky Mountain Poison Center in Denver, said, "I wouldn't call this a syndrome at all, because to me a syndrome is a disease and I've seen no evidence of that." Rumack, who also retired as a major from the Army Reserve, added, "There is no relationship between events purported to have occurred there, actual or potential, and these illnesses." Virginia Stephanakis of the Army surgeon general's office concurred. "We've looked very carefully for common exposures," she said, "and we can't find them of any sort. The soldiers were in different places in Saudi [Arabia] at different times and doing different jobs." An early Army study of 79 Indiana reservists who served in the Gulf and complained of a variety of symptoms found "no objective evidence for an outbreak of disease." It said, "Problems and symptoms like those found here would be expected to occur throughout the Reserve forces which deployed." The report said that to the extent there were any abnormalities, they appeared to be related to the stress of being ripped out of civilian life and being sent to a war zone and then, a few months later, thrust back into civilian life. "The only common denominator" of GWS, said Stephanakis, "is the complaints are overwhelmingly in Reserve and [National] Guard troops." A wider, ongoing Army study has compared 5,300 Gulf war veterans with 5,300 veterans who served elsewhere during the same period. So far, it has found that on the whole there has been no difference in illnesses. The only exceptions it found were that twice as many Gulf veterans showed symptoms of post-traumatic stress, and about 15 percent more showed signs of alcohol dependence. The report on the 79 Indiana reservists also found that many of the symptoms appeared to arise in response to reports of other people being sick. "When we have media reports of a particular symptom that hasn't been reported before," said Stephanakis, "suddenly, by God, we'll get plenty of those." According to Dr. Dimitrios Trichopoulos, head of epidemiology at the Harvard School of Public Health, to tell people that something is making them ill is often to induce illness, just as placebos often are effective at convincing sick people that they are becoming well and thereby actually making them well. "If you keep telling people they should be sick, of course they believe it," said Trichopoulos. Phantom epidemics in which massive numbers of people fall ill upon hearing of other people being sick are well-documented. Last year, more than 2,000 Egyptian children in and around Cairo suddenly fell ill in an epidemic of fainting that some blamed on chemical and biological agents. But researchers from the government and the World Health Organization found no poisons of any sort associated with the victims and declared that the problem was psychological rather than physiological. Curiously, GWS symptoms don't seem to have been reported among the hundreds of thousands of foreign troops who served in the Gulf region during the war. It appears to be essentially an American phenomenon. Some might argue that this is because only American soldiers have been exposed to the chemical agent causing the illness, but a better bet is that it's exposure to ABC's *20/20* and *USA Today* that counts. Only American soldiers have been exposed to the idea that they have reason to fear for their health. Yet while there's no evidence that veterans are suffering from anything to which they were exposed during Desert Storm, this doesn't mean they don't deserve sympathy or help. Stress- related illnesses, said Rumack, are "a devastating problem with physical consequences, it's just not anything chemical." But how about some of the illnesses that have been related to the Gulf which clearly are both serious, even life- threatening, and not the result of stress? For example, one veteran, helicopter pilot Mike Land, testified before the committee that he was diagnosed with non-Hodgkins lymphoma after he came home. A woman told the story of her son, who developed cancer of the heart, lungs, spleen, kidney and brain and died 11 months after he came home from Saudi Arabia. But drawing a causal link between anything in the Gulf region and these ailments is a huge leap. "If you take any population [this large] and look at it for normal rates of disease, there will be a certain number who will develop brain tumors, leukemia, adult-onset diabetes. You can expect to find any condition among 700,000 people," said Rumack. "You have to be able to demonstrate that it is different from [the background rate]." The scattered press reports, he notes, do not do that. For example, Land, the pilot, is 29. While cancer is relatively rare at that age, it is hardly unheard of. According to the National Center for Health Statistics, more than 1,000 men die of cancer each year between the ages of 25 and 29 in this country. Further, noted Stephanakis, "Lymphoma has an intermediary stage [the time between the promotion of cancer and its development] of many years and it would be almost impossible for these to be related. If they're looking for a specific cause of these lymphomas, they should be looking for something they were exposed to 10 or 15 years ago." In one case, Stephanakis said, a soldier who ultimately died of lymphoma had just arrived in Saudi Arabia when he was diagnosed. "He had rectal bleeding six days after arriving, and the family blamed it on the Gulf," she said incredulously. Some veterans and one advocacy group that opposed the Gulf war deployment, the Military Family Support Network of Fort Bragg, N.C., also have attributed both miscarriages and birth defects to exposures in the Gulf region. But again, miscarriages and birth defects among Gulf war veterans must be compared to the background rate. Various studies reported in medical journals have determined that the rate of miscarriage among recognized pregnancies (those where the mother knew she was pregnant) is about 12 percent to 15 percent, while at least 2 to 3 percent of babies in this country exit the womb with some sort of major malformation. Thus, if just 10 percent of female Gulf war veterans or the wives of veterans had a recognizable pregnancy in the last 10 years, one would expect 7,884 to 9,855 miscarriages by chance alone. Of those remaining babies born alive, 1,117 to 1,675 would be expected to be born with at least one major birth defect. Stephanakis said that a study of pregnancies at the Army's largest installations before and after the war "was the same -- about 8 percent of all pregnancies. That's half the national average." Speaking of the syndrome as a whole, Stephanakis said, "I think we're going to find that each case is unique" and unrelated to any given cause. But, she added, "it's complicated by politics. You have to look at the political side and note that it's a constituent issue and [lawmakers] would be loath to turn aside constituents." Politics, sensationalism, technophobia -- these are the ingredients of scares of the week. Note the similarity between this and another scare of the week, the infamous cellular phone scare. In both cases, alleged victims or their loved ones were treated as experts. Background rates of illness were ignored. And fears of something invisible and of modern technology were involved. In both cases, the media was too eager to pursue a hot story to consult with scientists who had expertise in the field being discussed. One caused needless terror for cellular phone users, the other did likewise for Gulf war veterans and their families. The public was cheated of its right to know the facts. _______ __________ ___________ / | / | | | |__________ | | | | \ | | \ _______ |__________ ___________ COMPETITIVE ENTERPRISE INSTITUTE 1001 Connecticut Ave. NW #1250 Washington, DC 20036 202-331-1010, fax 202-331-0640 Permission to copy granted as long as these lines are left intact. To subscribe to the cei list, send a message to cei@digex.com. "The Virtual Hand: CEI's guide to the information superhighway" is available for $5. CEI's monthly newsletter, "CEI UpDate," is free to contributors of $25.