Next Article in Journal
Healthy Choice Rewards: A Feasibility Trial of Incentives to Influence Consumer Food Choices in a Remote Australian Aboriginal Community
Previous Article in Journal
Attitudes to E-Cigarettes and Cessation Support for Pregnant Women from English Stop Smoking Services: A Mixed Methods Study
Previous Article in Special Issue
Influenza Vaccinations for All Pregnant Women? Better Evidence Is Needed
Article Menu
Issue 1 (January-1) cover image

Export Article

Open AccessReview
Int. J. Environ. Res. Public Health 2019, 16(1), 111; https://doi.org/10.3390/ijerph16010111

Gulf War Illness: Unifying Hypothesis for a Continuing Health Problem

1
Department of Epidemiology and Biostatistics, School of Public Health, Jackson State University, Jackson, MS 39213, USA
2
School of Health Sciences and Social Work, University of Portsmouth, Portsmouth P01 2DT, UK
*
Author to whom correspondence should be addressed.
Received: 20 September 2018 / Revised: 11 December 2018 / Accepted: 25 December 2018 / Published: 3 January 2019
(This article belongs to the Special Issue Vaccination and Health Outcomes)
Full-Text   |   PDF [650 KB, uploaded 3 January 2019]   |  

Abstract

An estimated 25%–32% of veterans of the 1991 Gulf War continue to experience multiple unexplained health problems known as Gulf War Illness (GWI). GWI encompasses chronic pain, musculoskeletal weakness, headache, fatigue, cognitive deficits, alterations in mood, and numerous multi-system complaints. Most potential exposures implicated in GWI were not well documented but included varying levels of several neurotoxicants as well as the anticholinergic drug pyridostigmine bromide (PB), which was routinely taken as prophylaxis against the nerve agent soman. While some veterans also took chloroquine as an antimalarial agent, the literature suggests an association between receipt of multiple vaccinations prior to or during the conflict (perhaps combined with other exposures), and GWI. In-theater exposures may account for any single individual veteran’s ill health but many veterans of the same era who were not deployed overseas also suffer the same or similar symptoms. The features of GWI also overlap with those of fibromyalgia, chronic fatigue syndrome and multiple chemical sensitivity, in all of which liver dysfunction has been documented, suggesting a unifying hypothesis. It is proposed that multiple vaccinations, with concurrent or subsequent exposure to PB or additional chemical insults of a liver-damaging nature, plausibly explain the pathogenesis and the observed chronicity of GWI. The suggested mechanism for GWI is thus a chemically-induced impaired liver function, with the spillage of stored vitamin A compounds (“retinoids”) into the circulation in toxic concentrations, resulting in an endogenous chronic form of hypervitaminosis A. Implications of the hypothesis are briefly reviewed. View Full-Text
Keywords: Gulf War Illness; musculoskeletal pain; fatigue; headache; cognition; veterans; risk factors; pathogenesis; vaccines; chemicals; exposures; retinoids Gulf War Illness; musculoskeletal pain; fatigue; headache; cognition; veterans; risk factors; pathogenesis; vaccines; chemicals; exposures; retinoids
Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
SciFeed

Share & Cite This Article

MDPI and ACS Style

Mawson, A.R.; Croft, A.M. Gulf War Illness: Unifying Hypothesis for a Continuing Health Problem. Int. J. Environ. Res. Public Health 2019, 16, 111.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Int. J. Environ. Res. Public Health EISSN 1660-4601 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top