Letter: Stress did not cause Gulf war illnesses

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Sir: Gulf war illnesses, of which there are many, have not been blamed on "everything from flea collars to sheep dip", as Elaine Showalter asserts ("Gulf War Syndrome: all in the mind's eye", 2 August). The chemicals used in such products have, however, been implicated in some of the many illnesses reported by Gulf war service and civilian personnel.

Governments and their scientific advisors worldwide have often accidentally or deliberately suppressed information or misled victims and their families about occupational disease recognition, diagnosis and exposure facts. This has been particularly the case for occupational hazards faced by military personnel. The evidence we have already about the Gulf war indicates what can at best be described as past government "errors" about what chemicals military personnel used or were exposed to, whether they were monitored effectively and appropriately and for how long.

There is plenty of evidence showing that a range of organophosphates cause neurological damage. There is some evidence too that these OPs can cause both neuropsychological and neuropsychiatric damage, sometimes at low levels. There is good evidence that certain OPs may be more damaging if mixed together or with some prophylactic drugs than on their own.

In occupational health, one knee-jerk official response to any report of illnesses due to chemical exposures has sometimes been that workers are "stressed" or hysterical and that the problem is psychological and not physical; hence the cases cannot be the fault of employers or governments who regulate such chemicals. It is strange to see this thesis now emerging as a catch-all explanation for many of the illnesses attributed to Gulf war veterans.

Some of the Gulf war veterans may well be experiencing such stress. To suggest that this explains the symptoms of all or most of the veterans ignores much evidence from occupational hygiene, toxicology, occupational health and safety and epidemiology. It may well, however, prove an easy and neat excuse for those governments wanting to avoid explaining what did happen in the Gulf and why many people serving there reported symptoms consistent with chemical poisonings.

Professor ANDREW WATTERSON

Centre for Occupational and Environmental Health

De Montfort University

Leicester

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