Subj: Statement of Rep Shays Sept 27

Doubts remain, and may always remain, about the role of battlefield toxins and medicines in causing Gulf War veterans' illnesses. Today, we continue our oversight of the statutory process established to resolve those doubts in favor of sick veterans seeking proper diagnosis, effective treatment and fair compensation for their war-related injuries.

Embodying a reccomendation made by this Subcommittee, the Gulf War Veterans Act of 1998 directs the Department of Veterans Affairs(VA) not to wait for scientific certainty, but to look for any plausible association between presumed exposures and subsequent ill-health. If the VA Secretary is authorized to presume the illness is service-related for purposes of health care eligibility and compensation determinations.

The National Academy of Sciences' Institute of Medicine(IOM) recently completed a study of peer -reviewed research on four of the agents of concern to Gulf War veterans; sarin, pb(pyridostigmine bromide), depleted uranium(DU) and vaccines against anthrax and botulinum toxin. The IOM report, now under review by the VA, suggests the difficulty, and the urgency, of linking presumed toxic exposures with chronic health effects.

Not surprisingly, medical literature to date contains little evidence to support an association between low doses of the agents in question and long term illnesses.

Those findings say far more about the stunted scope of scientific inquiry over the past decade than about the likely weight of scientific evidence. The significance of the report lies in the fact the IOM found virtually no evidence that would rebut a presumption of a casual association between these agents and many of the maladies suffered by Gulf War veterans.

As the IOM panel noted, the task of establishing plausible dose/response relationships was made more difficult by the lack of hard data on wartime exposures, and by a lack of adequate military medical records.

Based primarily on studies following the Tokyo subway attack, the committee did conclude sarin exposures inducing immediate, if moderate, symptoms could also cause longer term health effects similar to those observed in many Gulf War Veterans. But veterans' illnesses could not be more fully associated with sarin because battlefield medical surveillance did not distinguish between the acute symptoms of mild sarin toxicity and the myriad of other environmental and stress-related health effects suffered by US service personnel.

The IOM committee was also hampered by lack of access to classified information held by the Department of Defense(DOD) on toxic agents in the war theater. In the course of our oversight, many have called for full access to DOD records on chemical and biological detections. Given the statutory mandate that VA search broadly for information on toxic exposures, the VA should join us in pressing for declassification of all records relevant to the health of Gulf War veterans.

Doubts remain. But our obligation to act now on behalf of those willing to make a certain and timeless sacrifice can be subject to no doubt, no delay. They earned the benefit of any doubt about the extent of our debt to them. They should not be asked to wait for certainty that might come too late, if at all.