Original can be found at http://www.pan-uk.org/pex/pexartilces/Confs/2901000/OP+Gulf.htm

New findings in OPs and Gulf War Syndrome

Professor Malcolm Hooper

This was the most toxic war in Western military history. The toxins were NAPs tablets, given to people, experimentally, before they went out. Many vaccines were also given, including biological warfare vaccines: anthrax with whooping cough (experimentally given as an adjuvant, to improve the immunogenic response) and plague. Other things were given: small pox was considered a major threat from the Russians, and we think it was given to quite a few people, but this has been denied.

In the Gulf they faced an environment with lots of nasty insects: sandflies carrying leishmania, mosquitos carrying malaria and some viral diseases, including West Nile fever. Pesticides: organophosphates, carbamates, organochlorines, pyrethrinss, and DEET an insect repellant, were extensively used. People were “washing in the stuff”. Nicholas Soames statement that OPs were not used is now famous. This denial was followed by a grudging admission of greater and greater OP usage.

That was what we were doing to our troops. When they were out in the field they were faced with biological weapons and chemical weapons. The latter we know about: Nerve agents, mustard gas, and things like lewisite. The last two agents were developed in the First World War and nerve agents a little later. The nerve agents Sarin, Tabun, and VX were known to be held by Iraq but it was Soman, espoused by Russian military strategists, that worried the Coalition most and led to the use of NAPS (pyridostigmine bromide).

The American Type Culture Collection supplied many cultures, developed for biological weapons, to Iraq, including anthrax, botulinum, tularaemia, virulent strains of E. coli etc.            

It was the first war in which depleted uranium munitions were used and fired at enemy targets. Depleted uranium weapons, on impact, liberates large quantities of a very fine dust, which could be inhaled. Between 300 -800 tonnes have been distributed all over the battlefield areas. Again the harmful effects are being denied.

The troops were also exposed to oil and smoke, which can cause serious problems. This is not receiving the attention it needs and the problem has been denied.

The Gulf War lasted for five weeks. The USA sent 697,000 of which 300 died. The UK sent53,000 troops, of which 49 died. But now, at least, 9,000 (now nearer 11,000) Americans have died since the Gulf War. The British troops deaths have been one a week since the Gulf war ended; some 433 deaths are known. In the USA, records show that 253,000 have sought medical care, and 203,000 have filed claims for war-related illnesses. Similar records for the British troops are not available.

Gulf War Syndrome is part of a number of overlapping syndromes: Multiple Chemical Sensitivity, Irritable Bowel Syndrome, Chronic Fatigue Syndrome. There seems to be a common symptomology, which is not total but overlapping. OP poisoning is part of this. The syndromes are very similar, but not identical, and this is a gap which is being exploited to dismiss the evidence of a common underlying pathology, especially by psychiatrists.

We are trying to get hold of something which is proving difficult to define. Haley in the USA identified three different major complexes, with three sub-complexes, in a small group of people. 1.Impaired cognition, 2. confusion and ataxia, 3. arthro-myo- neuropathies. He related these syndromes to different exposures particularly the wearing of flea collars, excessive responses to pyridostigmine bromide and threat of chemical warfare. If people had a massive response to pyridostigmine bromide, when they then fell ill they exhibited either syndrome 1 or 2. He also engaged in a clinical study of patients, something not yet done for British Gulf War Veterans. He found injuries to the central, autonomic and peripheral nervous system but, significantly, no evidence of Post Traumatic Stress Disorder.

The nervous system, central, peripheral and autonomic, is divided into a number of sub-groups depending on the type of molecules involved in neurotransmission. Acetylcholine (Ach) is a major player every part of the nervous system. The effective levels of Ach are controlled by the enzyme acetylcholinesterase. Inhibition of this enzyme leads to a massive excess of Ach at nerve-nerve, nerve-muscle, and nerve-gland junctions with all the effects experienced by OP poisoned people.

Gulf personnel experienced the ‘cholinergic triple whammy’ which involves inhibition of acetylcholinesterase by reversible, pyridostigmine, and irreversible, OPs and carbamate insecticides, and nerve agents, inhibitors. These interactions are synergistic with each other and with pyrethrins, organochlorines and DEET. This results in a multiplication of their effects by over 100-fold.

Troops who had taken PB tablets suffered diarrhoea, muscle fatigue, and vision problems, including pupil changes: they couldn’t see, and they were supposed to be firing rifles at the enemy 800 yards away.

The other enzyme which is important is neuropathy target esterase, a protective enzyme in nerves. There is also a host of enzymes associated with the nervous system and with other parts of the body which are also affected by these compounds: serine esterases and proteases. David Ray of the Medical Research Council is looking at these enzymes and finding some data which is quite surprising.

In the Gulf War the OPs used included malathion dust for de-lousing prisoners. This was shaken from a tin like talcum powder. It is not approved for public health use. Delousing was done in a closed, twelve foot square, tent. The operatives were in the tent for hours, and had no protection. Inhalation was the problem. Fenitrothion was used in a 40 per cent emulsion spray, A neocidal/winter dip containing 60% Diazinon was used around latrines. Unidentified OPs were purchased locally. The carbamates used included bendiocarb as a wettable powder, and propoxur in a spray.

The pyrethrins included permethrin, as an emulsion on mosquito nets, bio-allethrin (7.5 per cent), piperonyl butoxide (75 per cent, in kerosene). Tetramethrin (6 per cent), piperonyl butoxide (60 per cent, and one of unknown composition), a pyrethrins/pyrethroids mixture and unknown pyrethrins for stored grain.

Paraoxonase (PON 1) is an enzyme which protects against atherosclerosis: the furring up of arteries, in which there is a deposition of atherosclerotic plaque which starts to cause the constriction of blood vessels and eventually obstruction. So it is a major player in coronary heart disease and strokes. It is also involved in non insulin-dependent diabetes. This enzyme occurs mainly in the liver, but there is also some in serum. The serum enzyme is important in removing any OPs that avoid metabolism n the liver. OPs that are inhaled, or absorbed through the skin tend to bypass the liver. Serum paraoxonase levels vary according to the genotype, QQ, QR, or RR, but within these genotypes levels of the enzyme can vary widely. Generally, it is the QQ genotype that has the lowest levels of activity against paraoxon the major toxic metabolite of parathion. Haley has identified a sub-group of very sick Gulf Veterans with low paraoxonase levels and activity Furthermore, using brain imaging by magnetic resonance spectroscopy, he has identified damage to the brain stem, basal ganglia with up to a 25% loss of neurones in the brain. Similar work is being done in this country in connection with ME.

Bone density studies are also important. In a study by Compston and Hodges et al (Lancet 1999, 354, 1791-2), 24 farmers with exposures from three to 20 years previously were examined. It was found that the cancellous (trabecular) bone density was significantly reduced, and margins eroded. Cellular and tissue indices were all reduced with osteoblast failure to fill in previous cavities.

The authors concluded that acetylcholinesterase may be the site of action of OPs since it is associated with osteogenic factor-binding motifs and located close to such motifs on the same gene.

Some Gulf War Vets suffer from osteoporosis, a rare condition in young men.

OPs and Post Traumatic Stress Disorder: this is an important story because at the bottom of it is political poisoning and murder. This is the story of a leader in South Africa. He took a flight from South Africa to the USA, and was taken off the plane at Namibia, suffering with abdominal pain, nausea, vomiting diarrhoea and extreme weakness. He was diagnosed as having gastroenteritis. In the USA the first diagnosis was acute pancreatitis: he had epigastric pain, nausea, vomiting, sweating, muscle twitching and respiratory arrest. Twenty-four hours later, he was suffering anxiety, confusion, hyperventilation, respiratory alkalosis, hypophosphataemia, and diagnosed as having Post Traumatic Stress Disorder.

Again, 24 hours later, in hospital, he was diagnosed as having OP poisoning: acetylcholinesterase levels were low and p-nitrophenol was found in his urine. His symptoms at that stage were: marked salivation, sweating, loss of coordination, dysconjugate gaze, ptosis, ataxia, Cheyne-Stoke respiration, hyperactive bowel sounds, diarrhoea, urine frequency and incontinence.

This was a political assassination attempt which came to light during the Truth Commission which was set up after Mandela came to power.

Post Traumatic Stress Disorder, the favourite diagnosis by psychiatrists of Gulf War Vets, can, in fact, be OP poisoning.

OPs absorbed through the skin can be fatal. There was an incident in which a.76 per cent solution of parathion was spilt over an operative’s groin area. He scrubbed himself down thoroughly immediately afterwards and sent his overalls to be burnt, but they were accidentally laundered instead. He was given prochlorperazine on day two, but at day four he had to be given the full treatment: atropine and pralidoxime. After two weeks his acetylcholinesterase level was still only 75 per cent of normal. A second employee went down with the symptoms of OP poisoning, though he had had no direct contact with any OP. He was admitted to hospital with apnoea, fits of unconsciousness and convulsions. He too had the antidote treatment: diazepam, atropine and pralidoxime. His overalls too were laundered. A third employee also went down with OP poisoning symptoms. The same overalls were found to have been worn by all three employees: the parathion was still in them. The initial contamination was 76 per cent. After laundering, it was still seven per cent. Even after two soda ash, detergent and bleach washes, the level of parathion was two per cent. Other overalls in the same wash were also found to have significant levels of the same OP.

Certain drugs will accentuate OP effects. Tagamet (cimetidine) affects the metabolism of these compounds, as recorded in the Wall Street Journal on 1 October 1991 (Frank Edward Allen): malathion caused chronic effects in a 36 year old man mowing a treated lawn. Other drugs with this property include: amphetamines, fenfluramine (anti-obesity drug, stimulant), dapsone, sulphanilamide (antibacterial, anti-inflammatory), diphenyhdramine (antihistamine), methadone (used as a painkiller, and in drug abuse) and the antidepressant nortryptyline. Piperonly butoxide, used as a synergistic agent with pyrethrins, is one of these compounds which disables the liver in dealing with OPs.

Reports by COT, the Institute of Medicine, and The Royal College of Physicians/Psychiatrists’ are more about politics than science. The truth is avoided by a variety of strategies. Both the COT report and that of the Royal College ignored important literature, for example, the Report prepared for the Commission of the European Communities (Industrial Medicine Unit) by M. Maroni, 1986. The Institute of Medicine report dealt only with active farmers and although their conclusions relating to the handling of concentrate have been listened to, they also pointed out the hazards of diluted sheep-dip which have been ignored.

By ignoring important literature, by selecting less ill patients, and not exhaustively examining very ill patients, the effects of OPs are minimised and treatment, diagnosis, and compensation denied. The COT report has been described as very disappointing for these reasons, although the resignation of Richard Packer, the civil servant most ardently opposed to any suggestion that OPs cause chronic ill-health, is welcome. The influence of civil servants on the work and judgement of ministers is very worrying. Who is feeding them information that is distorted and partial? Collusion between the departments of government and major commercial companies has now been demonstrated in a number of cases. The hidden sources of selective information leading to deception are cause for concern.

The Gulf War Veterans suffered both multiple chemical and biological assaults. What should be done are investigative tests to analyse their effects. What we have to do is to learn from other people.

These are the cross links which have emerged from other people. It was Dr Paul Shattock who used the IAG test on Gulf War Veterans after spotting similarities with some aspects of autism. This test is 80% positive with autistic children but 95% positive with GWVs. It has been suggested that there is a profound immunological imbalance in GWVs relating to Th1/Th2 balance, cytokine release on challenge, variations in Rnase-L. Treatment with alternative vaccines such as M. vaccae, which increases Th1 levels, has not been tried. Ampligen is being used, successfully, in ME. Diet changes eliminating milk and gluten have been helpful in some ME patients and in some GWVs. Low serum sulphate levels with sulphite in the urine, can be treated effectively, in about a third of people, with supplementary molybdenum as a trace element.

Jean Monro at the Breakspear Hospital has used a combination of established and complementary medicine procedures to treat effectively GWVs and OP poisoned farmers. John Richardson, in Newcastle, uses a simple mixture of choline citrate and vitamin C to detoxify patients with organochlorine poisoining. None of these treatments are being researched.

Joint studies involving academic research and clinical work will best attract funding.

Questions and answers

In American studies, there may have been as many as 21,000 deaths of Gulf War Veterans (that’s the unofficial figure). 16,000 to 21,000 is estimated. The excess deaths are put down to road accidents – but what happens to the lower limbs, the brains, the eyes of OP victims?

Birth defects: if you total these, and compare them with the rest of the population, there appears to be no difference. But in McGann in Mississippi 67 per cent of the children born to 251 Gulf War Veterans families have birth defects. Another example of bad science being used to deceive - don’t look too closely you might find some disturbing facts!

Professor Malcolm Hooper, University of Sunderland, malcolm.hooper@virgin.net

Proceedings from the conference held on 29/01/2000 at the University of Sunderland
[Published in PEX Newsletter No.6, March 2000]

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