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provide protection against botulism according to the Centers for Disease Control (CDC).  Though considered safe by the CDC when given as instructed, the DoD did not follow these guidelines.  The vaccine used was up to twenty years old and it is not known if it was still safe or effective. 
Many soldiers were threatened with court martial if they refused these immunizations, while others were held down and forcibly injected.  Vaccines usually were not noted in immunization records nor in the medical record of service members.  Some medical staff report that they were given orders not to annotate records and to destroy medical records during and after the war.

Depleted Uranium (DU) Munitions
Depleted uranium is the highly toxic, radioactive by-product of the uranium enrichment process.  Although it is normally stored in a radioactive waste repository, DU is used in munitions because of its extreme density, pyrophoric  properties, and cheap availability.

DU is used in the armor of M1A1 and M1A2 tanks, and as armor-piercing rounds fired by M1 and M60 tanks, the Bradley Fighting Vehicle, the A-10 and AV-8B aircraft, and other weapon systems used against armored targets.  DU munitions were used for the first time in combat during Desert Storm, and are credited with the destruction of approximately 1,400 Iraqi tanks, as well as other equipment.  Since Desert Storm, due to weapons sales by the U.S., U.K., France and Russia, DU munitions have rapidly proliferated and are now in the arsenals of dozens of countries.

When a DU penetrator impacts a hard target, up to 70% of the round burns up, scattering uranium dust in and around the target.  If  uranium dust enters the body via ingestion, inhalation, contamination of wounds, or injection into the body, the health effects can include kidney and liver damage, lung or bone cancer, leukemia, respiratory problems, dermatitis, and possibly reproductive problems.

Prolonged exposure to DU armor and/or penetrators may be dangerous, but DU has the greatest potential to cause health problems among people who: 

• Breathe smoke or dust from a burning vehicle hit by DU rounds;


• Eat food or drink water contaminated by DU dust;


• Climb on or enter a vehicle or bunker hit by DU rounds;


• Collect or handle spent DU fragments or penetrators;


• Breathe smoke or dust from a fire involving DU armor and/or rounds, such as the July 1991 fire at Doha, Kuwait, or;


• Were in a friendly fire incident involving DU rounds.

failure to inform and train service members about DU munitions resulted in tens of thousands of people being exposed to DU during and after Desert Storm.  In addition, a training regimen developed in 1995 by Dr. Rokke and the DU Project, has still not been implemented, putting current service members at risk.

The standard VA and DoD Persian Gulf medical exams do not include testing for internalized DU.  If the VA or DoD offers to test you for DU we recommend you obtain a written statement that the tests offered  will adequately assess, more than six years after exposure, the levels of inhaled, ingested, or imbedded DU.  For more information about DU, contact the National Gulf War Resource Center, Inc. or the Depleted Uranium Citizens' Network of the Military Toxics Project.  Their address and phone number is in the Health & Research Organizations area of the Resources section of this Guide.

Environmental Exposures
It has been said that during the war the Persian Gulf region was one of the most environmentally toxic places in history.  Those located in the Persian Gulf were exposed to a wide variety of toxic substances in varying degrees.  Many of these substances, including gases containing nitrogen oxides, sulfur dioxide, and organic carbon and metal particulates, were contained in the oil well fires.

One area that has received study from several sources is the interaction between the PB pills given troops and exposure to various insecticides, such as DEET.  It has been shown in several research efforts that the toxicity of either agent alone is not so great as when used in combination.  When combined a synergistic effect takes place and the toxicity of each increases up to 10 times.  This means that ingesting the PB pills and using DEET can be far more hazardous than use either one alone.  For more information on the potential health effects of PB and chemicals, see the Private Medical Research subsection of the Symptoms and Treatments section of this Guide

Other exposures include the spraying of diesel fuel to reduce dust, diesel fumes from stoves inside tents, the spraying and liberal use of pesticides, fumes from CARC (chemical agent resistant coating) paint, and others.

Leishmaniasis and Endemic Diseases
Leishmaniasis is a parasitic infection borne by sand fleas in Southwest Asia.  The disease can have extremely long dormancy periods, and manifests with non-specific symptoms such as chronic fatigue and rashes.  It can be difficult to diagnose and treat, and can be fatal if not diagnosed and treated properly.  The VA has found in one study that leishmaniasis is widespread among veterans of the Gulf war.  There is no easy non-invasive diagnostic test, so the number of diagnosed cases is probably far lower than the actual incidence.  Many physicians are not aware that the type of leishmaniasis typically borne by veterans of the Gulf region is unusual and needs specialized testing only performed by the Centers for Disease Control (CDC). Other diseases endemic to the area include brucellosis and cholera.  To date, we know of few Gulf veterans diagnosed with either disease.

Second Edition - Fall 1997          Page 6