Operation Desert Storm:

Questions Remain on Possible Exposure to Reproductive Toxicants

PEMD-94-30: Published: Aug 5, 1994. Publicly Released: Aug 5, 1994.

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Pursuant to a congressional request, GAO reviewed whether veterans of Operation Desert Storm were exposed to reproductive toxicants, focusing on the: (1) types of assessments performed before the deployment of troops to the Persian Gulf; (2) specific reproductive toxicants identified as a result of the assessments; (3) types of protection provided to active duty personnel who might have been exposed to the toxicants; (4) extent that active duty military personnel and veterans are monitored for reproductive dysfunction that may have resulted from duty in the Persian Gulf; and (5) substances likely to have been present in Operations Desert Shield and Desert Storm that could have potentially resulted in reproductive toxicity.

GAO found that: (1) the Department of Defense (DOD) performed many general assessments on potential health hazards in the Persian Gulf and also relied on assessments performed by other entities; (2) except for the occupational health hazard assessment, no other DOD assessment specifically addressed potential reproductive toxicants in the Persian Gulf; (3) the DOD health hazard assessment process identifies potential reproductive toxicants that are internal to a weapon system's development process; (4) DOD did not identify several toxicants that were unrelated to its assessment criteria, including toxicants from oil fires, pesticides, and decontaminating agents used in the war; (5) DOD made no effort to educate military personnel on how to avoid reproductive toxicants; (6) some activities covered by other directives would likely have minimized exposure to potential reproductive hazards; (7) although some activities have been undertaken to monitor servicemen and servicewomen for adverse reproductive effects after their deployment to the gulf, these efforts have major shortcomings; and (8) the Persian Gulf war cannot be ruled out as a cause of reproductive and developmental dysfunction among the veteran community.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: The Department of Veterans Affairs is forwarding its 60-day response to the Secretary for his signature.

    Recommendation: In regard to present efforts to ascertain any possible reproductive effects from service in the Gulf War, the Secretary of Veterans Affairs (VA) should direct that VA use the revised questionnaire to reregister the 20,000 veterans who have already had a VA registry examination. This should be done in order to obtain information on problems of infertility and miscarriages.

    Agency Affected: Department of Veterans Affairs

  2. Status: Closed - Implemented

    Comments: There are approximately 30 research projects related to health consequences of Gulf War service currently in progress, including work on multiple exposures. This work involves research to evaluate the possible sequelae from exposure to pyridostigmine and pyridostigmine in combination with other chemicals present during the Gulf War.

    Recommendation: The Secretary of Defense should ensure that DOD makes additional scientific inquiry on the possible synergistic effects of multiple exposures to hazards found in the Persian Gulf and the effects on the human immune system from these hazards as they relate to possible reproductive dysfunction.

    Agency Affected: Department of Defense

  3. Status: Closed - Implemented

    Comments: DOD responded that it explored possible approaches to collect baseline data and determined that an activity that involved a prospective cohort reproductive outcome surveillance system would be costly, invade the privacy of service members, and would be too complex (in regard to control of other factors). DOD has used an epidemiological approach to compare reproductive outcome information through the use of three retrospective case-control analyses which found no additional cases of major or minor birth defects, nor an increase in premature births.

    Recommendation: The Secretary of Defense should explore approaches to collect baseline data on birth outcomes and other reproductive indexes such as infertility and miscarriage rates of active duty and reserve military personnel so that these data are available for future comparability studies. This information should also include the collection of baseline data on exposure levels to potential reproductive toxicants in order to ascertain when exposures rise to dangerous levels in future conflicts. In order to ascertain any differences in health status, this information should be collected both before and after future conflicts.

    Agency Affected: Department of Defense

  4. Status: Closed - Implemented

    Comments: DOD is in the preliminary phase of planning a comprehensive deployment surveillance program that would incorporate expanded pre-deployment health assessments and enhanced in-theater industrial hygiene and environmental monitoring. However, DOD does not plan to develop a special surveillance program to specifically address reproductive toxicants.

    Recommendation: The Secretary of Defense should develop procedures to better ensure that troops are informed of possible reproductive toxicants before deployment and that efforts are undertaken to monitor exposure levels to such hazards.

    Agency Affected: Department of Defense


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