Researchers at UT Southwestern Medical Center (UTSWMC) conducted a study looking into the cause of Gulf War Illness (GWI) in Veterans. Specifically, researchers examined the impact of Sarin exposure among Gulf War Veterans and its’ impact. On May 11th 2022, UTSWMC published their research study results in the Environmental Health Perspectives Journal and the Study is titled: “Invited Perspective: Causal Implications of Gene by Environment Studies Applied to Gulf War Illness” | Environmental Health Perspectives | Vol. 130, No. 5 (nih.gov). The Environmental Health Perspectives Journal is a peer-reviewed journal supported by the National Institute of Environmental Health Sciences. Further, this research study had an accompanying editorial review, published by leading environmental epidemiologists.
The research study not only discovered that Veterans exposed to Sarin were more likely to develop Gulf War Illness, but it also found the risk of developing GWI, was affected by a gene called Serum paraoxonase and arylesterase 1, or more often referenced as PON1. The PON1 genotype regulates how a person’s body breaks down nerve gas, including Sarin. Gulf War Veterans with a weakened form of the PON1 gene, who were exposed to sarin, were more likely to develop symptoms of GWI than other exposed veterans whose gene PON1 was not weakened or damaged.
What is SARIN and how does it affect the body?
Sarin is a human-made chemical warfare nerve agent and is one of the most toxic and rapidly acting nerve agents.
Sarin is also known by the military designation GB.
Sarin is a clear, colorless, tasteless liquid with no perceivable odor.
Sarin can readily evaporate into a vapor (gas) and spread into the environment.
Sarin, like all nerve agents, interferes with the operation of an enzyme that stops muscles from contracting. When this enzyme does not work correctly muscles are constantly being stimulated. With continuous contraction of muscles, exposed people may become tired and no longer be able to keep breathing.
High exposure levels to Sarin can cause death.
Low exposure to Sarin attacks the Central Nervous System.
In summary, Sarin is a toxic man-made nerve agent, first developed as a pesticide, that was used in chemical warfare, until it was banned in the U.S. in 1997. When exposed to liquid or gas form, Sarin enters the body through the skin or the respiratory system and attacks the nervous system. High-level Sarin exposure often results in death. Whereas lower-level Sarin exposure attacks the Central Nervous System and can lead to long-term impairment of brain function and brain lesions.
Sarin: Exposure, Decontamination, Treatment | Chemical Emergencies | CDC
How were U.S. military service members exposed to Sarin?
In March 1991, troops from the U.S. 37th and 307th Engineering Battalion destroyed enemy munitions throughout the occupied areas of southern Iraq. The large storage complex at Khamisiyah, Iraq, which contained more than 100 bunkers, was destroyed. Two sites within the complex contained stacks of 122-mm rockets loaded with sarin and cyclosarin. U.S. troops performing demolitions were not aware of the nerve agents being present due to their detectors, which were sensitive only to lethal or near-lethal levels of nerve agents, did not set off any alarms before demolition. It was not until October 1991 that inspectors from the United Nations Special Commission (UNSCOM) first confirmed the presence of a mixture of sarin and cyclosarin at Khamisiyah.
In addition, two other storage sites in central Iraq sustained damage from air attacks during the Gulf War. At one site, known as Muhammadiyat, munitions with 2.9 metric tons of sarin–cyclosarin and 1.5 metric tons of mustard gas were damaged. At the other site, known as Al Muthanna, munitions containing 16.8 metric tons of sarin–cyclosarin were damaged. Atmospheric modeling by the CIA and DoD determined, that at the time these two munitions’ sites were damaged, the nearest U.S. personnel, were located 400 km away, which is outside the range of contamination. However, researchers, epidemiologists and chemists surmised the possibility of the chemical weapons damaged, being absorbed in the ground, and some could have been released into the atmosphere. These factors help identify some of the instances in which U.S. Military Services Members were exposed to Sarin.
GULF WAR ILLNESS AND FIBROMYALGIA:
The Veteran Affairs recognizes Gulf War Illness to be a presumptive service-related medical condition. Meaning, a Veteran does not have to prove Gulf War Illness is related to their Military Service and qualifies for service-related Compensation. If a Veteran is diagnosed with Gulf War illness, then develops Fibromyalgia, then it is presumed Fibromyalgia is a service-related medical condition, qualifying for service-related compensation, secondary to Gulf War Illness.
It should be noted the intersectionality between Gulf War Illness and Fibromyalgia. Both conditions have overlapping symptoms. In addition, On October 1st, 2015, Fibromyalgia was classified as Central Nervous System medical condition, by the International Classification of Diseases and Disorders. Many medical institutes throughout the world and research studies support the medical indications that Fibromyalgia has roots within the Central Nervous System. With Gulf War Illness, Sarin is a nerve agent which attacks the Central Nervous System and can cause long term impairment of brain function and brain lesions.
All these factors also highlight that both medical conditions have neurological components to them. While research studies have concluded that Gulf War Illness is due to exposure to the nerve agent, Sarin, there has been no known research identifying what causes Fibromyalgia. Fibromyalgia is often cited as “being higher risk of developing this illness” due to:
Family History: We often see multigenerational Fibromyalgia within biologically related family members.
Serious Physical Injury such as repetitive sports injuries, concussions, car accident and/or multiple surgeries.
Serious Illnesses such as: Autoimmune Diseases, Lymes Disease, Epstein Barr Virus (EBV), Cancer, Gulf War Illness, etc.
Traumatic Emotional Experiences such as being in combat, domestic abuse, sexual assault, physical assault, witnessing serious crimes or accidents, PTSD, etc.
While more research needs to be done for both Gulf War Illness and Fibromyalgia; the neurological factors for both conditions, and having a correlation to each other, strengthens medical theories indicating Fibromyalgia is neurologically based. It would be interesting, if a case review research study was conducted on Fibromyalgia patients looking at exposure to toxic particulates, harmful chemicals, burn pits and nerve agents, to determine if there is a prevalence percentage rate of Fibromyalgia patients developing this illness, due to exposure to toxic elements.
Last but not least, the month of May is the awareness month for Fibromyalgia and Gulf War Illness, and May 12th is designated as the official awareness day, for both Fibromyalgia and Gulf War Illness. I would be remiss if I did not write this article in the Month of May, to promote awareness and understanding, for both of these highly misunderstood medical conditions.
Evaluation of a Gene–Environment Interaction of PON1 and Low-Level Nerve Agent Exposure with Gulf War Illness: A Prevalence Case–Control Study Drawn from the U.S. Military Health Survey’s National Population Sample | Environmental Health Perspectives | Vol. 130, No. 5 (nih.gov)