TABLE 2 Research Recommendations

Biological, Chemical, and Psychological Interactions


  • Research on the interactions among the multiple agents and stressors to which military personnel were exposed as a result of the Gulf War conflict.

Depleted Uranium


  • Continued follow-up of the Baltimore cohort of Gulf War veterans with DU exposure. Long-term studies of the health of other Gulf War veterans at high risk for DU exposure (e.g., cleanup or radiation control units).

  • Continued follow-up of the cohorts of uranium processing workers.

  • Additional studies of the effects of DU in animals.



  • Long-term follow-up of populations exposed to sarin in the Matsumoto and Tokyo terrorist attacks.

  • Studies in experimental animals to investigate the long-term effects of an acute, short-term exposure to sarin at doses that do not cause overt cholinergic effects and minimal acetylcholinesterase inhibition.

  • Research on genetic factors that may alter susceptibility to sarin toxicity.

Pyridostigmine Bromide


  • Research on chemical interactions between PB and other agents such as stress, and certain insecticides.

  • Research on genetic factors (e.g., genetic polymorphisms of butyrylcholinesterase, paraoxonase) that may alter susceptibility to the effects of PB.

  • Epidemiologic studies on the possible long-term health effects of PB.



  • Long-term longitudinal studies of participants in the Anthrax Vaccine Immunization Program that would actively monitor and systematically collect and analyze data about symptoms, functional status, and disease status.

  • Long-term systematic research to examine potential adverse effects of anthrax and botulinum toxoid vaccination in multiple species and strains of animals.

  • Careful study of current symptoms, functional status, and disease status in cohorts of Gulf War veterans and Gulf War-era veterans for whom vaccination records exist.


Anderson JH Jr, Lewis GE Jr. 1981. Clinical evaluation of botulinum toxoids. In: Lewis GH Jr, ed. Biomedical Aspects of Botulism. New York: Academic Press.

Bellone J, Ghigo E, Mazza E, Boffano GM, Valente F, Imperiale E, Arvat E, Procopio M, Nicolosi M, Valetto MR, D’Antona G, Rizzi G, Camanni F. 1992. Combined administration of pyridostigmine and growth hormone releasing hormone in the diagnosis of pituitary growth hormone deficiency. Acta Medica Auxologica 24(1):31–37.

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