Adequacy of the VA Persian Gulf Registry and Uniform Case Assessment Protocol (1998) / Chapter Skim
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Appendix D: Adequacy of the Comprehensive Clinical Evaluation Program: Nerve Agents
Appendix D: Adequacy of the Comprehensive Clinical Evaluation Program: Nerve Agents
Pages 97-104
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From page 97... ...
Recent reports suggesting a possible toxic synergistic effect following exposure to multiple agents known to influence cholinesterase activity will require extensive research to determine their significance (Haley and Kurt, 1997; Haley et al., 1997a,b; Lottie et al., 1993~. The results of the research to date, however, did not appear to indicate any additional possible health effects should be considered by the committee other than those already identified.
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From page 98... ...
In addition, if there are longterm health effects of nerve agent exposure, it is possible that these effects could be manifested as changes in mood or behavior. The committee will be conducting an in-depth examination of the adequacy of the CCEP as it relates to stress and psychiatric disorders at a later time; however, because of the increased importance of ensuring that all possibilities are thoroughly checked, better documentation in this area is encouraged.
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From page 99... ...
The committee recommends that physicians take more complete patient histories, particularly regarding personal and family histories, the onset of health problems, and occupational and environmental exposures. While there currently is grave concern about exposure to nerve agents during deployment in the Persian Gulf, other factors have an affect on psychological and neurological disorders.
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From page 100... ...
Such an approach provides an appropriate public health mechanism for imparting information and addressing concerns and should be made available to all Persian Gulf veterans. Although it is beyond the scope of the charge to this committee to determine whether low-level exposure to nerve agents causes long-term health effects, the committee believes strongly that this is an important research area that ought to be pursued.
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From page 101... ...
The committee emphasizes that the CCEP is not an appropriate vehicle for scientifically assessing questions about long-term health effects of low levels of exposure to nerve agents. The CCEP is a clinical treatment program, not a research protocol.
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From page 102... ...
Bleecker, Director of the Center for Occupational and Environmental Neurology, Baltimore, Maryland Evelyn J Bromet, Professor, Department of Psychiatry, State University of New York at Stony Brook, Stony Brook, New York Gerard Burrow, Dean, Yale University School of Medicine, New Haven, Connecticut Howard Kipen, Associate Professor and Director, Occupational Health Division, Robert Wood Johnson Medical School, Piscataway, New Jersey Adel A
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From page 103... ...
Livingston, Project Assistant James A Bowers, Project Assistant Kathleen R
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