This initial volume in an ongoing study of the potential health consequences of service during the Persian Gulf War responds to a request from Congress to determine whether actions taken to evaluate health effects have been appropriate. It reflects the committee's examination of health outcomes and related research efforts, women's health and reproductive health issues, infrastructure and procedures for data collection, health services influences, the role of psychiatric diagnosis, and a review of the activities of boards and coordinating groups, as well as how issues stemming from involvement in the Persian Gulf might be relevant for possible future conflicts. While the committee continues its full-length study of the problem, the recommendations in this volume are for actions it feels should be taken immediately.

In January 1995 the Institute of Medicine released a preliminary report containing initial findings and recommendations on the federal government's response to reports by some veterans and their families that they were suffering from illnesses related to military service in the Persian Gulf War. The committee was asked to review the government's means of collecting and maintaining information for assessing the health consequences of military service and to recommend improvements and epidemiological studies if warranted. This new volume reflects an additional year of study by the committee and the full results of its three-year effort.

Many individuals, groups, and federal agencies have a strong interest in finding answers to the numerous and complex questions regarding the health of Gulf War veterans. Various types of research and health measurement are needed to address these diverse issues. The Institute of Medicine (IOM) was asked by the Department of Veterans Affairs (VA) and the Department of Defense (DoD) to undertake a study to identify important questions concerning the health of Gulf War veterans and then to design a study to answer those questions. The committee determined that it is of fundamental importance to ask how healthy are Gulf War veterans? Are they as healthy as others? What characteristics are associated with differences between the health of Gulf War veterans and the health of others? To address these questions, it will be necessary to measure not only the health status of those who served in the Gulf War, but also to compare Gulf War veterans with other groups. Further, one must continue to follow these groups through time to determine whether the groups differ in the way their health status is changing. As the committee began to develop a design that would address the fundamental questions identified, it realized that such a study could have important implications for understanding not only the health of Gulf War veterans, but also the health of veterans of other conflicts.

Emotional Aftermath of the Persian Gulf War explores the impact of war from a unique perspective -- it addresses not only the effect of trauma on soldiers in combat but also the toll war takes on families and communities as a whole. In this book, experts from the Department of Defense (including Dick Cheney, former Secretary of Defense, who provides the preface), the Veterans Administration, the National Institute of Mental Health, Israel Defense Forces, and academia provide an integrated look at the psychiatric and psychological effects of war and the treatment of war-related stress and psychiatric disorders. The authors focus on the experience of servicemembers and of their families in response to deployment, separation, and loss, and reintegration after the war. They discuss the treatment of combat casualties, those with and without psychiatric illness, who were rapidly returned home still in the acute stage of their injuries. The authors emphasize providing the best support, both medically and psychologically, for military personnel and their families for the essential mental health and effectiveness of the fighting force and the improved quality of life of individual people. The special needs of families and of reserve and guard members are considered, and models of community outreach programs for coping with the stressors of war are discussed. Unique in terms of the role that technology played -- including live TV coverage, Patriot missiles, and "smart" bombs -- the Gulf War was a part of the day-to-day lives of the fighting forces and their families, communities, and nations.

In this provocative look at the US military from the Persian Gulf War through the 2003 invasion of Iraq, investigative journalist Gary Matsumoto contends that an anthrax vaccine dispensed by the Department of Defense was the cause of Gulf War Syndrome and the origins of a massive cover-up. Matsumoto calls it the worst friendly-fire incident in military history. A skillfully-woven narrative that serves as a warning about this man-made epidemic, Vaccine A is a much needed account of just what went wrong, and why.