Since the end of the Gulf War,
tens of thousands of American, Canadian and British soldiers who participated in that war have claimed to be suffering from a variety of incapacitating symptoms which are generally termed as
Gulf War Syndrome (GWS). The symptoms are multiple but mainly consist of excessive tiredness, muscle and
joint pain, loss of balance, sensory symptoms, neurobehavioural manifestations, diarrhoea, bladder dysfunction, sweating disturbances, and respiratory, gastrointestinal, musculoskeletal and
skin manifestations. These veterans have been exposed to a variety of damaging or potentially damaging risk factors including environmental adversities, pesticides such as
organophosphate chemicals, skin
insect repellents, medical agents such as
pyridostigmine bromide (
NAPS), possible low-levels of
chemical warfare agents, multiple vaccinations in combinations, depleted
uranium, and other factors. A large number of basic research findings, clinical epidemiological studies, and case control studies are reviewed to try and link them together to produce a coherent picture and to demonstrate the complexity of the interaction of
biological systems, environmental and genetic factors, combinations of drugs and toxins with human health. The findings of these studies so far have demonstrated that many of the previous assumptions made about the 'safety' of certain drugs and toxic substances or
vaccines must be radically reviewed. Many of the findings have far reaching implications not only in terms of explanation of what might have gone wrong during the Gulf War, but also have wider implications for many occupational groups who are exposed daily to some of these risk factors. More open-mindedness and much less prejudice are required concerning the basic biology of interactions of the above factors and their effects on cell functions and wider intelligent research is urgently required with high priority. This review highlights the importance of intelligent research for answers for a new phenomenon, and demonstrates the necessity for a combination of this approach with high quality epidemiological research. The reader will notice an emerging clear picture that the majority (if not all) of these advances have been achieved from studies funded by independent or charity organizations rather than by the responsible authorities who are supposed and are duty bound to take on this task.