U.S. use of PB pills in gulf should be investigated now Soldiers were given medication during war to combat nerve gas


WASHINGTON -- The mystery of Gulf War Syndrome might never be solved. No single, unequivocal cause of the vets' maladies will likely emerge - whether sarin gas from Iraqi missiles or from exploded Iraqi chemical-weapons bunkers, or exposure to certain chemicals, pesticides or oil-fire smoke, or perhaps contact with some yet unknown form of Iraqi germ warfare. Indeed, a House panel concluded last week that the mysterious illnesses reported by 100,000 Gulf War vets were probably caused by a "variety of toxic agents," including Iraqi chemical weapons.

In its report, a House Government Reform and Oversight subcommittee called for the Pentagon to give up its lead role in investigating the syndrome and to hand over the search for answers to an independent agency.

One mystery that should be investigated right away: Why did the military administer pyrodistigmine bromide (PB) pills to U.S. forces deployed to the gulf, and why was there no systematic policy in place for ensuring that the distribution of the toxic, anti-nerve-gas pills was carefully administered and monitored?

Recent conversations with several scientists close to the issue point up the following telling components in the mystery about pyrodistigmine's use as a prophylactic in the Gulf theater:

n PB, as the Army's chemical-warfare specialists in places such as Aberdeen Proving Ground were well aware, does not appear to be effective against sarin. It is somewhat effective against another lethal organophosphate nerve agent, soman. If the perceived larger threat was sarin, why did the military chose to distribute huge quantities of PB?

n PB was not meant to be "popped" as a pill on a regular basis but rather taken highly selectively - that is, before what appeared to be an imminent nerve-gas attack. But anecdotal accounts from the gulf point to a scenario in which absolutely no systematic procedure for taking these pills was in place. Some GIs have said they voluntarily swallowed PB pills on a regular basis (in some cases, daily) throughout the duration of their deployment; others said they were ordered to take considerable quantities of PB by their commanding officers.

n PB, which inhibits the action of a critical enzyme that regulates neurotransmission, might well have created neurological injuries among soldiers serving in the gulf, particularly when those same soldiers had been exposed to other so-called cholinesterase-inhibiting agents.

Those agents were commercial-grade organophosphate pesticides like Dursban (chlorpyrifos), Diazinon and Malathion shipped over by the U.S. Army to rid clothing, bedding, sleeping and latrine facilities of desert pests.

The effect might have been to create a double-whammy of overstimulation of the central nervous system, perhaps with delayed symptoms. As has been reported, scientists at Duke University have demonstrated that, at high doses, PB combined with organophosphate pesticides can produce a synergistic effect in certain lab animals.

Whether those effects create chronic long-term neurological damage in people along the lines of complaints that many gulf vets have been reporting is uncertain. Much more scientific research needs to be undertaken here, with adequate funding.

Obviously, the issue of PB and its distribution to thousands of Allied soldiers deployed to the gulf is not just a matter for the military but also for other federal institutions, such as the Food and Drug Administration, which approved pyrodistigmine bromide's use on an emergency basis by the Pentagon.

"What seems obvious is that the information and directives that the military bio-medical community put together on PB did not sink in at the troop level," says Dr. Vincent F. Garry, director of the Environmental Medicine and Pathology Laboratory at the University of Minnesota and an adviser to the Pentagon on chemical warfare during the Gulf War.

Garry, who is engaged in intensive research on organophosphate pesticide poisonings in the agricultural community, says he is dumbfounded by the reports of GIs taking heavy, multiple doses of PB during their deployment.

The Environmental Protection Agency, which is scrutinizing the health issues surrounding indoor use of organophosphate pesticides, might also have something to add.

One of its senior epidemiologists wrote a 70-page report recently on potential adverse health effects of chlorpyrifos, the nation's most widely used insecticide. The report said that the household product "may be a significant cause of chronic neurobehavioral effects," and called for further study to determine the prevalence and severity of those effects.

Jerome Blondell, the author of the report, visited the Pentagon brass last year to alert the military over what he said were some startling parallels between apparently long-term ill-effects reported among civilians acutely poisoned by organophosphate pesticides in their home and the long-term effects (blurred vision, confusion, memory loss, inability to concentrate, poor sleeping patterns and respiratory ailments) being reported by numerous Gulf War vets. Blondell's comments were shrugged off.

DowElanco, which makes chlorpyrifos-based Dursban, says the Blondell report is "seriously flawed" based on the company's own extensive safety studies that the company asserts prove the product Dursban is safe when used as labeled. But late last month, the company said it would embark on further human-risk-assessment studies.

At a minimum, the saga of PB use and pesticide use among Gulf troops needs further intensive investigation. Surely, these issues will easily crop up again if the United States and its allies are once more forced to mobilize hundreds of thousands of troops in that unstable, nerve-agent-rife region.

Warren Getler is a journalist based in Washington specializing in science, environmental and national security issues. This article was distributed by Knight-Ridder/Tribune Information Services.

Pub Date: 11/23/97

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