Editing Gulf War (section)

===Gulf War illness===
{{Main|Gulf War syndrome}}

Many returning coalition soldiers reported illnesses following their action in the war, a phenomenon known as [[Gulf War syndrome]] (GWS) or Gulf War illness (GWI). Common symptoms reported are chronic fatigue, fibromyalgia, and gastrointestinal disorder.<ref>{{cite web|title=Gulf War Veterans' Medically Unexplained Illnesses |url=http://www.publichealth.va.gov/exposures/gulfwar/medically-unexplained-illness.asp|publisher=U.S. Department of Veterans Affairs|access-date=25 February 2014}}</ref> There has been widespread speculation and disagreement about the causes of the illness and the possibly related birth defects. Researchers found that infants born to male veterans of the 1991 war had higher rates of two types of heart valve defects. Some children born after the war to Gulf War veterans had a certain kidney defect that was not found in Gulf War veterans' children born before the war. Researchers have said that they did not have enough information to link birth defects with exposure to toxic substances.<ref>{{cite journal |title=Gulf war syndrome; higher rates of specific birth defects in gulf war veterans' children|date=29 June 2003 |journal=Medical Letter on the CDC & FDA |page=14 |id={{ProQuest|211397084}}}}</ref>

In 1994, the US Senate Committee on Banking, Housing, and Urban Affairs with Respect to Export Administration published a report entitled, "U.S. Chemical and Biological Warfare-Related Dual Use Exports to Iraq and their Possible Impact on the Health Consequences of the Gulf War". This publication, called the [[Riegle Report]], summarized testimony this committee had received establishing that the U.S. had in the 1980s supplied Saddam Hussein with chemical and biological warfare technology, that Saddam had used such chemical weapons against Iran and his own native Kurds, and possibly against U.S. soldiers as well, plausibly contributing to the GWS.{{Citation needed|date=February 2023}}

A 2022 study by Dr. Robert W. Haley of the [[University of Texas Southwestern Medical Center]], ''et al.'', of 1,016 U.S. Gulf War veterans found evidence of a [[Causality|causal]] link between GWS and exposure to low levels of the nerve agent sarin, which was released into the air by coalition bombing of Iraqi chemical weapons facilities. Significantly, the study found an increased incidence of GWS not only among veterans who recounted hearing nerve agent alarms, but also among veterans with the RR or QR (as opposed to the QQ) forms of the [[PON1]] gene, which produces an [[enzyme]] that deactivates [[organophosphate]]s (including sarin) through [[hydrolysis]]. By contrast, GWS was ''inversely'' associated with higher levels of the type Q [[isozyme]], which is more efficient at breaking down sarin than its type R counterpart. The authors "found that the PON1 [[genotype]] and hearing nerve agent alarms were independent and the findings robust to both measured and unmeasured [[confounding]], supporting a mechanistic [gene–environment] interaction.&nbsp;... Moreover, the change in the combined effect from one category to the next was significantly greater than the sum of the independent effects of the environmental exposure and the genotype".<ref>{{cite journal|last1=Haley|first1=Robert W.|last2=Kramer|first2=Gerald|last3=Xiao|first3=Junhui|last4=Dever|first4=Jill A.|last5=Teiber|first5=John F.|title=Evaluation of a Gene–Environment Interaction of PON1 and Low-Level Nerve Agent Exposure with Gulf War Illness: A Prevalence Case–Control Study Drawn from the U.S. Military Health Survey's National Population Sample|journal=[[Environmental Health Perspectives]]|volume=130|issue=5|date=11 May 2022|page=57001 |publisher=[[National Institute of Environmental Health Sciences]]|doi=10.1289/EHP9009|pmid=35543525 |pmc=9093163 |bibcode=2022EnvHP.130e7001H |s2cid=248694742 }} cf. {{cite web|url=https://www.utsouthwestern.edu/newsroom/articles/year-2022/sarin-nerve-gas-gulf-war-illness.html|title=UTSW genetic study confirms sarin nerve gas as cause of Gulf War illness|publisher=[[University of Texas Southwestern Medical Center]]|date=11 May 2022|access-date=11 May 2022|quote=For Gulf War veterans with the QQ genotype, hearing nerve agent alarms—a proxy for chemical exposure—raised their chance of developing GWI by 3.75 times. For those with the QR genotype, the alarms raised their chance of GWI by 4.43 times. And for those with two copies of the R gene, inefficient at breaking down sarin, the chance of GWI increased by 8.91 times. Those soldiers with both the RR genotype and low-level sarin exposure were over seven times more likely to get GWI due to the interaction per se, over and above the increase in risk from both risk factors acting alone. For genetic epidemiologists, this number leads to a high degree of confidence that sarin is a causative agent of GWI.}}</ref>