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The Honolulu Advertiser
Posted on: Monday, November 13, 2006

Are veterans at higher risk of ALS?

By RANDOLPH E. SCHMID
Associated Press

ON THE WEB

Institute of Medicine: www.iom.edu

Department of Veterans Affairs: www.va.gov

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WASHINGTON — Military service, particularly in the Gulf War, may be linked to development of Lou Gehrig's disease, the Institute of Medicine said Friday.

The evidence, however, is limited and inconsistent, the Institute said.

The degenerative nerve disease, formally known as amyotrophic lateral sclerosis, or ALS, gradually destroys the ability to control movement. Patients lose their ability to move or speak, but their minds remain unaffected. Most victims die of respiratory failure within a few years.

According to the report, released late last week as Veterans Day was being observed, five studies have been done on the subject.

Three indicated a higher rate of ALS among veterans of the 1990-91 Gulf War, one found a link to veterans who served prior to that war and one found no link at all.

"The evidence base to answer the question of whether military service increases a person's chances of developing ALS later in life is rather sparse, so we could not reach more definitive conclusions at this time," said Richard T. Johnson, chairman of the panel that wrote the report.

"Because ALS occurs so rarely, any individual veteran's chances of developing the disease are still low," he added. ALS affects between 20,000 and 30,000 Americans.

Johnson is a professor of neurology at the Johns Hopkins University school of medicine in Baltimore.

The individual studies had been previously reported, and the Department of Veterans Affairs asked the Institute to review what was known and provide a new overview. The Institute of Medicine is an arm of the National Academy of Sciences, an independent research organization chartered by Congress to provide scientific advice to the government.

In its analysis, the institute said three studies indicated the chance of developing ALS as much as doubles for Gulf War veterans. Another study concluded that veterans who served prior to that war had 1.5 times the rate of the nonveteran population for ALS.

A fifth study found no relationship between military service and ALS.

Overall, the institute concluded, "There is limited and suggestive evidence of an association between military service and later development of ALS."

The report called for more research to confirm this relationship and to determine the cause of any increased risk — which it said could include chemicals, involvement in traumatic events, intensive physical activity or other substances or activities.

Officials of veterans organizations could not immediately be reached for comment on the report.

ALS got the name Lou Gehrig's disease from the famed New York Yankees baseball player who died from it. Another well-known victim is English physicist Stephen Hawking, author of "A Brief History of Time." Hawking uses a wheelchair and communicates using a computer and voice synthesizer.

Between 5 percent and 10 percent of ALS cases are thought to be inherited; the causes of the rest remain unknown.