threatened and servicepersons taking protective agents more greatly endangered. They would be additionally endangered if they attempted to help these servicepersons.

Fortunately, the degree to which these agents would protect servicepersons from the effects of chemical and biological weapons was never tested in the Persian Gulf. Yet, investigations following the war have indicated that Iraq had these weapons ready for use. It may have been only because Iraq falsely believed that the US would retaliate with nuclear weapons that Iraq decided not to use them. Our information regarding the weapons Iraq could have used was accurate. For example, Iraq was prepared to deliver botulism, a highly lethal disease, by missile attack. Botulism vaccine was one of the protective agents given to servicepersons.

Thus, this chilling question remains. What would have happened if Iraq had used these weapons and U. S. forces had not had as much protection as possible? The grim outcome which can be imagined supports the wisdom of the ethical judgements actually made. It suggests as well, several new needs, such as to insure that servicepersons are protected as much as possible in the future and to establish means by which other countries' forces, captured enemy servicepersons and civilians can be protected as well. These initiatives may go beyond the scope of this discussion, but, hopefully, will be among the ethically important outgrowths of this meeting.

Mr. Towns. Mr. Chairman, I yield back.

Mr. SHAYS. Thank you.

Mr. Snowbarger.

Mr. SNOWBARGER. Thank you, Mr. Chairman. I apologize to you and also to the witnesses that I was not able to be here for most of your testimony. So I apologize if I am asking questions that you feel like you have already answered, but if you would bear with me, I would appreciate it.

One of the problems that has faced this panel and faces you in this issue is the question of information that is available to you, particularly exposure information; and it seems that without that exposure information, at least accurate exposure information, that we are spending millions of dollars on research here, and I am just not confident that I know whether or not we are going to be able to produce any results, much less accurate results.

I guess, Dr. Feussner, if I could ask you, could you tell me what studies are under way that you think are going to produce valid definitions of what Gulf war veterans' illnesses are all about?

Dr. FEUSSNER. Well, that is a difficult question. I think your assertion is correct. Highly problematic is the observation that there are multiple potential exposures that occurred at multiple potential times and in multiple potential combinations. It is not-I do not believe it is possible to specify who was exposed to what with any precision. That causes difficulty in doing the research on two fronts. Less desirable definitions of exposure must be used, for example, in the VA mortality study, deployment to the Gulf versus being active duty and not deployed to the Gulf.

That level of imprecision introduces noise into the assessment and that requires large sample sizes of study patients followed for a long duration of time to try to detect differences in those groups.

For example, I believe that, the mortality study that has now had 4 years of followup may present useful information about whether survival is different, whether disease-specific survival is different in deployed versus nondeployed study subjects.

The other way I think that we can approach that, short of human studies, is to look at animal studies where a research project, for example, showed that pyridostigmine bromide does not cross the blood-brain barrier, but when animals were exposed to stressful situations, the stress modified the permeability of the blood-brain barrier and that chemical was able to get across the blood-brain barrier.

I think opportunistic efforts, for example, the collaboration with the Japanese where they have known exposures and they can study those exposures soon after they occurred, may provide us some insights, but saying what causes this, how do we fix this, as opposed to merely treating this are very nettlesome issues.

Mr. SNOWBARGER. Well, I guess the reason for my question is, we are 3 years down the road from the time the initial studies were begun. I mean, the problem showed up earlier than that, but we didn't start until 1994, or somewhere in that neighborhood; and here we are almost 4 years later, and I am not getting any sense of confidence that we are going to be able to do the studies that are going to lead us to the right answers.

Let me followup with a question on animal studies. I found this one rather fascinating.

Dr. Winegar, if you could help me with this one, there is a Defense Department study that was approved by the Working Group, and it has spent about $262,000 to date. It doesn't look like it is using money in fiscal year 1998, so perhaps this study is done at this point. But the hypothesis that it was testing was that, “In the final analysis, there would be no differences in the diagnosis between the Gulf military working dogs cohort and the comparison group of dogs which never deployed to the Gulf War."

According to public reports, the dogs no longer in active service are being observed and posthumously examined. First of all, what is the status of that study?

MS. WINEGAR. I don't have the details as to whether that study has been completed or not, or whether we have received a final report, but I will be happy to provide that information to you.

Mr. SNOWBARGER. OK. The report that we have indicates that it is ongoing, but again, without any expenditures expected in fiscal year 1998, so I am presuming all the research has been done; it is a matter of analysis at this point, I would presume.

MS. WINEGAR. That could be, but I will have to verify that.

Mr. SNOWBARGER. Well, OK.

[The information referred to follows:]

FACT SHEET

DOD Military Working Dog Evaluation

Indicators of Human Disease from Persian Gulf War Service: A Study of Military Working Dogs Deployed in Operations Desert Shield/Storm

The Department of Defense (DOD) is conducting a comprehensive evaluation to determine if any diseases exist in Military Working Dogs (MWDs) deployed during the 1990-91 Persian Gulf War that do not exist in non-deployed dogs. Both populations of animals will be evaluated following completion of a working career. No dogs have been or will be euthanized because of this evaluation. MWDs die of natural medical causes following a working service that usually lasts 10-12 years or are euthanized, based on the clinical judgement of a veterinarian, due to debilitating and incurable diseases that occur in all aged dogs.

MWDs with Persian Gulf War service inhabited similar environments as U.S. Armed Forces service members. At the Armed Forces Institute of Pathology, the American Registry of Pathology funded a pilot protocol in 1994 enabling the early implementation of a data collection system that will include pathologic, demographic, temporal and clinical findings from initially identified PG MWD cohort and matched comparison MWDs. This pilot protocol expired in 1995. The current protocol title is: Indicators of Human Disease from Persian Gulf War Service: A Study of Military Working Dogs Deployed in Operations Desert Shield/Storm. The hypothesis (null) to be tested is that in final analysis, there will be no significant differences in clinical or pathologic diagnoses between the Persian Gulf War cohort and the comparison group.

Methodology: This evaluation includes retrospective and prospective components. Retrospectively, the medical and training records of the 118 MWDs that deployed to the Persian Gulf, and 472 non-deployed MWDs matched four to one based on age, gender and breed, will be abstracted for the following variables: animal identification; age at death; date of death; breed; gender; location during the time frame 1 August 1990 to 31 December 1991; and duration of deployment. Parameters being assessed include: clinical, clinicopathological, autopsy findings, histopathological, toxicological (if indicated) and epidemiological.

Prospectively beginning in 1996, those 39 Persian Gulf cohort dogs, which remained on active service, and comparison cohort of 156 non-deployed MWDs will be relocated to DOD Military Working Dog Veterinary Service (DODMWDVS), Lackland AFB, TX, when the attending veterinarian determines these animals are unable to perform military missions. This process was initiated in order to conduct comprehensive physical, neurological, behavioral, radiographic, clinicopathological, electrodiagnostic, autopsy and histopathological examinations in a

standardized methodology. The above 39 dogs and the matched comparison group are expected to complete active service within the next 12-18 months.

The

This evaluation has not had any impact on the operational readiness of the DOD working dog program. only change has been the administrative procedures to relocate dogs to Lackland, AFB, TX when these animals are unable to perform military missions.

Generation of data: All MWDs receive semi-annual physical examinations that include panels of hematologic, selected serologic, and blood chemical analyses. The results are posted in the medical record. Complete medical records from all deceased MWDS in the Department of Defense are archived at DODMWDVS, Lackland Air Force Base, Texas. Following the completion of a working career with death from natural causes or euthanasia for medical reasons, complete autopsies are performed in accordance with a standard protocol. Histopathological assessment and archival of military working dog tissues are completed at the Armed Forces Institute of Pathology, Washington, DC. The clinical and pathological information generated from this effort will be electronically stored in a database for comparison of these two animal populations and statistical analysis.