ALS Risk Appears Increased in Veterans: New Government Report Agrees

Roberta Friedman, Ph.D., Research Department Information Coordinator

Pat Wildman, Director Communications and Public Policy

[Quick Summary: A new report from experts convened by the Institute of Medicine agrees with prior conclusions that U.S. military veterans appear to have increased risk of developing ALS. The report recommends additional research to further assess the relationship between ALS and military service and determine what factors of military service may cause the disease.]

The Institute of Medicine (IOM) has issued a new report from experts supporting an association between military service and later development of ALS. Published reports reviewed by the experts show up to a two fold increased risk of developing amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease) among veterans deployed in the Persian Gulf War of 1991. Veterans from other eras, dating from World War II to post Vietnam , also appear to be at greater risk of developing ALS.

“A diverse panel of experts was able to conclude that existing evidence supports the increased risk for veterans,” said Lucie Bruijn, Ph.D., science director and vice president of The ALS Association. “We intend to continue our efforts to help veterans and to continue to search for the cause and effective treatment of ALS.”

The ALS Association has worked with Congress and the Administration to increase funding for ALS research, including research seeking to determine why veterans are at greater risk of the disease. When the first studies were published that found a link between ALS and service in the 1991 Persian Gulf War, The Association strongly supported former Secretary Anthony Principi’s policy to aid Gulf War veterans with ALS. Under that policy, ALS is considered a service-connected disease for those veterans who served in the Gulf War between August 2, 1990 and July 31, 1991.

However, ALS is not presumed to be a service-connected disease for the thousands of other veterans diagnosed with ALS even though research has demonstrated elevated rates of ALS in all veterans, regardless of whether they served in the 1991 Gulf War.

“The IOM’s conclusions help to validate what the ALS community knows all too well that if you served in the military, you are more likely to die from ALS,” said Steve Gibson, vice president of Government Relations and Public Affairs for The ALS Association. “We strongly support calls for expanding ALS research at both the Department of Veterans Affairs and the Department of Defense. We also believe that ALS should be considered a service connected disease regardless of when a veteran served in the military. And we hope that the Members of the newly elected 110 th Congress will join our fight in support of all veterans with ALS.”

Four studies have found evidence of the increased risk of ALS in military veterans, both those who served in the Gulf War and those with any history of military service, the IOM committee reported. The risk is as much as twice that in the general population.

Of particular importance, the IOM reviewed a study conducted by researchers from Harvard University ’s School of Public Health that found that veterans who served in the military, whether World War II , Korea or Vietnam , are at greater risk of ALS. According to the IOM report, “[T]he implication is that military service in general not confined to exposures specific to the Gulf War is related to the development of ALS. The findings, if validated in other studies, suggest that exposures during military service, even among those with no wartime service, might be responsible.”

The committee called for new, high quality studies to further investigate the connection between ALS and military service and to examine those aspects of military service that may cause the disease.

Factors that might feed into the increased risk of ALS in veterans include exposure to lead, pesticides or other environmental contacts, use of tobacco or alcohol or extreme physical exertion.The ALS Association has recognized the need for larger population based studies and is working with Congress to pass the ALS Registry Act (HR 4033/S. 1353), legislation that would establish a national ALS registry at the Centers for Disease Control and Prevention. The registry would collect data about ALS that could provide vital clues into the causes of the disease, including why veterans may be at greater risk.

Experts who served on the committee for the report were Richard T. Johnson, M.D. (chair), Johns Hopkins University, Baltimore, Walter Bradley, D.M., University of Miami, Florida, Beate Ritz, M.D., Ph.D., M.P.H., University of California, Los Angeles, Walter A. Rocca, M.D., M.P.H., Mayo Clinic, Rochester, Minn., Jeremy Shefner, M.D., Ph.D., State University of New York at Syracuse, and Christina Wolfson, Ph.D., McGill University, Montreal.

A report issued by the IOM in September was unable to find evidence that supports the idea of a Gulf War Syndrome but did agree that existing evidence shows increased risk of ALS among Gulf War veterans ( click here for the report.)

Copies of the latest IOM report, “Amyotrophic Lateral Sclerosis in Veterans: Review of the Scientific Literature,” are available from the National Academies Press; tel. 202-334-3313 or 1-800-624-6242 or click here.

See The ALS Association’s web site under the research tab for further information about environmental factors in ALS. Copies of The ALS Association report: “ALS in the Military: the Unexpected Consequences of Military Service” also is available here.

For additional information about The Association’s advocacy efforts to support military veterans, contact The Association’s Capital office at 202-638-6997.