§ Mr. StinchcombeTo ask the Secretary of State for Defence what consultations the Government have had with other Governments on the subject of research and evidence of Gulf War Syndrome. [64997]
§ Mr. Doug HendersonThe Ministry of Defence continues to liaise closely with the US Government on all aspects of Gulf veterans' illnesses. These links are of444W particular importance because the USA has the largest population of Gulf veterans—some 700,000 US personnel deployed to the Gulf in 1990–91—and there is a substantial federally funded research programme underway there.
My predecessor, my right hon. Friend the Member for Hamilton, North and Bellshill (Dr. Reid), visited the US in October 1997 to discuss Gulf veterans' illnesses issues and I intend to visit the US myself later this year to see at first hand how the US Government are responding to this complex and difficult problem and to discuss the way forward. The MOD has a full time Gulf Health Liaison Officer based in Washington, who works on a daily basis with US federal agencies and research teams. In addition, the UK is represented on the US Persian Gulf veterans Co-ordinating Board Research Working Group, which oversees all US federal research looking at Gulf veterans' illnesses, in order that the UK can have full visibility of that research, both to keep abreast of the latest developments and to avoid duplication of effort. In the course of dealing with this subject, MOD officials have also discussed Gulf veterans' illnesses issues with officials and researchers from a number of other counties, including France, Canada, the Netherlands and Denmark.
The MOD continues to monitor all published research which may be relevant to the issue of Gulf veterans' illnesses. In June last year, my Department announced that it would be funding an independent systematic literature review of worldwide published research relating to Gulf veterans' illnesses. The review, commissioned through the Medical Research Council (MRC), will be carried out over a period of 3 years by a team led by Professor Glyn Lewis at the University of Wales School of Medicine in Cardiff. The findings of the review will be published at six-monthly intervals. An initial report to the MRC is expected in the Spring, with the first full report likely to be published in Autumn.
§ Mr. BeithTo ask the Secretary of State for Defence how many British Gulf War veterans have subsequently tested positive for depleted uranium poisoning having not exhibited symptoms during examination by Medical Assessment Programme physicians which indicated a requirement for a specific referral to another agency or organisation for depleted uranium testing. [65974]
§ Mr. Doug HendersonIn general, the Ministry of Defence has no knowledge of any tests, including those to detect the presence of DU, which may have been carried out on Gulf veterans independently of the Gulf veterans' Medical Assessment Programme (MAP), through other organisations providing medical or radiological services. However, the Ministry of Defence is aware that a US physician is reported as having carried out tests for the presence of DU on some UK Gulf veterans. So far, however, my Department has not received any details of the methodology behind the tests which have been performed or of the results reportedly obtained. Hence, at present, the MOD is not able to comment on these reported findings.
Nevertheless, as I explained in my reply of 16 December 1998, Official Report, column 521, I have asked my officials to collate the information which the 445W MOD possesses concerning mechanisms which could be used to test for the presence of uranium in the human body. I expect to publish this work shortly, and shall make arrangements for copies to be placed in the Library of the House.
§ Mr. BeithTo ask the Secretary of State for Defence for what reason the standard battery of tests routinely carried out on Medical Assessment Programme patients does not include a specific test to detect depleted uranium. [65973]
§ Mr. Doug HendersonThe medical programme which became the Gulf veterans' Medical Assessment Programme (MAP) was set up in July 1993 in order to examine veterans who were unwell and who believed their illness was related to their service in the Gulf. The intention was to provide a diagnosis wherever possible and to document all illness in veterans referred to the Programme. A veteran referred to the Programme was examined by a Consultant Physician and a number of tests and examinations were carried out. This essentially remains the case today.
When the Programme was first established, Wg Cdr (now Gp Capt) Bill Coker (who ran it until December 1996) initially carried out those tests he felt necessary on clinical grounds to establish a diagnosis. When the number of patients referred to the MAP increased, he carried out a number of screening tests, similar to those then used by the US Department of Defense's Comprehensive Clinical Evaluation Programme (the US DoD's equivalent to the MAP). These screening tests did not include a test to detect the presence of uranium because Gp Capt Coker had not previously seen any features in patients to indicate that such testing was clinically necessary. The US experience had suggested that the urinary excretion of uranium was only significantly increased in those veterans with retained DU fragments. As MOD was not aware of any UK Service personnel who had sustained shrapnel injuries from DU-based ammunition, it was not thought appropriate to screen routinely for uranium excretion, although testing could be carried out on a case by case basis if clinically indicated. Any other tests considered clinically appropriate would also be performed, these additional tests varying from patient to patient. This system of investigation was in place at the time of the Royal College of Physicians' (RCP) clinical audit in 1995.
The RCP's subsequent report, published in July 1995, endorsed the MAP's professional independence and integrity and made specific comments on how the Programme could be improved. However, with the exception of a recommendation concerning psychiatric assessments, the RCP did not recommend any changes to the tests and examinations carried out by the MAP.
446WThe baseline tests currently carried out on MAP patients by St. Thomas' Hospital on the MAP's behalf are very similar to those which were in place at the time of the RCP audit in 1995. They are as follows:
- Full blood count and sedimentation rate (FBC/ESR)
- Full biochemical screen, including renal function tests (urea, electrolytes and creatinine) liver function tests (LFT), calcium and blood sugar
- Immunoglobulin analysis
- Creatine kinase
- Thyroid function tests (TFT)
- Serological screening tests
- Chest X-ray (CXR)
- Ultrasound abdominal scan
- Electrocardiogram (ECG)
- Urinalysis
- Peak-flow lung measurement (to determine the necessity for vitalography)
A thorough audit of the MAP is currently under way. It is looking at all aspects of patient care and the service provided by the MAP. The range of tests and examinations currently undertaken at the MAP will be reviewed in the light of the results of this audit process.
I should stress that the tests listed are only baseline investigations; additional and/or referrals to other consultants/specialists are sometimes required. Any tests which are considered clinically appropriate by the examining MAP physician, including those to detect the presence of uranium, will be arranged, as I explained in my reply of 16 December 1998, Official Report, column 521.
In the same answer, I also announced that I had asked my officials to collate the information which the MOD possesses concerning mechanisms which could be used to test for the presence of uranium in the human body. I expect to publish this work shortly, and shall make arrangements for copies to be placed in the Library of the House.
§ Mr. StinchcombeTo ask the Secretary of State for Defence (1) what research has been conducted into Aspartame as a possible cause of Gulf War Syndrome; [66676]
(2) what evidence he has assessed of a possible link between Aspartame and Gulf War Syndrome. [66675]
§ Mr. Doug HendersonThe Ministry of Defence is aware that Aspartame, an artificial sweetener, has been suggested as a possible cause of the illnesses being experienced by some Gulf veterans. However, this is only one of many such suggestions in this context and my Department is not aware of any published scientific evidence to support this theory. So far as the Ministry of Defence is aware, no specific research is being conducted to investigate a possible relationship between the consumption of Aspartame and Gulf veterans' illnesses.
§ Mr. ToddTo ask the Secretary of State for Defence if research on exposure of military personnel to organophosphates in the Gulf War has been completed; and whether it will be published. [67477]
§ Mr. Doug HendersonWhen it became apparent that organophosphate (OP) pesticides had been more widely used by UK forces during the Gulf conflict than had previously been thought, the Ministry of Defence carried out an urgent investigation into the circumstances in 447W which they had been used. The investigation team's report was published on 10 December 1996. Copies of this report were placed in the Library of the House. Broadly, the team found that OP pesticides were, in the main, used properly by personnel who are trained in the safe use of such products, including the wearing of Personal Protective Equipment.
The Ministry of Defence is currently funding a programme of research into different aspects of Gulf veterans' illnesses. None of these studies is specifically aimed at investigating a possible relationship between exposure to OP pesticides and such illnesses.
Research to investigate the effects of low level exposure to OP pesticides in the context of the health concerns of farm workers, funded jointly by the Department of Health, Ministry of Agriculture, Fisheries and Food (MAFF) and the Health and Safety Executive, is well under way at the Institute of Occupational Medicine in Edinburgh. This will be an important step towards understanding the possible effects of potential exposures during the Gulf conflict. Final data analysis is currently taking place and the study as a whole is expected to be completed in April this year. The study team's report is expected later in the Summer. The MAFF is also currently funding a study at the Chemical and Biological Defence Sector of the Defence Evaluation and Research Agency (DERA) at Porton Down to determine whether a low dose of the OP diazinon will give rise to adverse long term effects.