From 2003 to 2007 the VA enrolled Veterans with ALS in a National Registry. The registry collected data, including DNA, to be used for a number of studies on ALS. This registry was a result of the VA-DOD study that compared case rates of ALS in Gulf War veterans with non-deployed veterans and found a statistically significant increased risk for developing ALS. The Gulf War vets had a case rate of 6.7/million/year compared to a population case rate of 3.5/million/year.
In September 2008, the VA Secretary announced that there is a presumption that ALS is a service-connected condition for all vets with ALS who had greater than 90 days of service. The wording of “presumption” rather than “cause” is significant.
Since that time, there have been a number of studies that suggest the development of ALS in Gulf War vets was time limited to the decade after service. Other studies have suggested that all military veterans, regardless or time and place of service, have a higher risk of developing ALS. The ALS Association published a White Paper last year detailing the current state of the research into ALS and military service and concluded there was enough research to support a causal link.
Medical research, based on the way a study is designed and conducted, can suggest a relationship between two things without being able to prove a cause and effect relationship. This is due to the difficulty of accounting for all the extraneous variables that can affect the results. At this time, the majority of studies are “presuming” a relationship between ALS and military service without being about to prove a direct cause and effect. This is because we still have not found the cause. The ALS Association White Paper is supporting a causal relationship between ALS and military service because the number and quality of the studies all show the relationship, without being able to detail a cause.
ALS is only one of a group of neurological conditions that seem to affect Gulf War vets at a greater rate than the general population. The VA reports Parkinson’s Disease, MS, and Brain Cancer are more common in this group of vets. The cause or causes are still unknown.
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