Letters to the Editor

Military Medicine, Oct 2003

To the Editor:

Referring to the article Chemical Warfare and the Gulf War: A Review of the Impact on Gulf War Veterans' Health [Milit Med 2003;168:606-613], the authors write "Individual investigators have reinforced unsubstantiated allegations that chemical warfare nerve agents were widely used in the Gulf War, for example, alleging [and cite one of our published papers in Military Medicine (above)], " ...large numbers of military personnel were repetitively exposed to low environmental levels of the organophosphate chemical nerve agent sarin..."

We need to correct the authors. We did not write that citation. In fact, we wrote in the cited article "...Whether the coalition forces had any exposure to CW agents is debated extensively and remains as controversial as the quantity and quality of the exposure ..." We do not want our statements about our research findings distorted.

Andras L. Korenyi-Both

COL, MC, US Army (Ret)

To the Editor:

In his letter, Colonel Korenyi-Both asserts that we have misquoted him. We feel we have not. The direct quote we cite is from Haley RW et al. As we state, this quote is merely an example of the unsubstantiated allegations individual investigators have made that chemical warfare nerve agents were widely used in the Gulf War. Korenyi-Both et al. make similar allegations, thus the citation, but we did not mean to imply that this direct quote was taken from Korenyi-Both et al. It was not.

Example quotes supporting these unsubstantiated allegations from Korenyi-Both et al. [Milit Med 2000; 165:321-336] would include "A growing body of evidence shows that coalition forces have encountered Iraqi chemical warfare in the theater of operation/Persian Gulf War to a much greater extent than early U.S. Department of Defense information had indicated. Veterans of that war were exposed to chemical warfare agents in the from of direct (deliberate) attacks by chemical weapons, such as missiles and mines, and indirect (accidental) contamination from demolished munition production plants and storage areas, or otherwise." "Recent evidence suggests that chemical warfare (CW) exposure may have been nearly widespread" as exposure to the "Arabian sand".

Based on his letter and [his article's] reference to the Riegle Report, it appears that Colonel Korenyi-Both no longer supports his initial allegations that veterans of the Gulf War were deliberately and widely exposed to CW agents.

James R. Riddle, DVM. MPH

Mark Brown, Ph.D

Tyler Smith, M.S.

Elspeth Cameron Ritchie, M.D.

Kelley Ann Brix, M.D., M.P.H.

James Romano, Ph.D.

To the Editor:

Ankle injuries are common among military parachutists. External outside-the-boot braces reduce but do not eliminate injuries. There is a device that would almost entirely eliminate such injuries and is robust and relatively cheap. No prototype exists and the device is not subject to a patent.

There are two inter-connected air sacs, one under the boot and the other investing the ankle. The sacs are nested in protective canvas covers and the inferior sac has an integral protective sole to avoid friction damage. After entering the aircraft the parachutist inflates the inferior sacs by mouth. The devices are then strapped onto the boots by two strong velcron straps. The straps are attached to the internal surfaces of the sacs to prevent tearing with rapid inflation. On landing the impact is cushioned by the inferior sac. The air immediately erupts through four one-way valves to inflate the vertical enveloping sac and provide support to the ankle. The height of these enveloping sacs would need to be determined by trial and error. The two devices are then removed, deflated by the insertion of a pencil point into the bleeder valves and packed away for re-use. The inferior sacs also have bleeder valves for use if the jump is aborted.

Alan M W Porter, MD, PhD, Ret'd

Great Britain

[Reference and figure available upon request.]