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Better Health Records Urged for Troops


WASHINGTON — An expert advisory group blasted the Pentagon on Tuesday for failing to improve medical record-keeping for deployed troops, warning that without action the nation could experience another post-war mystery like the still-unexplained "Gulf War syndrome."

The report, by a committee of the Institute of Medicine, said the Pentagon urgently needs better data on the medical histories of military personnel, movements in battle zones and wartime environmental hazards. It said the department has dragged its feet on making such improvements, even though five in-house and outside groups have made similar recommendations.

The government has made "little progress" in the 10 years since the Persian Gulf War, the report said. It warned that further delay would pose "unnecessary risks to service members' health," jeopardize military missions and "further erode trust" between troops and their leaders.

The Pentagon did not dispute the group's fundamental critique.

Army Col. Francis O'Donnell, a senior aide on medical readiness, said the Pentagon has "no argument with those conclusions. . . . That pretty much mirrors our own internal self-examination."

He said the department has made progress in several areas. Troops now are required to undergo more health exams, and the services are taking greater care in identifying environmental hazards in deployments, he said.

The issue gained attention in the aftermath of the Persian Gulf War, when tens of thousands of veterans began complaining of chronic symptoms such as fatigue, joint pain, digestive troubles and poor memory. The veterans feared that their illnesses might have been caused by exposure to dangerous substances in the battle zone, including pesticides, low-level radioactive material, pollution from oil-well fires and poison gas.

But the military had not kept good records on the troops' prewar and postwar medical histories, where they had been during the war, and the illnesses and dangerous substances to which they might have been exposed. As a result, studies seeking the cause of Gulf War syndrome have been inconclusive, and some researchers have predicted that the cause will never be known.

The Institute of Medicine, a group of prominent experts from various backgrounds, was organized by the National Academy of Sciences to provide expert advice. Four years ago, Pentagon officials asked the institute to examine the lessons of the Persian Gulf conflict and other recent deployments for military health care.

Previous study groups that looked at the issue have recommended that the Pentagon evaluate troops' health before and after deployment and keep records in a central location so physicians can find them at any time. They have urged the Pentagon to carefully monitor environmental conditions in the battle theaters and to set up medical "control groups" of troops not in war zones to permit better epidemiological research.

Members of the Institute of Medicine panel noted that medical record-keeping for troops remains fragmented. Computers are used in some military organizations, but others rely on paper records. For individual soldiers, records can be scattered in several locations.

The report said that, when troops are given health care in the field, it may or may not be recorded.

Military units still do not keep close track of where individual soldiers have gone, it said. And it said that the military has not taken steps to ensure that commanders are always aware of environmental and medical hazards in the battle zones, as they should be.

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