"There's something about going to the Gulf and serving in the Gulf that has caused something bad and persistent and real, but we have not found any evidence for a specific cause," said Dr. Harold C. Sox, chairman of a 2000 institute study and editor of the journal Annals of Internal Medicine.
Veterans blame the institute's reports for the difficulties they've faced in getting treatment for their problems.
"Everyone quotes the Institute of Medicine documents as meaning nothing's going on here," said Roberta F. White, associate dean of research at the Boston University School of Public Health and the congressional panel's scientific director. "Some people feel that the IOM reports have been permission to ignore these guys."
The new report cites dozens of research studies that have identified "objective biological measures" that distinguish veterans with the illness from healthy controls.
The major causes of the disorder appear to be self-inflicted. Pyridostigmine bromide was given to as many as half of the troops in the fear that the Iraqis would unleash chemical warfare against them.
According to the report, at least 64 pesticides containing 37 active ingredients were used during the war. They were sprayed not only around living and dining areas, but also on tents and uniforms, White said.
There was less evidence to support a link to the U.S. demolition of Iraqi munitions near Khamisiyah, which may have exposed about 100,000 troops to nerve gases stored at the facility, according to the panel.
The panel said it could not rule out a link between the illness and exposure to oil well fires and multiple vaccinations. But it could find no evidence linking it to depleted uranium shells, anthrax vaccine and infectious diseases.
In addition to increased rates of memory loss, fatigue and pain, Gulf War veterans have higher rates of brain cancer and amyotrophic lateral sclerosis, or Lou Gehrig's disease, the panel also noted.
The panel called on Congress to appropriate $60 million a year to conduct research into finding a cure for the disorder.
"The tragedy here is that there are currently no treatments," said the panel's chairman, James H. Binns, a former principal deputy assistant secretary of Defense and a Vietnam veteran.
Binns emphasized that the report was not written to yield recriminations about past actions.
"The importance . . . lies in what is done with it in the future," he said. "It's a blueprint for the new administration."
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mary.engel@latimes.com
thomas.maugh@latimes.com
