There were many factors present in the Gulf during the war that could have played a role in causing illness in those present at the time. It is likely that a combination of these factors together is what led to the illness.

1. Potential Causative Factors
Infectious Diseases – A number of infectious agents were present in the Gulf but medical records generally show that they weren’t a major problem for personnel due to extensive precautionary measures. Of course, many infectious agents may lie dormant without causing an acute illness. The most common infectious agents present were thought to be cutaneous travelers, diarrhea, sand-fly fever, and malaria. One unique infectious disease has been linked to the Gulf war deployment; (Leishmaniasis). Leishmaniasis is a parasitic disease found in parts of the tropics, subtropics, and southern Europe. Leishmaniasis has several different forms. CL is transmitted through the bite of an infected female phlebotomine sand fly but can also occur after accidental occupational (laboratory) exposures to Leishmania parasites.

Biological Weapons – Exposure to biological warfare agents has been put forward as a possible causative factor in Gulf war syndrome. No evidence that such an agent was deployed has been found however. It should be noted however that Iraq was known to be experimenting with the use of anthrax and an organism responsible for gangrene. There is also the possibility that Iraq deployed bio-toxins; toxins produced by living organisms such as bacteria. Endotoxins, those given off when a cell dies, can produce similar effects to chemical toxins/weapons and do not cause infectious disease as a living organism would. 

Chemical Weapons – As with biological agents, chemical warfare agents have also been suggested. There is more concern here however as it is known that a number of Iraqi facilities containing chemical agents were hit during the air and ground offensives which could have led to low-level exposure to Coalition troops. 

Other Chemical Agents – Besides possible exposure to chemical warfare agents, the coalition troops were constantly exposed to chemicals whose use is considered safe. It must be noted, however, that they were just the type of chemicals reported to cause symptoms in multiple volatile organic compounds.

2. Chemicals
Organophosphate Pesticides -Organophosphates are the basis of many insecticides, herbicides, and nerve agents. The United States Environmental Protection Agency lists organophosphates as very highly acutely toxic to bees, wildlife, and humans. Recent studies suggest a possible link to adverse effects in the neurobehavioral development of fetuses and children, even at very low levels of exposure. 

Pyridostigmine Bromide – A drug given to troops to counteract chemical warfare agents. 

CARC – Chemical agent resistant coating is a specialized form of automobile paint, designed to prevent chemical warfare agents leaching onto a vehicle’s finish. According to manufacturers’ data sheets, chronic overexposure to the paint’s vapor can lead to asthma-like symptoms.

Prolonged exposure can permanently damage the brain, nervous system, liver, and kidneys. 

Fuel – Gulf War veterans often recall an association between diesel and petrochemical fume exposure and symptoms during service. Many suspect these exposures may be the cause of their ongoing health complaints after the war. 

Decontamination Solutions – Decontamination solutions were widely used in the gulf to sterilize vehicles, equipment etc. The decontamination agent used most widely in the first gulf war was decontamination solution 2 (DS-2). DS-2 is an effective decontamination agent but is highly caustic and is known to damage equipment, pollute the environment and cause personal injury, according to experts. 

Oil Well Fire Smoke – The retreating Iraqi army ignited approximately 600 oil wells in February 1991 which burned for about 9 months. These fires produced massive amounts of thick smoke which sometimes drifted to ground level causing increased exposure to ground troops. When this occurred, the air pollution was far greater than would be experienced in the average traffic congested western city. 

Vaccinations – Troops sent to the Gulf were given a large cocktail of vaccinations in a short period of time. In total, US servicemen may have received as many as 17 different vaccines, including live vaccines (polio and yellow fever) as well as experimental vaccines that had not been approved (anthrax, botulinum toxoid) and were of doubtful efficacy . In the UK, the Ministry of Defense has declared only 10 vaccines given but reports from veterans and official documents seem to tell a different story. 

Depleted Uranium (DU) – During the Gulf war, depleted uranium was used for the first time, both in vehicle armor and offensive munitions, as well as in various other components of vehicles and other equipment. It was used widely due to it being cheap and widely available as a by-product of nuclear energy and nuclear weapon production. In Operation Desert Storm over 350 metric tons of DU was used, with an estimate of 3-6 million grams released in the atmosphere. Inhaling particles of depleted uranium may have contributed to sickness after the war due to DU’s chemical and radiological toxicity and mutagenic and carcinogenic properties. Internal contamination with inhaled DU has been demonstrated by the elevated excretion of uranium isotopes in the urine of the exposed veterans 10 years after the Gulf War.