Mike Tidd, 65, is a fourth-generation plumber in Georgia who spent his early career making 12 to 14 repair calls a day to different homes.
But that changed after the Gulf War, when he served as a Seabee in the US Navy in Kuwait and Saudi Arabia working construction projects. He says his ability to do his job has steadily declined since then, and now he can only handle about four calls a week.
Tidd has Gulf War syndrome, also known as Gulf War illness, a set of symptoms poorly understood by doctors that many veterans who served in the conflict in the early 1990s experience.
Among Tidd's symptoms: short-term memory loss, chronic fatigue, struggles with word recall, sleep disturbance and tremors. The last symptom directly affects his ability to work.
"Sometimes holding the screwdriver and trying to put a screw in a site, it's hard to do," Tidd told USA TODAY. "I just have to kind of work with it."
Gulf War syndrome is estimated to affect between 175,000 and 250,000 of the nearly 700,000 troops from the United States, United Kingdom and other allied countries who were deployed in the Gulf War conflict from 1990-1991, according to a 2020 Department of Defense report.
While up to a third of Gulf War troops experience these symptoms, there is not a consensus on what causes them, as outlined in a 2013 National Academies of Medicine report. A 2021 Veteran's Affairs study found Gulf War veterans are more likely than their non-deployed counterparts to report chronic disease, as well as to report it earlier.
The VA refers to these illnesses as "chronic multisymptom illness" or "undiagnosed illnesses," rather than “Gulf War Syndrome,” because of how widely the symptoms can vary.
Thirty years after the Gulf War conflict, a new genetic study has found a link between a specific gene and likelihood of symptom severity when environmental exposure to sarin gas is taken into account. Experts say it's a step toward better understanding an illness that has long been called a mystery.
The study, partially funded by the U.S. government, found veterans with a weak variant of a gene that normally allows the body to break down sarin gas were more vulnerable to the gas when exposed. Sarin was often released as the result of bombings of chemical weapon storage facilities in Iraq during the Gulf War.
Dr. Robert Haley, lead researcher on the study with the University of Texas, Southwestern, said experts studied which veterans reported hearing "chemical alarms," audible alarms used to alert servicemembers to the presence of chemical weapons, during the Gulf War. Those servicemembers were likely to have been exposed to sarin gas.
Researchers' analysis found that among that group, a weak variant of the gene was strongly associated with chronic multi-symptom illness, or Gulf War syndrome.
"People who had both of those — who had a weak form of the gene and heard the alarms — they had about nine times greater risk of Gulf War illness than having just one of the risk factors," Haley said. "The two risk factors are acting synergistically."
Tidd, who served in the Navy Reserves in a unit that was activated for Operation Desert Storm, participated in the study alongside other veterans who experienced symptoms of Gulf War Syndrome as well as those who didn't.
He recalled that when he was deployed in January 1991, gas sensors sounded at the compound where he was working, signaling he needed to put on protective gear: a mask, suit and gloves. His unit then had to stay at the location for almost 12 hours to complete their assignment.
How could this study help?
From a research perspective, the study's findings open doors for the possibility of funding into much-needed treatment research, Haley said.
"For 30 years we've been trying to come up with treatments. We've been shooting in the dark because we there was no consensus on what we're treating, what the cause is," Haley said. "I think this should create another real new era in looking for treatment."
Anthony Hardie, 54, served in the Gulf War with the U.S. Army and first began experiencing respiratory symptoms of Gulf War syndrome while still serving in the Gulf. During and following his service, he's also experienced chronic fatigue, irritable bowel syndrome and chronic widespread pain, among other issues.
When he first sought treatment for his symptoms at Fort Bragg after returning to the U.S., Hardie said his symptoms, like those of many other Gulf War veterans, were dismissed and largely ignored by medical providers.
His experience has led him to years of advocacy for Gulf War veterans including congressional testimony and his current role as national chair and director of Veterans for Common Sense.
"This study with this magnitude of findings has many implications: treatment research, disability claims for Gulf War veterans continuing to suffer 31 years after the after the war, but also for also for other toxic exposures," Hardie told USA TODAY.
Affected veterans face hurdles getting medical coverage
Gulf War veterans have attempted to draw attention to their symptoms but were often met with skepticism, in part because the illness didn't have a formal medical explanation. A lack of verified causation has also led to challenges getting Veteran Affairs to cover claims for illness and disability, according to Gulf War veterans and legal advocates.
Veteran Affairs data for claims filed for Gulf War Illness medical issues from 2010-2015 showed Gulf War illness medical issues were only approved 17% of the time, significantly below the 57% that is typical for other medical issues, according to a 2017 report from the Government Accountability Office.
Veterans for Common Sense, alongside Vietnam Veterans of America, also analyzed VA claim decisions between 2002 and the first quarter of 2018 and found that VA rejected 90% of undiagnosed disability claims from Gulf War veterans, as reported by nonprofit newsroom The War Horse.
Hardie said this new study could provide the "missing link" for Gulf War veterans to get approved for claims.
"This study has a clear possibility of making a difference," Hardie said. "It provides a clear pathway for the VA to definitively presume exposure to sarin and stop denying nearly all Gulf War veteran's claims for Gulf War illness."
Travis Martin, director of the Kentucky Center for Veterans Studies at Eastern Kentucky University and an Iraq War veteran, told USA TODAY that work is continually being done to ensure the symptoms veterans experience are taken seriously, rather than immediately attributed to psychological disorders.
"For decades, through legislative inaction and misdiagnoses, a generation of veterans were gaslighted into thinking it was all in their heads, the result of a societal implicit bias that has always plagued American veterans," Martin said. "One can only hope, at some point, we learn from our mistakes and give future generations of veterans the benefit of the doubt.”
Implications for veterans who served outside the Gulf
Tidd has participated in numerous blood and neurological studies since experiencing symptoms and returning from service. While new treatments that come as a result of the study may not help his neurological problems, Tidd said he wanted to work with Haley to potentially help other veterans.
Hardie said the genetic study on Gulf War syndrome could make a difference for veterans and others who suffer health effects due to chemical exposure — like those exposed to burn pits. Burn pits are massive, open-air ditches used to dispose of wartime waste that have been shown to cause enduring health effects to service members who were exposed.
Most recently, troops serving in Iraq and Afghanistan were ordered to dispose of military waste by digging big holes in the ground and setting the waste on fire. President Joe Biden, meanwhile, has linked burn pits to the death of his son Beau Biden, who died of brain cancer in 2015.
The Senate Veterans’ Affairs Committee has recently announced a bipartisan agreement on legislation aimed at expanding health care and benefits for toxic-exposed veterans.
"This study not only has implications for 1991 Gulf War veterans and the VA finally getting it right for those veterans, but also for current and future forces, who will also be exposed," Hardie said.
This article originally appeared on USA TODAY: Gulf War syndrome study links sarin gas exposure, gene to illness