Imagine surviving two deployments in Iraq, constantly dodging bombs and enemy gunfire, only to realize that the air you were once thankful to be able to breathe was making you sick. This is what happened to Sergeant Major Rob Bowman, who passed away from cholangiocarcinoma, a rare form of bile duct cancer, at the age of 44.

Unfortunately, as many military families know all too well, Sergeant Major Bowman’s situation is not unique. “Of the 30 men in Rob’s platoon who returned home, nearly one-third of them developed uncommon cancers and medical conditions,” said Coleen Bowman, Rob’s surviving spouse, “and the first doctor we saw confirmed immediately that the cause of Rob’s cancer was environmental, not genetic.”

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The environmental exposure Bowman referenced — known as toxic exposures in the military — is of increased interest to lawmakers, advocates, and medical professionals as a result of the frequency with which it is occurring in post-9/11 veterans. However, given the notoriously slow pace of legislative oversight and government-funded medical studies, advocacy groups are now playing an important role in finding answers for military families.

History of Military Toxins

Although most people are familiar with the term Agent Orange, problems that stem from toxic exposures while serving in the military are nearly as old as civilization itself. Arrows with poisoned tips were used on the battlefield as early as 1500 B.C. And in 1776, a Tory sympathizer tried to add an unknown poison to George Washington’s food at a New York City tavern.

However, military toxicology, i.e., the study of substances that cause harmful effects in those who serve, became exponentially more harmful during the 20th century. And, unfortunately, we, as a nation, still have not figured out how to take care of those who have come into contact with such toxic exposures during their military service.

“We need the VA and the DoD to acknowledge that this is how these soldiers are dying,” Bowman stated, “we need better screenings, both before and after deployments. Rob’s complaints were initially blown off by his doctors. We’ve made progress, but we still have a long way to go.”

Current legislative efforts

This year’s National Defense Authorization Act, which has been agreed to by both the House and the Senate, contains two important provisions regarding veterans who’ve been subject to toxic exposures in the military. Unfortunately, these provisions, which pertain to the declassification of certain Department of Defense documents related to toxic exposures, and requiring the VA to “coordinate efforts” to better understand toxic exposures, do not go far enough toward remedying this problem.

Section 738, the section that pertains to the VA, is the epitome of many Americans’ frustrations with Washington; it uses vague language that allows members to feel as if they are addressing the issue, but the language fails to require any specific action that would translate to tangible efforts to veterans and their survivors.

By contrast, S. 319, introduced by Senator Amy Klobuchar Amy KlobucharSocial media platforms put muscle into National Voter Registration Day Battle lines drawn on precedent in Supreme Court fight Sunday shows - Ruth Bader Ginsburg's death dominates MORE (D-Minn.), would have required VA to establish a center of excellence to focus on “the prevention, diagnosis, mitigation, treatment, and rehabilitation of health conditions relating to exposure to burn pits and other environmental exposures in Afghanistan or Iraq.”

Although it is not unusual for legislative language to be toned-down during the conference process in efforts to come to agreement on certain provisions, there is no legislative definition of how, exactly, to “coordinate efforts,” leaving a large amount of deference to an agency that has epically failed in its previous efforts to understand and treat veterans with toxic exposure-related conditions.

To this end, although legislation in 2013 required VA to create an Airborne Hazards registry, to date, VA has claimed that data gathered from the registry is “inconclusive” and, as a result, does not service-connect veterans for unusual medical conditions that are more than likely caused by toxic exposures.

As noted by the Institute of Medicine, such registries “rely on voluntary participation and self-reported data . . . mak[ing] them an intrinsically poor source of information on exposures, health outcomes, and possible associations among these events.”

Advocates take matters into their own hands

Fortunately, several veterans service organizations are taking matters into their own hands. The Tragedy Assistance Program for Survivors (TAPS), in conjunction with the Vietnam Veterans of America (VVA), were recently awarded a grant by the Wounded Warrior Project (WWP) aimed at increasing the understanding of the impact of toxic exposures in the military, and to assist surviving family members whose loved ones died after experiencing symptoms of that exposure.

Although there have been other initiatives in the past, the collaboration between TAPS, VVA and WWP is unique in that it unites generations of veterans, rather than isolating specific groups of veterans depending on the conflict in which they served. Specifically, the new initiative will draw on the past experience of Vietnam-era veterans, and what they learned fighting for recognition of Agent Orange benefits; work with the current generation of post-9/11 veterans, to ensure greater understanding, access to treatment and benefits than the previous generation had; and, most importantly, look forward to prevent uncertainties surrounding toxic exposures for future generations of veterans.

“In recent years, TAPS has seen an increase in the number of families seeking support after a loved one died from an illness, such as cancer," said Walter Sweeney, Casework Advocate at TAPS. "It can take years for symptoms to appear, so sometimes it's difficult for people to recognize the link between service, which may include exposure to environmental toxins, and the death. The primary focus of TAPS efforts will be to ensure the families of service members, including both veterans and those still serving, who have died as a result of these types of illnesses are recognized, cared for and are able to receive all benefits they are entitled.”

Surviving spouses like Bowman are excited about the undertaking. Congress should be too, because advocacy efforts like this will help to better inform future legislative efforts, and save lives.

Rory E. Riley-Topping has dedicated her career to ensuring accountability within the Department of Veterans Affairs (VA) to care for our nation’s veterans. She is the principal at Riley-Topping Consulting and has served in a legal capacity for the U.S. House of Representatives Committee on Veterans’ Affairs, the National Veterans Legal Services Program, the U.S. Court of Appeals for Veterans Claims, and the Department of Veterans Affairs You can find her on Twitter @RileyTopping.