WASHINGTON — Some two million men and women have served in Iraq and Afghanistan since the wars began in 2001. Little did these individuals know that surviving the improvised explosive devices and insurgent gunfire wouldn’t necessarily guarantee their health or survival once they got home.

We of course have heard about the high suicide rate among veterans, and about the substance abuse in many cases brought on by a combination of over-medication during service and post traumatic stress disorder (PTSD), but less talked about are the debilitating and unexplained heart, lung, skin — even neurological — health issues plaguing veterans of both Afghanistan and Iraq.

We’ve been following the issue of toxic environmental exposure of U.S. servicemen and women here at Antiwar.com since 2009. Mounting evidence strongly suggests that the unregulated open-air burn pits used to incinerate everything from medical waste to batteries and rubber tires, has contributed to the fine particulate matter found carried in the dust, including metals and bacteria, and has something to do with the dramatically changed health of returning veterans.

“What makes healthy individuals who have never had asthma end up in wheelchairs on oxygen, or a 34-year-old non-smoker who has near-normal [physical fitness tests] but is short of breath and has lungs that are totally destroyed? These are the problems we are trying to solve,” exclaimed Dr. Anthony Szema, Stony Brook University Medical Center Assist Professor of Surgery, in a recent interview for the Army Times.

Szema recently wrote about a soldier serving both in Iraq and Kuwait who has lung tissue riddled with fine particles of titanium, iron and copper. He published his findings recently in the Journal of Occupational and Environmental Medicine. It is part of his ongoing study of soldiers suffering from unexplained illnesses.

This particular soldier, according to the report, is suffering from nonspecific interstitial pneumonitis, a rare and dangerous type of pneumonia that afflicts people for no known reason, cannot be treated and is 60 percent fatal within the first six months of diagnosis, according to Wikipedia. What we know about the soldier is where he was stationed, and that he came into contact with “the laundry facility, improvised explosive device blasts, sandstorms, burn pits and the occasional cigar.”

How a young soldier could be afflicted with “hot spots all over his lungs” is the subject of great debate, Szema and other health researchers and scientists, have boldly given it a name and are mainstreaming the question. Last year at a conference, Szema announced:

We’ve described a new disease called Iraq-Afghanistan War lung injury (IAW-LI), among soldiers deployed to these countries as part of Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn.… Not only do soldiers deployed to Iraq and Afghanistan suffer serious respiratory problems at a rate seven times that of soldiers deployed elsewhere, but the respiratory issues they present with show a unique pattern of fixed obstruction in half of cases, while most of the rest are clinically-reversible new-onset asthma, in addition to the rare interstitial lung disease called nonspecific interstitial pneumonitis associated with inhalation of titanium and iron.

The Pentagon, on the other hand, still denies that these long-term illnesses are at all connected with their service.

It may be that the Army’s resistance to the possibility is becoming less and less credible, however, as the evidence mounts up. And for the first time since the burn pit issue was first raised in a buried Air Force memo in 2006, the top minds on the issue will gather in open forum next week to discuss it.

“It’s now really starting to come around — it’s starting to become more mainstream,” said U.S. Navy Capt. Mark Lyles, chair of medical sciences and biotechnology at the Center for Naval Warfare Studies at the Naval War College in Newport, R.I. He has been studying the toxicity of dust in Iraq and Kuwait since 2003.

Lyles and other researchers have found more aluminum, lead, manganese and chromium in the dust than any acceptable health levels here in the U.S. He will be one of the key speakers next week at the 1st Annual Scientific Symposium on Lung Health after Deployment to Iraq & Afghanistan, chaired by Szema at Stony brook University Feb. 13.

“I think this meeting at Stony Brook could potentially blow this up especially for the press. You’re going to have total access to a lot of people you’d never get into the same room at the same time before,” said Lyles. “It’s really going to be really good and I’m telling you, it’s going to be fairly emotional. A lot of people are trying to get to this because they think this is going to be ‘ground zero’ for this issue coming out.”

Lyles, whose work in this area was profiled on Antiwar.com last year, is of the mind that much of the toxicity could be naturally occurring in the dust. He’s not quick to blame the war, but acknowledges that the diffusion and circulation of heavy metals into the air through the dust has been accelerated by the relentless pounding of the earth by the machines of war. In Iraq, that would reach back to the tank battles of the 1980s and 1990s.

Bottom line: he claims to have warned the military years ago so that they could protect the soldiers most exposed by simply making them wear masks, but he never heard a thing in response.

“A dust nuisance mask would have reduced the exposure 99 percent. Especially people in convoys or laying on the ground,” Lyles told us last year. “That’s what we’re talking about, are they still not taking the proper steps in acting on this?”

Meanwhile, after a few years of pressure, which included successful Congressional efforts towards getting most of the burn pits shut down, the DoD has become slightly more amenable to acknowledging there a link between the nasty pits and soldiers’ nasty symptoms. Very slightly.

In early 2010, R. Craig Postlewaite, director of health force protection and readiness programs at the DoD, told a congressional hearing that “we do feel like some people probably have suffered some untoward health effects” from burn pits, he testified. Yet, “we don’t feel like the numbers are large, based on the total numbers of people that were probably exposed to smoke throughout the theater.” He said some 56 percent of soldiers had been exposed to the pits during deployment.

A month later, he acknowledged that respiratory issues had gone up among those deployed, but still insisted they weren’t chronic or long-term, according to a report in the Army Times. At the time, the DoD clung — as it still does — to its own studies that they say remain “inconclusive” on the actual toxicity of the air around the burn pits.

A study released in October by a team commissioned by the Veterans Administration and conducted by the Institute of Medicine (IOM) said “the committee is unable to say weather exposures to emission from the burn pit at (Joint Base Balad) have caused long-term health effects,” a recognition that skeptics have seized upon to cast doubt on the burn pits’ critics. However, less widely reported is the fact the committee was relying on old data and air samples, and that their conclusions, when read in full, were much more damning about the situation overseas. From the full study:

However, the committee’s review of the literature and the data from JBB suggest that service in Iraq or Afghanistan — that is, a broader consideration of air pollution than exposure only to burn pit emissions — might be associated with long-term heath effects, particularly susceptible (for example, those who have asthma) or highly-exposed subpopulations (such as those who worked at the burn pit). Such health effects would be due mainly to high ambient concentrations of (particle materials) from both natural and anthropogenic sources, including military sources. If broader exposure to air pollution turns out to be relevant, potentially related health effects of concern are respiratory and cardio vascular effects and cancer.

If this is the macro view, the micro view of what is actually happening to soldiers is much more grim, indicating strongly that veterans are indeed sick from their service, the remaining question is how.

Balad burn pit

So What Do We Know?

Thousands of veterans have been pouring their stories into unofficial registries and online bulletin boards offered at the Army Times (an interesting snapshot of symptoms here), Burn Pits 360, Disabled American Veterans and the Burn Pits Action Center, started by U.S. Rep. Tim Bishop (D-N.Y) in 2009. Rep. Todd Akin, R-Mo., introduced legislation in November that would create an official burn pit registry of veterans who have health problems believed to be burn-pit related.

Staff Sgt. Daniel Meyer, 27, told Antiwar.com in a recent email exchange that he was medically discharged from the Air Force in October. He believes his exposure to burn pits in both Iraq and Afghanistan from 2007-2009 led to his severe health condition, which includes fatty tumors on his legs and bronchiolitis obliterans, a rare, irreversible and life-threatening lung disease that can be caused by the inhalation of toxic fumes.

Staff Sgt. Daniel Meyer

“I have gone from an extremely fit military man to a very limited man who is completely dependent on my wife for help with everything,” Meyer said, pointing out that he’s now carrying around an oxygen tank to breathe, and relying on a wheelchair to get around.

“Since the beginning of my illness, I have been treated quite unfavorably in regards to my health,” he said of the Air Force. “To gain an inch, I have had to fight for a mile. I was ridiculed, punished, and struggled to get anything close to proper medical attention.”

When he finally did, it was through Dr. Robert Miller, one of the pioneering medical professionals in veterans’ lung injury and the burn pit connection today. Miller, an associate professor of pulmonary and critical care medicine, and his former colleague, Dr. Matt King, now an assistant professor at Meharry Medical College, have been conducting biopsies on soldiers’ lung tissue since 2004.

Time and again, they have found that soldiers suffering from shortness of breath and other symptoms, but had otherwise passed all of the standard X-ray and pulmonary fitness tests, had lungs riddled with tiny holes, later diagnosed as constrictive bronchiolitis. The soldiers, all from the 101st Airborne, stationed at Ft. Campbell in Kentucky and suffering from unknown respiratory problems, were exposed to fumes from a 2003 sulfur plant fire in Mosul (the fire raged for a month, pumping an estimated 21,000 tons of sulfur dioxide into the air), or had lived and worked near a burn pit.

“So far, all but a few of these soldiers we have biopsied have had constrictive bronchiolitis,” Miller told Vanderbilt medical center’s newspaper in 2010. “These are inhalation injuries, suffered in the line of duty.”

“In every war there is a unique health syndrome. It is possible that whatever is causing the shortness of breath will be the ‘agent orange’ of this war,” Miller added.

He and King published their comprehensive findings — that 38 out of 49 soldiers they had biopsied had been suffering from the rare bronchial condition —in the New England Journal of Medicine, in July 2011.

Both men ascertain there is likely a range of exposures related to the condition, not just the burn pits. But they have said — and testified to Congress as much — that the Army should be doing more to test troops before and after their service to diagnose and gauge the pervasiveness of this problem more accurately.

“I don’t think our study links this disorder to burn pits,” Miller said. “Burn pits may be a problem that contributes to this disorder. I think what we can say is that this disorder is linked to service in the Middle East. We haven’t been able to definitively link what the cause is for this.”

According to a June New York Times report, the Army has stopped referring Fort Campbell soldiers to Dr. Miller. The Army says it just wants to maintain its health care in-house, but Miller suspects the Army wants to reduce the number of biopsies that might show serious lung injuries. This would not be surprising, since it has yet to fully acknowledge Gulf War Illness, and it took years (and a class action lawsuit) for the government to start compensating Vietnam-era veterans sick from their battlefield exposure to Agent Orange. In fact, the VA was just forced to ease its standards against which veterans had to prove their illnesses were caused by AO. Now, some 90,000 initially denied AO claims, plus an estimated 150,000 new ones, are flooding a healthcare system overrun by more than 500,000 new Iraq and Afghanistan veterans and nearly one million backlogged claims overall.

The cost is astronomical and it is all coming out of taxpayer pockets — and it’s putting the country more into debt, say critics.

But ignoring or minimizing it won’t make the story go away, as the military has often tried to do. As it tries to maintain the fiction that the current problem is not that bad, the evidence is suggesting otherwise. According to statistics compiled by USA Today last year, since the wars began, the military has seen a 251% increase in the rate of neurological disorders per 10,000 active-duty servicemembers, a 47% rise in the rate of respiratory issues and a 34% increase in the rate of cardiovascular disease. Meanwhile, new registries like Burn Pits 360, has gathered information from some 400 soldiers and veterans, says Meyer, who helps maintain the project. He is excited to hear about the Feb. 13 medical symposium, which he believes will rally more interest to the cause.

“I believe that many (soldiers) have come down with illnesses or diseases and not even realized that it was more than likely caused by a toxic burn pit,” he said. “As far as my confidence that the government will do the right thing in regards to all the veterans who have debilitating conditions as a result of burn pits, I’m hopeful, but not confident.”

As for Lyles, who maintains it’s toxic dust making the soldiers sick, he says he is feeling vindicated these days as more scientists and medical professionals are compelled to take his findings more seriously.

“For me the thing is, it’s not a matter of if, it was always a matter of when we would see the clinical ramifications of this exposure.”

Notes in the Margin



Many of you might be thinking, “What about the Iraqi and Afghan people who most assuredly are suffering from much of these toxic exposures too?” We don’t forget. People I have spoken to with intimate knowledge of the war and the landscape say we have no doubt created an environmental disaster in these places. We have growing evidence of this, as studies in population centers like Fallujah in Iraq, which were heavily bombarded by U.S. airstrikes during the war, are exhibiting high rates of birth defects and cancer. Not to mention the destruction and slow if non-existent reconstruction of key infrastructure like water treatment plants and sewage systems. I wrote about this for The American Conservative in 2011. Our toxifying presence in that country, i.e., depleted uranium, burn pits, etc., has left a radioactive scar on that country for years to come.

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