11/8/13. Veterans of Iraq, Afghanistan Battle Lung Disease. Ben Kesling, wsj.com
“Staff Sgt. Moses Scarberry was a former high-school football player who could easily run seven-minute miles when he joined the military in 2001.
After convoys through sandstorms and exposure to trash burning in open pits during a tour each in Iraq and Afghanistan, he has changed. In a recent physical-fitness test, he couldn’t complete a mile run without stopping to walk. “I felt like I was breathing through a plastic bag,” said the 30-year-old military policeman with the West Virginia Army National Guard.
As another Veterans Day nears, lung problems have proved to be a persistent concern for those who have returned from Iraq and Afghanistan, and the military is struggling with how to address the phenomenon. Now, the Department of Defense is reviewing its policy of not requiring mandatory lung tests for troops amid growing outside pressure to take a harder look at what two wars in perennially dusty, sometimes toxic climates have done to soldiers’ lungs and how to better handle these issues in the future.
Staff Sgt. Scarberry will get some disability compensation for below-average performance on lung-health tests. But because he was never tested before his deployments, it is impossible to know how much his lungs have actually deteriorated.
Other service members are in similar situations, because unlike many fire departments and industries where workers face potential lung problems, the military doesn’t require the tests until after troops report problems.
Returning veterans and contractors have brought lawsuits against their employers and the U.S. government, citing exposure to burn pits, where troops typically burn all their trash while on deployment, including plastics, human waste and things like batteries. Congress has ordered the VA to establish a burn-pit registry by January, where vets from Iraq, Afghanistan and the Gulf Wars can log on and document their concern about health problems tied to the exposure.
But the military has been reluctant to take baseline measurements when troops join, which would cost about $254 million to implement for the 2.3 million service members, according to the DoD. Some military doctors also are reluctant to test soldiers before problems show up, saying there are questions whether such testing is effective. “In general, there is no evidence to say that baseline testing will inform our response” to a soldier who is having lung problems, said Paul Ciminera, director of post-deployment health at the Veterans Health Administration.
Yet some medical experts say such information can be invaluable. The Fire Department of New York instituted mandatory lung testing before Sept. 11, 2001, and has been able to track lasting health problems from the terror attacks. “In medical school we learn the most important thing is [patient] history,” said David Prezant, FDNY’s chief medical officer.
Nearly two million troops have deployed to Iraq and Afghanistan since 2001. About 14% of deployed troops complained of lung problems, according to research cited in a 2012 article in the Journal of Occupational and Environmental Medicine. Separate research showed 6.6% of troops who had deployed to Iraq had VA-diagnosed asthma, higher than the figure for troops not deployed to those countries.
A DoD-funded working group made up of civilians and military doctors recommended in mid-2012 that the DoD establish standard lung-function testing, both before and after deployment, to gather service-wide data on pulmonary degradation. The most common of this type of test is called spirometry.
The DoD, citing a lack of consensus on the issue and the need for further study, rejected implementing the recommendations. “Given that our Service members are mostly young and in good health, identifying lung disease at accession would be infrequent,” a Defense spokeswoman said in an email.
One series of studies, at Brooke Army Medical Center, aims to determine if baseline tests, along with pre- and post-deployment tests, make as big of a difference as proponents claim.
The DoD’s Defense Health Board is scheduled to make recommendations on broad lung testing in about a year, according to R. Craig Postlewaite, head of the Public Health Division of the DoD’s Defense Health Agency.
Master Sgt. Jessey Baca had his first spirometry test in 2008, which led to a diagnosis of chemically induced asthma. But by that point, he had already been in the military since 1978 and served two tours in Iraq.
Now, the 53-year-old reservist from Albuquerque, N.M., who has since been diagnosed with a slew of health problems including emphysema, wonders if regular testing could have identified his disease earlier and gotten him medical help and compensation. “I noticed things changing, but they were very subtle,” he said. “It almost didn’t show a change.”
11/5/13. The Military’s Open-Air Burn Pits Have Left A Generation Of Troops With Health Problems.
One of the most dangerous hazards of the wars in Iraq and Afghanistan was a product of the U.S. military, according to a new investigative report by The Verge’s Katie Drummond.
U.S. soldiers have been coming home with respiratory issues that they say are a result of the noxious fumes spewing from burn pits on U.S. Military bases.
Burn pits, many as large as 10 acres wide, have been used extensively on military bases to incinerate the Army’s trash since the start of the Iraq and Afghanistan wars.
The military burned nearly everything in the pits, including plastic, styrofoam, electronics, metal cans, rubber, ammunition, explosives, feces, lithium batteries and even human body parts, according to a 2010 report from The New York Times’ James Risen.
There have been numerous news stories since 2008 detailing the dangers of burn pits and investigating their effects. Over that time, military officials have resolutely denied any connection between the burn pits and soldiers’ health concern.
The Department of Defense’s position, unchanged since 2008, is that the pits “may cause temporary coughing and redness or stinging of the eyes” but that they “usually do not cause lasting health effects…”
This is in contrast to reports from soldiers who have come back with asthma, chronic bronchitis, constrictive bronchiolitis, and, in some cases, terminal Amyotrophic lateral sclerosis (or Lou Gehrig’s disease).
The pits were originally supposed to be a makeshift solution at the beginning of the war, until the bases became more established. Then large, safer incinerators would be used. Even as recent as this past July, incinerators in Afghanistan were still not being used.
However, Drummond contends that the military has long known that burn pits can harm health. The Department of Defense’s 1978 waste-management guidelines cautioned against open-air burning and said that it should only be used “[when] there is no other alternative.”
Last year, Wired surfaced a 2011 Army memo by G. Michael Pratt, an environmental science engineering officer, that acknowledged the dangers of the pits:
The long term health risk associated with air conditions on BAF from PM2.5 and PM10 indicates there is a potential that long term exposure at these levels may increase the risk for developing chronic health conditions such as reduced lung function or exacerbated chronic bronchitis, chronic obstructive pulmonary disease (COPD), asthma, atherosclerosis, or other cardiopulmonary diseases. This does not mean that service members that served on BAF will acquire adverse long term pulmonary or heart conditions but that the risk for such is increased.
Even after a scathing Senate hearing in 2009, the Pentagon’s position remained unchanged, according to a New York Times report in 2010:
“At this point in time, there is no medical data to indicate any specific illness or illnesses have been caused by exposure to burn-pit smoke,” Dr. Michael E. Kilpatrick, the deputy director of the Pentagon’s Force Health Protection and Readiness Programs, said in a statement.
Despite a 2012 study showing the deleterious effect of the burn pit particles and the thousands of veterans reporting health issues, the DoD has yet to significantly alter their position.
In January, the Obama administration mandated the creation of a Veteran Affairs “Airborne Hazards and Open Burn Pit Registry, which at first seemed like progress. According to Drummond’s report, the registry required veterans to fill out a multiple-choice survey. Many veterans felt the survey was written in such a way to discount the effects the burn pits might have had on their health.
Two groups, led by soldiers and their families, are now fighting for an official change in position from the government that might get them benefits and medical research to alleviate the health issues.
The Sergeant Thomas Joseph Sullivan Center, led by Daniel Sullivan, has fought for the passage of the “Helping Veterans Exposed To Toxic Chemicals Act” which would fund three research centers dedicated to studying exposure-related illnesses. Iraq veteran LeRoy Torres and his wife Rosie maintain Burn Pits 360, an online registry where veterans can document their deployments, exposure and health issues.
Sullivan and the Torres have achieved one significant victory: getting the VA survey rewritten to be less antagonistic towards veterans. Other progress still seems to be slow going.