DoD shows first signs of acknowledging burn-pit woes - Navy News | News from Afghanistan & Iraq - Navy Times

DoD shows first signs of acknowledging burn-pit woes

Just after returning home from Afghanistan in 2002, Army Maj. Gen. Michael Dunlavey collapsed from what doctors first thought was a “near-fatal” heart attack.

“But I’m a general and a judge,” he said with a laugh. “I never use my heart.”

His blood work showed that it was actually a viral infection that had hit him “like a freight train.”

After the attack, the then-56-year-old nonsmoker developed a constant cough and he could never quite catch his breath. Now, his throat closes up at night and he often must gasp for air.

“I’ve lost the ability to bring in oxygen,” he said.

Dunlavey said he was exposed to particulate matter from burn pits and sand storms while in Afghanistan. He began to wonder how the burn pits played into his symptoms after reading studies of bronchiolitis cases that doctors believed resulted from exposure to chemicals and ash emitted by the burning trash in the pits.

Later, while being treated for his symptoms at Walter Reed Army Medical Center in Washington, D.C., Dunlavey said he ran into other much-younger soldiers dealing with the same symptoms — but nobody seemed to be listening.

The former commander of the detention center at Guantanamo Bay, Cuba, found that his general officer status did not seem to carry weight, either. When he went before his evaluation board for medical retirement, he said a doctor told him his symptoms were “psychosomatic.”

“They almost had me convinced I was a malingerer — until a heart scan inadvertently revealed scarring of my lungs,” he said.

Signs of DoD recognition

At a Senate Veterans Affairs Committee hearing on Oct. 8, the Pentagon finally took a step back from its months-long insistence that burn-pit smoke carries “no known long-term health effects.”

R. Craig Postlewaite, the Pentagon’s acting director of force health protection and readiness, publicly acknowledged for the first time that the burn pits may be causing health damage

“We do feel like some people probably have suffered some untoward health effects” from burn pits, he told lawmakers. “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 about 56 percent of troops who have deployed to the war zones report being exposed to burn-pit smoke.

In a Dec. 21 e-mail to Military Times, Postlewaite said: “DoD acknowledges that burn pit smoke causes acute health effects in some people consisting of irritated eyes and irritation of the upper respiratory system, which in some people can lead to a persistent cough. At this time, it is less clear what other longer-term health effects may be associated with burn pit smoke inhalation.”

In December, Pentagon officials announced the launch of a study of the possible long-term effects of burn-pit smoke. “Our number one priority is the health of service members,” Postlewaite said.

Adding up the costs

Dunlavey has no patience for defense officials who insist that levels of particulate matter in the war zones are safe.

“It’s about cost-benefit,” he said of the military’s approach to dealing with the huge amounts of potentially toxic trash and waste produced by U.S. forces in the war zones.

The costs are considerable.

A report last February by Col. John Cawthorne, Air Force deputy director of installations and mission support, said the average cost of “complex” clean-ups at some bases in Iraq — sorting, segregating, incinerating, landfilling with liners and transporting hazardous waste — would run $23 million to $37 million per base. Simpler clean-ups at other bases — “do what you can” in 100 days — would cost $1 million to $3 million per base.

He estimated the total cost of cleaning up 65 U.S. bases in Iraq at $401 million to $750 million.

But if epidemiology experts, doctors and service members who say burn pits are making them sick are right, the related health issues also could ultimately cost the government untold millions, just as Agent Orange did after Vietnam. Respiratory illnesses, cancers and other conditions linked to particulate matter among troops have been on the rise since 2001.

Dr. Bob Miller, assistant professor of pulmonary and critical care medicine at Vanderbilt University, began testing soldiers at Fort Campbell, Ky., who were exposed to the Mishraq Sulfur Mine in Mosul, Iraq, when they began noticing their physical fitness run times were increasing. Biopsies showed bronchiolitis — a disease that essentially shuts down the small airways in the lungs.

But as his work progressed, he found cases of bronchiolitis in 44 other soldiers at the post who also had deployed to Iraq but had not been exposed to the mine fire.

He said people have been calling him since he talked about his findings with Military Times several months ago to ask if he could test them as well.

“Almost all reported inhalational exposures were common to the Iraqi experience, including fumes from burn pits, burning human waste, fire and dust from combat, burning oil and diesel exhaust,” he said at the same Oct. 8 Senate Veterans Affairs Committee hearing at which Postlewaite testified.

“We have received … communications from soldiers and providers throughout the country, leading us to believe that this condition is present but not being diagnosed at other facilities,” Miller said.

He told Military Times he did not think the damage came just from blowing sand because there was no evidence of silica in the lungs of the troops he tested.

David Mannino of the division of pulmonary and critical care medicine at the University of Kentucky said people exposed to dust, vapors, gases and fumes “can certainly develop respiratory symptomology like this.”

“We have known for years that exposure to smoke by a firefighter, say, can result in bronchitis and bronchiectasis,” he said. “Exposure to any type of smoke can result in respiratory disease.”

Dr. Coleen Weese, an expert in environmental medicine with the U.S. Army Center for Health Promotion and Preventive Medicine, has written a paper that notes the symptoms being reported are consistent with what would be expected from heavy exposure to particulate matter.

“The potential for health hazards from this one is real,” said Weese, who is working on a study of long-term health effects of particulate matter in a young, healthy population.

‘Unusual’ findings

Shira Kramer, an expert on environmental health and author of an epidemiology textbook, said it’s about more than potential.

“Open, uncontrolled burning of solid and liquid wastes, including plastics, paper, wood, metals, oils, fuels, pain and human wastes, generates some of the most harmful chemicals known to man and represents an unacceptable health risk,” she said. “You would not expect to see [chronic obstructive pulmonary disease] in a young, healthy population — certainly not in this age range. It’s an extremely unusual and unexpected finding.”

There are two kinds of COPD: emphysema, which destroys the air sacs in the lungs, and chronic bronchitis, which causes airways in the lungs to swell. Both reduce lung capacity. Symptoms include coughing, fatigue, respiratory infections, shortness of breath and headaches. There is no cure.

Dr. Anthony Szema, chief of the allergy section at the VA Medical Center in Northport, N.Y., told lawmakers in November that he is seeing more young veterans with respiratory problems.

“Until 2004, I mostly saw 80-year-olds,” Szema said. “From 2004 to present, I have begun seeing young men … previously healthy athletes capable of passing basic training and performing combat operations … [who are suffering] from a variety of respiratory illnesses, including asthma and difficulty breathing during exertion, and are not fit for continued military duty.”

He said VA reports that the rate of new-onset adult asthma diagnoses in Iraq war veterans is double the rate for troops who did not deploy there.

“It is common sense and widely known that smoke from any fire can affect health,” he said.

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