Defense officials seek better data on burn pits - Army News | News from Afghanistan & Iraq - Army Times

Defense officials seek better data on burn pits

A top military health official told doctors that cases of chronic obstructive pulmonary disease and undiagnosed respiratory symptoms at Joint Base Balad — former home of Iraq’s largest burn pit — may be as much as 30 percent higher than at other bases.

“We clearly understand it can cause problems in some people,” said R. Craig Postlewaite, acting director of force health protection and readiness. “What we’re not sure is if there are long-term effects or latent effects.”

He also said it is possible that bronchiolitis in some troops that initially was attributed to their exposure to a sulfur fire near Mosul, Iraq, actually may have been caused by the burn pits, or a combination of factors including the burn pits, the sulfur fire, pre-existing health conditions and tobacco use.

That view has emerged after several Fort Campbell, Ky., soldiers who were nowhere near the sulfur fire came down with the same symptoms as those who were exposed to the fire.

“The question is, ‘What’s going on here?’ ” Postlewaite said. “What makes this group of individuals different?”

However, he acknowledged that recent studies through Vanderbilt University, the Veterans Affairs Department and the military show an increase of asthma and COPD in troops.

“Those are long-term health effects,” he said.

In one study, 10 percent of those who haven’t deployed showed respiratory symptoms, compared to 14 percent of those who have deployed.

“That’s a fairly modest elevation, but perhaps there’s something there,” he said.

And though the burn pit at Balad closed last fall, “there is still lots of burn-pit exposure throughout theater,” Postlewaite said.

Part of the problem is that there are no local contractors to take care of the waste, he said.

Postlewaite said initial studies did not show a potential for long-term health effects. The environmental expert who took the initial air samples at Balad has since said there was no way to conduct that sampling effectively because of weather changes and logistics issues.

Postlewaite said the Defense Health Board validated those initial studies. However, the board did not receive the military’s information about fine particulate matter from that sampling data as part of that report. Military and civilian environmental health experts have said fine particulate matter is known to cause some of the symptoms service members are complaining about.

Since Military Times first reported on the burn pits in October 2008, more than 400 service members have come forward with respiratory issues, neurological problems and cancers that they believe are related to their exposure to burn pit smoke while deployed. And military morbidity reports show huge increases in respiratory issues and COPD among active-duty troops.

Postlewaite said military health officials decided to go back and look at burn pits and particulate matter despite the initial findings because, he said, they had not considered the possibility of a combination of exposures, such as the burn pits, pollution and smoking.

Military Times has found that a majority of people sickened after living within a mile of the Balad burn pit were nonsmokers.

Postlewaite said health officials reconsidered after reading some of the service members’ stories at www.burnpits.org, a Web site established by Rep. Tim Bishop, D-N.Y.

“I tell you, if you haven’t read some of those accounts, it’s very, very sobering to look at those blogs and see how sick they are,” Postlewaite said.

As a result, he said, the military is conducting some “hypothesis-based studies” using hospital and self-reported data, as well as a better monitoring system in Iraq or Afghanistan.

He has asked for better biomarkers to determine what a person has been exposed to, dose-response relationships based on when a person might have been exposed to the pits, health outcomes at bases other than Balad, persistence of symptoms over time, and good case studies.

He also said exposure and symptom data would be available for VA claims adjudicators so they could links ailments to service.

“Service members shouldn’t have to prove exposure to VA,” he said. “It’s time to take the onus off the service member.”

He advised doctors to report when they see several service members with similar symptoms and similar exposures, and said it’s important “not to sit on” data.

“We need that in order to connect the dots on subtle kinds of exposure,” he said.

More also needs to be done in theater, he said. Base camp assessments should be done before people set up housing near environmental hazards; environmental personnel and doctors need to be strong advocates for risk mitigation by line commanders; and doctors need to document environmental exposures and symptoms in medical records in Iraq and Afghanistan, and report it using specific codes.

“This is a data point that deserves to be captured,” he said.

However, he said calls by some critics for a service member registry is unnecessary because the Defense Department already should have that information. Since the start of the wars, the location of every service member is recorded every day he or she is in theater.

“We shouldn’t need to create a separate database,” Postlewaite said.

He added that military environmental personnel and doctors should investigate, document and report all exposure incidents, and that assessment should include a roster of anyone who might have been exposed.

“We’ve already acknowledged we have huge health effects associated with exposure,” he said.

Disabled American Veterans is maintaining a registry of people who believe they have been sickened by exposure to the burn pits. For information, e-mail legislation@davmail.org.