Veterans sound alarm about health problems from burn pits

From The NY Times:

WASHINGTON — When former Staff Sgt. Susan Clifford was stationed in 2004 and 2005 at Balad Air Base in Iraq, she was assigned to help dump her Army unit’s trash into a massive, open-air pit.

Every conceivable type of waste was piled high in the pit — plastics, batteries, appliances, medicine, dead animals, even human body parts — and burned, with a dousing of jet fuel. A huge black plume of smoke hung over the pit, nearly blinding Ms. Clifford on her twice-a-month visits, and wafted over the entire base.

By 2005, Ms. Clifford, who had been a serious runner, began to cough up phlegm, and soon found it difficult to do any physical training. As her breathing got worse and other symptoms became more serious, doctors discovered that her lungs were filling with fluids.

“The doctors say they have never seen anyone like me, and they don’t know what to do,” she said.

Ms. Clifford, who retired from the Army with full disability in April, is one of the first veterans to receive an official ruling from the military that exposure to open-air burn pits at American bases in Iraq and Afghanistan have caused medical problems. Hundreds of other veterans have complained of similar illnesses that they believe were caused by exposure to the pits, forcing the Pentagon to restrict their use and the Department of Veterans Affairs to begin an investigation.

About 300 victims or their families have joined a class-action lawsuit against KBR, the military contractor that operated some of the burn pits at bases in Iraq. The company is fighting the suit, filed in federal court in Maryland, claiming that it operated some pits at the military’s direction, while most were operated by the Army.

The Defense Department and the Department of Veterans Affairs are proceeding cautiously in linking soldiers’ symptoms to the burn pits. While dealing with disability claims on a case-by-case basis, like Ms. Clifford’s, they have not developed a broad policy on the issue.

“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.

In response to complaints from hundreds of veterans and growing pressure from Congress, the V.A. has provided money for the Institute of Medicine, part of the National Academy of Sciences, to conduct a large-scale study, scheduled to be completed next year, of the possible consequences of burn-pit exposure. This year, the V.A. issued new guidelines for its staff to be on the lookout for veterans with illnesses that may have been caused by burn-pit exposure.

Meanwhile, the Pentagon is conducting a separate review of burn pits and their current status in Iraq and Afghanistan, and Congress has passed legislation requiring the military to justify any further use of them. Many of them in Iraq have been shut down as a result.

As of May, 42 were still operating in Iraq, and 184 more in Afghanistan. The burn pits began as a makeshift solution in a war zone, and critics say they remained in place long after alternatives, like incinerators, could be used.

Some veterans complained that the Pentagon has moved slowly and only reluctantly to deal with their medical complaints. Former Sgt. Kimani Grant of Cleveland said that after he served on an American base near Tikrit, Iraq, in 2005, where he lived and worked near a large burn pit, he developed persistent shortness of breath.

“It’s difficult for me to walk or run,” said Mr. Grant, who is 28. “I used to be real active in sports, and now I can’t do any of it. But when I went to the Army doctors, they never told me I had any kind of disease.”

While medical experts caution that it can be difficult to establish causality between environmental exposure and illness, several physicians who have conducted independent studies of the problem said that military medical officials have played down any connection. They pointed to a 2008 study by the military that found no evidence of a significant health risk tied to burn pits in Iraq.

“I’ve been concerned that the military really seems like they are trying not to find much of a link,” said Dr. Robert F. Miller, a pulmonary expert at the Vanderbilt University Medical Center, who has conducted extensive studies of veterans returning from Iraq with respiratory diseases.

He has treated dozens of soldiers from Fort Campbell, Ky., who served in Iraq, and he said he has found a pattern of unusual respiratory and pulmonary disease. He said he saw soldiers from the 101st Airborne Division who had fought a major sulfur mine fire in Iraq in 2003, many of whom had developed constrictive bronchiolitis. He then found other soldiers who had not been involved in fighting that fire but had similar symptoms that he believed might be linked to burn-pit exposure.

“How big a problem is it?” Dr. Miller asked. “I think it’s pretty big. The soldiers know more about it than the physicians. I get calls from soldiers all over the country.”

Dr. Anthony Szema of the Stony Brook University Medical Center published a study this week that found that soldiers from Long Island who were deployed to Iraq from 2004 to 2007 had a higher rate of asthma than those who remained in the United States. Of 900 soldiers from Long Island who were deployed to Iraq during that time, 6.6 percent came back with new diagnoses of asthma, compared with 4.4 percent of those who stayed in the United States.

In an interview, Dr. Szema said that the study “raises the concern of whether this is really asthma, or lung injuries. All of the soldiers in our study passed through Camp Anaconda, where a burn pit was going full blast. It doesn’t prove causality, but we know that if you burn things slowly in an unregulated manner, it creates more air pollution than if you use an incinerator.”

Officials of the Disabled American Veterans said they had been contacted by more than 500 veterans complaining of illnesses they believed were caused by burn-pit exposure. Representative Timothy H. Bishop, a Democrat from Long Island who has taken the lead on the matter in Congress, said he believed that the burn-pit issue could grow as the health effects are more widely recognized.

“To me, this is very evocative of the experience we’ve had with the exposure to toxins at ground zero in New York,” Mr. Bishop said. “Just like with ground zero, we are going to see the numbers of people who contract illnesses grow dramatically as the years pass.”