Burn Pits: Cut the Denials, Injuries Were Real

Photo: U.S. Department of Defense

The Mammoth 2000 page National Defense Authorization Act passed the House Wednesday and is now headed to the Senate

The Department of Veterans Affairs estimates as many as 3.5 million service members and veterans may have been exposed to airborne toxins since 9/11. The Bill requires the Pentagon to create and submit to Congress a plan to phase out use of burn pits. During the height of Operation Iraqi Freedom, as many as 63 burn pits blazed across the country, according to the Defense Department. At the peak of their use in both Afghanistan and Iraq, the Pentagon and military contractors operated 250 burn pits of varying sizes, connectingvets reports.

Burn pits were a common way to get rid of waste at military sites in Iraq and Afghanistan.

At this time, research does not show evidence of long-term health problems from exposure to burn pits. VA continues to study the health of deployed Veterans.

Health effects from burn pit smoke

Toxins in burn pit smoke may affect the skin, eyes, respiratory and cardiovascular systems, gastrointestinal tract and internal organs.

Veterans who were closer to burn pit smoke or exposed for longer periods may be at greater risk. Health effects depend on a number of other factors, such as the kind of waste being burned and wind direction.

Most of the irritation is temporary and resolves once the exposure is gone. This includes eye irritation and burning, coughing and throat irritation, breathing difficulties, and skin itching and rashes.

The high level of fine dust and pollution common in Iraq and Afghanistan may pose a greater danger for respiratory illnesses than exposure to burn pits, according to a 2011 Institute of Medicine report.

Type of waste burned DOD

Waste products in burn pits include, but are not limited to: chemicals, paint, medical and human waste, metal/aluminum cans, munitions and other unexploded ordnance, petroleum and lubricant products, plastics, rubber, wood, and discarded food.

Burning waste in open air pits can cause more pollution than controlled burning, such as in an incinerator.

High rates of respiratory symptoms (14%) and new-onset asthma in previously healthy soldiers (6.6%) have been reported among military personnel post-deployment to Iraq and Afghanistan. The term Iraq/Afghanistan War-Lung Injury (IAW-LI) is used to describe the constellation of respiratory diseases related to hazards of war, such as exposure to burning trash in burn pits, improvised explosive devices, and sandstorms. 

Burnpits360.org is a nonprofit civilian website which voluntarily tracks medical symptoms among soldiers post-deployment to the Middle East. Subsequent to initiation of the Burnpits360.orgwebsite, the Department of Veterans Affairs started the Airborne Hazards and Open Burn Pit registry.

Adverse environmental exposures in the Middle East region include: 1) burning trash in open air “burn pits” ignited with JP-8 jet fuel; 2) improvised explosive devices (IEDs) with associated “blast overpressure” or shock waves (with the capacity to aerosolize metals); 3) aeroallergens; and 4) massive sandstorms consisting of sharp, respirable, metal-laden, geoparticulate matter (Szema, 2013; Szema et al., 2014).

In 2010, families of affected military personnel started Burnpits360.org, a nonprofit website that functions as a database to voluntarily collect self-reported information on soldiers affected by burn pit exposure. These families raised significant awareness to the issue of open-air burn pits, resulting in the passage of the Open Burn Pits Registry Act by President Obama in 2013 (http://sgtsullivancenter.org/wp-content/uploads/2015/04/IOM-Registry-Final-Letter.pdf).

Subsequently, the Department of Veterans Affairs (VA) established the Airborne Hazards and Open Burn Pit (AH&OBP) registry to monitor health effects due to airborne hazard exposure during deployment. This registry collected data from veterans and active duty service members using a voluntary self-assessment questionnaire from April 25, 2014 to September 30, 2014. Data were acquired from 32,306 participants with 19,082 total completed questionnaires. The first report was released in April 2015 (U.S. Department of Veteran Affairs, 2015).

During deployment, 13% of U.S. Army Medic visits in Iraq were for new-onset acute respiratory illness (personal communication Michael Kilpartrick, MD, Pentagon). Both asthmatic and nonasthmatic Department of Defense personnel report increased respiratory symptoms of wheezing, cough, sputum production, chest pain/tightness, and allergy symptoms (Roop et al., 2007; Szema et al., 2010). Among patients at the Veterans Affairs Medical Center, Northport, New York, deployment to Iraq and Afghanistan was associated with: (a) higher risk of asthma and (b) higher rates of new-onset respiratory symptoms leading to more frequent ordering of spirometry versus those deployed to other locations, 14.5% versus 1.8% (Szema et al., 2010; Szema et al., 2011). Cumulative length and frequency of deployment are not associated with increased incidence of respiratory disease among U.S. military personnel, suggesting that Middle East respiratory hazards encountered during a single deployment are severe enough to induce acute and chronic lung injury (Abraham et al., 2012).

Among common respiratory hazards are: (a) open-air Burn Pits used to burn trash with JP-8 jet fuel in the absence of incinerators; (b) improvised explosive devices (IEDs), often detonating vehicles roadside; (c) blast overpressure or shock waves causing shear stress on lung tissue; (d) seasonal aeroallergens, as well as indoor dust mite antigens and mold; and (e) naturally-occurring sandstorms (so-called Shamal and Sharq, named for the direction of motion).

Burn pits are open-air fields of burning trash ignited by JP-8 jet fuel, utilized for the disposal of water bottles, Styrofoam trays, medical waste, unexploded munitions, and computers (Szema, 2013). Incineration of these products, and use of JP-8 jet fuel containing benzene, releases dangerous toxins, as well as products of incomplete combustion, which accumulate as measurable particulate matter air pollution (Engelbrecht et al., 2009; Szema, 2013). Open air burn pit exposure is analogous to airborne hazard exposures at the World Trade Center disaster post September 11, 2001, in New York City (Prezant et al., 2002). Firefighters and rescue workers were exposed to burning buildings ignited with jet fuel, JP-8, from two airplanes which deliberately crashed into the twin towers. Post 9/11, at 5 years, firefighters and rescue personnel with more than 1,000 hours in the aftermath at Ground Zero had airway hyperresponsiveness on methacholine challenge, as well as accelerated decline in lung function of approximately 500 ml (Banauch et al., 2006). World Trade Center Cough describes a symptom constellation believed to be related to inhalation of dust in lungs, which also was swallowed or nasally inhaled in the midst of massive clouds of airborne particulate matter (Prezant et al., 2002). Children living and attending school in Manhattan’s Chinatown proximal to Ground Zero—and enrolled in an asthma registry in the 12 months preceding September 11, 2001—had reduction in peak expiratory flow rates, compared with those living further away (over 5 miles). These asthmatic children closer to Ground Zero also had more visits to the pediatrician for asthma specifically, and their pediatricians prescribed more asthma medications compared with those living further away (Szema et al., 2004).

The wars in Iraq and Afghanistan (Operation Iraqi Freedom, Operation Enduring Freedom, Operation New Dawn) have seen the prominent use of roadside bombs or IEDs. These are typically detonated with the intent to explode vehicles. For phosphate bombs, this may lead to vaporization of a Humvee within minutes. Some soldiers have been found to have metal in their lungs, with iron bound to titanium in fixed mathematical ratios, supporting the concept that the source is anthropogenic (Szema et al., 2012; Szema, 2013). Specialized techniques and expertise with sophisticated equipment are necessary to determine the spatial resolution of metals in lung; this is often not available, except at quaternary care medical centers associated with national laboratories. Polarizable crystals seen in soldiers’ lungs with constrictive bronchiolitis (King et al., 2011) have been shown to be these metals when particulate matter models are used to duplicate lung injury in mice.

Explosive devices accounted for 36.3% of battle injuries in Operation Iraqi Freedom and Operation Enduring Freedom (Murray et al., 2011). Mortars, roadside IEDs, vehicle IEDs, suicide bombers utilizing C4—all of these culprits cause blast overpressure or shock waves leading to shear stress on delicate lung alveoli. Reported complications related to explosive damage include primary blast lung injury and adult respiratory distress syndrome (Johnston et al., 2013; Mackenzie & Tunnicliffe, 2011; Singleton, Gibb, Bull, Mahoney, & Clasper, 2013; Szema, 2013).

Registry

Join the Airborne Hazards and Open Burn Pit Registry and contact your local Environmental Health Coordinator to help you complete the free voluntary medical evaluation. Check your eligibility and sign up through an online questionnaire.

Compensation benefits for health problems

Health concerns?

If you are concerned about your exposure to burn pits, talk to your health care provider or contact your local VA Environmental Health Coordinator to help you get more information from a health care provider.

Veterans may file a claim for disability compensation for health problems they believe are related to exposure to burn pits during military service. VA decides these claims on a case-by-case basis. File a claim online.

Read Federal Benefits for Veterans, Dependents and Survivors to learn more about VA benefits.