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Environmental and Occupational Exposures

The Potential for Causing Gulf War Illnesses

Contents

Oil Well Fires
Particulate Matter
Water Use
Pesticides
Chemical Agent Resistant Coating
Retrograde Equipment
Depleted Uranium
Focus on Current and Future Deployments
Additional Information Resources

Many Gulf War veterans have experienced a variety of physical symptoms, collectively called Gulf War illnesses. In response to veterans’ concerns, the Department of Defense established a task force in June 1995 to investigate those incidents and circumstances related to possible causes of these unexplained illnesses. The Office of the Special Assistant assumed responsibility for these investigations on November 12, 1996, and continues to gather information on environmental and occupational exposures during the Gulf War and their possible effects on the health of the troops who served there.

To inform the public about the progress of this office, the Department of Defense publishes (on the Internet and elsewhere) accounts related to the possible causes of illnesses among Gulf War veterans, along with documentary evidence or personal testimony used in compiling the accounts. The following is a summary of the reports we have published concerning our investigations into environmental and occupational exposures.

We are all exposed to chemicals every day.

We are all exposed to chemicals in the air we breathe and in the food and water we consume every day. Some of these chemicals are man-made while others occur in nature. Someone living in a rural area will be exposed to different chemicals than someone who lives in a large city. Proximity to farms and industries, prevailing winds, and sources of food and water are some of the variables that affect the types and levels of chemicals in our environment. Furthermore, all environmental media can be affected; that is, air, water and soil can become repositories for chemicals released on a daily basis from human activities and natural actions. As a result, we are exposed to chemical contaminants on a continuous basis in our everyday lives.

Chemical exposure varies depending on where you live...

Our occupations often expose us to chemicals, too. A factory worker may be exposed to all the chemicals used in the factory, more so to those specific chemicals he or she works with every day. Occupational exposures can potentially be more severe than other types of environmental exposures because the concentrations of chemicals encountered in an occupational environment tend to be much higher than in the ambient environment, and individual workers are exposed to these higher levels of chemicals over longer periods.

...and where you work

Several factors combine to determine an exposure’s potential for causing illness: the toxicity of the chemical, the concentration of the chemical, and the duration of exposure are important factors for the potential for causing illness. An individual’s susceptibility to the chemical adds another variable.

Occupational exposures are usually calculated for a 40-hour workweek, 50 weeks a year, over a 40-year working life. Human health effects from chemical exposures are determined from actual incidents experienced by people in occupations where they are routinely exposed to toxic chemicals, or are estimated based on studies involving animals in controlled laboratory environments.

A factory worker is potentially exposed to all the chemicals used in the factory.

US military personnel who served in the Gulf War were not only exposed to chemicals in the ambient environment; they were also exposed to chemicals associated with their occupational activities. For example, pesticides were widely used to control insects, rodents, and other disease-carrying pests. These pesticides were applied where veterans worked, ate, and slept. Some subgroups of the general military population, that is, applicators who were involved in the day-to-day handling and use of pesticides, and who did not wear personal protective equipment, may have been exposed to certain pesticides above levels considered safe for human health. This is a concern because if improperly used, pesticides have the potential to cause adverse health effects. That is, pesticides that were used improperly may have created exposures above recommended limits – for example, the use of some pesticides formulated for use only in an outdoor environment were sometimes used indoors. Such use could have resulted in overexposures.

Pesticides were used extensively in the Gulf to control sand flies and other disease-carrying insects.

The Office of the Special Assistant has investigated the potential for human health effects arising as a result of exposure to pesticides and a number of other environmentally and occupationally related factors experienced by some US military personnel during the Gulf War. These investigations have resulted in the preparation of environmental exposure reports that discuss the issues and facts surrounding specific exposures. Some of these reports also estimate the likelihood that long-term adverse health effects could result. The reports are divided between environmentally and occupationally related exposures. Environmentally related issues included oil well fire smoke, particulate matter, and contaminated water. Occupationally related issues included pesticides, chemical agent resistant coating (CARC) paint, retrograde contaminated equipment, and depleted uranium.

All of the environmental and occupational related reports prepared by the Office of the Special Assistant have been published on the Department of Defense’s GulfLINK Web site and are briefly discussed in the following paragraphs.

To many, oil well fires were the most obvious threat to the health of our troops.

Oil Well Fires

In response to the Iraqi’s occupation of Kuwait, nearly 700,000 US troops were deployed during the Gulf War in 1990 and 1991. In addition to the risk of sustaining combat casualties, many of these troops were exposed to a number of toxic substances from a variety of sources. The most visible source was the smoke from hundreds of oil well fires that burned out of control over a period of about nine months. Depending on their proximity to the burning oil wells, veterans were exposed to varying levels of petroleum combustion pollutants for hours to months in duration. Non-documented reports by some veterans of various short-term, adverse health symptoms occurred during the war. Some of these may have been related to exposures to oil fire smoke. Air monitoring studies and a review of records of reported adverse health effects did not reveal a widespread short-term problem, but the possibility remained that smoke exposures could cause diseases to develop in the future. The results of the investigation into the potential health effects of exposure to the smoke from the oil well fires in Kuwait is documented in our Oil Well Fires Environmental Exposure Report. Our report includes a summary of the facts associated with this issue as well as the results and findings of research conducted by other organizations.

Particulate Matter

Particulate matter levels were often twice that recommended for safeguarding health.

The Oil Well Fires Environmental Exposure Report identified several issues that required additional investigation by us and further research by other organizations to resolve whether exposure to contaminants from natural and man-made sources could lead to long-term illness or explain any of the undiagnosed symptoms reported by some Gulf War veterans. One area identified for further investigation was the health effects associated with exposure to particulate matter. The Particulate Matter Environmental Exposure Report presents the results of our investigation and discusses what we currently know about US personnel exposures to particulate matter during the Gulf War.

Some veterans voiced concerns that the water supply may have contributed to their unexplained illness.

Water Use

The rapid influx of Coalition forces into the Persian Gulf region during the early stages of Operation Desert Shield taxed the region's available potable water resources. Host nation and commercial outlets were unable to provide sufficient supplies of potable water to incoming troops. Water purification systems were brought in by the United States to supply US forces with chlorinated drinking water and water use policies were implemented in theater with respect to non-potable water.

After the Gulf War, some veterans became concerned about a possible relationship between water use during the Gulf War and their illnesses. Anecdotal reports suggested that some short-duration illnesses such as diarrhea and similar gastrointestinal illnesses may have been triggered by contaminated, over-chlorinated, or improperly stored drinking water, or by contaminated water used to grow the local produce eaten by veterans. The Office of the Special Assistant initiated the Water Use investigation to determine if these individual episodes could be linked to post-war illnesses reported by some veterans.

Pesticides

Flea and tick collars used by some US troops caused skin irritation.

Troops used pesticides during the Gulf War for a number of purposes: on their skin and uniform to repel insects; in area sprays and fogs to kill flying insects; in pest strips and fly baits to attract and kill flying insects; and as delousing agents applied to enemy prisoners of war to control body lice. Pesticides used according to label directions (and with the use of appropriate personal protective equipment) pose a minimal health threat to most adults, but there are numerous reports of health problems, in occupational settings, resulting from overexposure—either through accident or misuse—to pesticides. The photo to the right illustrates misuse of a pesticide product. In this case the individual experienced a dermal reaction from wearing pet flea and tick collars. The potential for health problems from pesticide overexposure led some veterans and members of the medical and scientific communities to express concern over the long-term health consequences of pesticide use during the Gulf War. In response to these concerns, the Office of the Special Assistant investigated pesticide use during the Gulf War, and in March 2001, published the Pesticides Environmental Exposure Report. Our report describes how pesticides were used in the Gulf and describes what is known in the general literature about health effects associated with exposures to pesticides. In addition, the report presents what is known regarding the health effects that may have been experienced by those who were exposed to pesticides during their deployment to the Gulf.

Much of the equipment arrived in the Gulf with a green woodland camouflage scheme.

Chemical Agent Resistant Coating

As part of the Operations Desert Shield and Desert Storm deployment, the US shipped thousands of vehicles and other equipment to the Persian Gulf. Much of the equipment had the three-color woodland camouflage scheme designed for the European theater, which would make it easy to spot in the barren desert environment. Consequently, there was an operational requirement to repaint incoming equipment with tan-colored urethane-based paint called chemical agent resistant coating, or CARC, to provide desert camouflage protection.

Coatings used in repainting operations contain isocyanates, which in an occupational setting have shown to cause respiratory problems.

The military established a hand full of painting operations in Saudi Arabia to paint the vehicles. Some of these sites lacked the appropriate personal protective equipment to assure safe spray painting operations. Due to the lack of adequate personal protection, and a failure to adhere to applicable safety and occupational health policies and procedures, a number of soldiers directly involved in CARC painting may have suffered adverse health effects, primarily respiratory effects from exposures to hexamethylene diisocyanate (HDI) and solvents. Several spray painters at these sites reported short-term symptoms, including coughing, eye and throat irritation, skin rashes, headaches, and nausea. The Office of the Special Assistant investigated CARC to document its use, estimate to potential for exposure, and identify the potential health issues associated with these exposures.

Retrograde Equipment

Some are concerned they may have been exposed to contaminants from equipment shipped back to the US.

At the end of the Gulf War, US military units began preparing equipment for redeployment back to their respective peacetime installations. These retrograde operations saw large numbers of vehicles and equipment assembled at sites where they were cleaned and processed in accordance with strict protocols for materials about to enter US air and sea ports. These protocols are meant to prevent the spread of disease and protect US agricultural resources from plant and animal pests and diseases that may be brought into the country by contaminated equipment.

Some military and civilian personnel who participated in processing the retrograde equipment are concerned that they may have been exposed to battlefield or general environmental contaminants that may have resulted in adverse health effects. In response to these concerns, the Office of the Special Assistant conducted the Retrograde Equipment investigation to determine whether there were any documented incidences of adverse health effects resulting from exposures to this equipment.

Some veterans expressed concern about the chemical toxicity and radiological properties of DU and possible health risks from its use.

Depleted Uranium

The Gulf War was the arena for the first battlefield use of armor-piercing munitions and reinforced tank armor incorporating depleted uranium. This very dense metal is a byproduct of the process by which natural uranium is enriched to produce reactor fuel and nuclear weapons components. The leftover uranium, 40% less radioactive than natural uranium, is called depleted uranium, or DU. DU played a key role in US forces’ overwhelming success during the Gulf War. The extreme density of the metal and its self-sharpening properties make DU a formidable weapon. DU projectiles slice through thicker, tougher armor at greater ranges than do other high-velocity rounds. US forces also used DU to enhance their tanks’ armor protection. While DU’s combat debut showed the metal’s clear superiority for both armor penetration and protection, its chemical toxicity—common to all forms of uranium and similar to other heavy metals such as lead and tungsten—and its low-level radioactivity raised concerns about possible combat and non-combat health risks of DU. An investigation into the use of DU in the Gulf was conducted to determine whether DU posed an unacceptable health risk to American forces and whether personnel had been adequately trained to deal with this risk.

Focus on Current and Future Deployments

Collectively the investigations to-date into environmentally and occupationally related factors have further demonstrated the Office of the Special Assistant’s intention to leave no stone unturned in attempting to answer the question of what is causing the unexplained illnesses reported by some Gulf War veterans. While we have found no evidence of any environmental factor that can be directly and solely attributed to any of the illnesses reported by some veterans, we continue to pursue issues that may have a bearing on this question. Currently our efforts continue to focus on the health-related environmental issues not only of the Gulf War but also on current and future deployments. The ultimate goal is to insure that the concerns of veterans are consistently answered for them by the Department of Defense through consistent implementation of force health protection activities.

Additional Information Resources

The following web links provide additional scientific and technical information related to the environmental and occupational exposures that may have been experienced by our troops during Operations Desert Shield and Desert Storm.

  • Department of Health and Human Services, "Preventing Asthma and Death from Diisocyanate Exposure," Department of Health and Human Services (NIOSH) publication no. 96-111, 1996.
  • RAND Corporation, A Review of the Scientific Literature as it Pertains to Gulf War Illnesses, Vol. 6 – Oil Well Fires.
  • RAND Corporation, A Review of the Scientific Literature as it Pertains to Gulf War Illnesses, Vol. 7 – Depleted Uranium.
  • RAND Corporation, A Review of the Scientific Literature as it Pertains to Gulf War Illnesses, Vol. 8 – Pesticides
  • US Army Center for Health Promotion and Preventive Medicine – Depleted Uranium.
  • US Environmental Protection Agency, Office of Pesticides Programs.
  • US Environmental Protection Agency, Technology Transfer Network, Hexamethylene-1-6-Diisocyanate.
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