DoD assesses Marines' injuries unlikely due to
chemical warfare agent exposure

By Lisa A. Gates
OSAGWIMRMD Public Affairs

WASHINGTON, May 31, 2001 (GulfLINK) - After a two-year investigation, investigators from the Office of the Special Assistant for Gulf War Illnesses, Medical Readiness and Military Deployments concluded the Marines involved were unlikely exposed to chemical warfare agents. The "Reported Chemical Warfare Agent Exposure in the 2d Reconnaissance Battalion," case narrative focuses on a group of Marines who reported experiencing injuries that originally appeared symptomatic of chemical warfare agent exposure.

Investigators from the special assistant's office based their assessment on the opinion of a medical expert who specializes in identifying chemical warfare casualties, interviews with medical, chemical and command personnel, and interviews with the Marines, the Navy corpsmen, doctors and nurses directly involved in the incident.

"We began this investigation as the result of interviews that took place in February 1998 with three servicemembers who were stationed at Fleet Hospital 15 in Al Jubayl, Saudi Arabia during the Gulf War," said Tom Sellers, the lead investigator and author of the report. "These individuals told us that doctors at the hospital treated 15-20 2d Reconnaissance Battalion Marines for mustard agent exposure approximately two weeks after the war ended"

These reports were significant because they described post-war chemical warfare agent exposures to U.S. military personnel that had not been documented in any unit chronologies or Gulf War histories, continued Sellers.

After researching admission logs and medical records, investigators determined that these Marines were treated for respiratory illnesses, not a chemical warfare agent exposure as previously thought. However, one of those Marines treated for respiratory problems had a pre-existing condition that formed the basis for the original report.

"We learned from hospital personnel that one Marine had residual scarring on his hands from what he described as blisters, bumps or sores on his neck, ears and hands," said Sellers. "This Marine told us the he and five other Marines, who were not part of the group of Marines treated at Fleet Hospital 15 for respiratory ailments, were treated for these symptoms at a field first aid station approximately one month prior to his visit to the Fleet Hospital."

The six Marines were part of the United States Marine Corps' 2d Reconnaissance Battalion, Company B, and had been assigned to different reconnaissance teams operating different observation posts at the time of the blisters appeared. Some time between February 4 and 14, 1991, they reported developing blisters, bumps or sores on their hands, ears and necks. Due to the high probability of Iraq using chemical and biological warfare munitions, the company commander instructed the Marines to seek medical attention at the nearest first aid station.

Navy corpsmen and various medical personnel examined the Marines, but no one could diagnose a cause. However, some speculated the blisters formed because of something the Marines came into contact with while digging in the sand at the berm. Due to the high probability of chemical attack, a chemical agent monitor was used to test the Marines and their equipment for possible contamination. The monitor alerted for the presence of a blister agent on a Marine's glove. However, when the glove was re-tested, the monitor gave no indication that of a chemical warfare agent. This led the monitor's operator to decide the first alert had been a false detection. The chemical agent monitor detection is not considered evidence of chemical warfare agent presence without a secondary test to validate the first test for possible chemical warfare agent exposure.

"The chemical agent monitor is a very sensitive device. Many other vapors cause positive detections, such as insect repellent, breath mints, ammonia, perfumes and after-shaves, food flavorings and cleaning compounds," said Sellers.

Because of the undiagnosable nature of the blisters, the Marines were sent to 1st Battalion, 8th Marine Regiment's battalion aid station for further examination. Medical personnel examined the blisters and again found no cause. The Marines were sent to a larger aid station operated by 8th Marine Regiment where one of the Marines remembered having one of his blisters opened for closer inspection and cleaning. Further inspection of the blisters prompted one unidentified person to speculate the cause could be the result of leishmaniasis. However, this probable cause was dismissed due to the lack of other physical symptoms associated with the disease.

Although medical personnel could not make a definitive diagnosis and the symptoms were neither severe nor debilitating, the Marines were declared fit for duty and returned to their unit. They were advised by medical personnel to wash their hands daily. After nearly three to five weeks, the blisters healed without further complications. The Marines went on to participate in the ground war operations.

"There is little documentation that describes the treatment of these injuries," said Sellers. "However, it is clear that these Marines experienced symptoms that concerned them, and the threat of chemical attack at the time of the Gulf War was real."

During the investigation, a medical expert who specializes in chemical warfare agent casualty identification and treatment evaluated the six Marines. The medical expert used information gathered by the investigators from the special assistant's office and interviewed four of the six Marines. During the interviews, the Marines described the nature of their blisters to the best of their abilities and discussed their environment and what they were doing at the time the blisters appeared. The Marines questioned also viewed images of skin lesions caused by various conditions, including mustard agent exposure. When asked to identify which skin conditions most resembled what they experienced, none of the Marines identified the images of blisters caused by exposure to mustard agent.

The medical expert could not identify with any degree of certainty what might have caused the Marine's blisters. He listed several reasons why he concluded it is unlikely mustard agent exposure caused these Marines' blisters. The medical expert cited that at the time of their skin problems, the Marines experienced none of the other symptoms commonly associated with mustard exposure such as eye irritation, redness, eye pain, sore throat or cough. Additionally, the blisters did not form in warm, moist areas of the skin where mustard is most likely to produce lesions, and these blisters did not form larger ones.

There was only one reference to this incident in all the medical records, unit histories and watch logs researched by investigators. When medical personnel were questioned separately several years following the Gulf War, none could recall anyone receiving treatment for symptoms of chemical warfare agent exposure. The only evidence indicating a possible chemical warfare agent exposure were the blisters and a single chemical alarm monitor alert, where subsequent tests of the CAM proved negative. The most compelling evidence to support the assessment made by the investigators is the opinion of the medical expert who found these Marines' symptoms to be inconsistent with those associated with chemical warfare agent exposure, and believes it is unlikely that mustard or any other chemical warfare agent exposure caused the blisters.

This is an interim report. Veterans who may have additional information and want to share that information, should call the special assistant's office at
(800) 497 - 6261. Case narratives examine Gulf War incidents that might have involved chemical warfare agents. They are part of DoD's efforts to inform the public about its investigations into the nature and possible causes for the illnesses experienced by some Gulf War veterans.