(MILITARY TIMES) Seven months before Defense Department officials said there were no known long-term health effects due to exposure to open-air burn-pit smoke, Army researchers sent out a report on the health effects associated with particulate matter exposure in Iraq and Afghanistan that paints a slightly different picture.
“Particulate matter air pollution is hypothesized to affect health on two time scales,” states the report by the Army Center for Health Promotion and Preventive Medicine. “Long-term exposure, on the scale of months to years, may influence the incidence of chronic disease and susceptibility; and short-term exposure, on the scale of days, may precipitate acute health events. Health effects of particulate matter on both scales may range in severity from subclinical to deadly.”
The report, “Potential Health Implications Associated with Particulate Matter Exposure in Deployed Settings in Southwest Asia,” was submitted for publication to Inhalation Toxicology Journal in December and published in March.
It included data from a second report, “Characterizing Mineral Dusts and other Aerosols from the Middle East,” that showed particulate matter levels at each of 15 sites — including Joint Base Balad, Iraq, where an open burn pit once devoured as much as 240 tons of trash a day — was above World Health Organization, as well as military, standards for fine particulate matter.
The report attributed that particulate matter to sand, fossil fuel combustion, industrial aerosols — and fires. Each of 15 sites the center tested in Afghanistan, Kuwait, Iraq and Qatar had fine particulate matter counts that exceeded military guidelines for yearlong exposure — in some cases by as much as threefold.
All of the sites were at least double the one-year military guidelines for fine particulate matter.
“Open burn pits and simple incinerators with little or no air pollution control devices, used at some locations to process waste in [Iraq and Afghanistan], generate smoke plumes that may pose a considerable health hazard to deployed personnel,” lead author Coleen Weese wrote in the Army report.
Weese, environmental medicine program manager for the Center for Health Promotion and Preventive Medicine, co-authored the report with epidemiologist Joseph Abraham.
“The health effects of chronic exposure to particulate matter include increases in lower respiratory symptoms, chronic obstructive pulmonary disease, reductions in lung function, and … in life expectancy [primarily due to cardiorespiratory mortality],” she wrote.
Since the wars began in Iraq and Afghanistan, the annual number of respiratory and chest symptom cases among service members has increased by 20,000, according to military morbidity reports. Annual chronic obstructive pulmonary disease cases have increased by 10,000, chronic sinusitis cases by 20,000 and “all other respiratory disease” cases by 8,000.
Of about 400 troops who have come forward to say they believe they were sickened by burn-pit smoke, about 300 have respiratory illnesses. And a study by a Vanderbilt University doctor found that about 50 Fort Campbell, Ky., soldiers had been sickened with bronchiolitis — a rare lung disorder — because of “inhalational exposure.”
According to the Weese report, a 2005 survey of 15,000 troops deployed to Iraq or Afghanistan found that 69 percent had a respiratory illness, one-fourth of whom required medical care.
GREATER EXPOSURE, GREATER RISK
Exposure to fine particulate matter — tinier than the circumference of a human hair — has been linked to a “6 percent increase in the risk of death from all causes” with each increase of 10 micrograms per cubic meter, Weese wrote.
Fine particulate matter generally is human-caused: combustion of fossil fuels, industrial aerosols and fires. The problem is exacerbated in the Middle East, a region that is already comparatively heavily polluted. In Iraq, civilians use leaded gasoline and businesses melt down computers to get at recyclable materials. In Kuwait, petrochemical processing pollutes the air. And in Iraq and Afghanistan, giant burn pits at every military installation add to the mix.
When asked if troops are being warned of the danger, monitored for exposure or notified to look for symptoms, Army officials said they could not comment on the report before press time because they were busy preparing for a deployment health conference.
On July 13, Craig Postlewaite, deputy director of the Pentagon’s office of force readiness and health assurance, told Military Times that a 2008 study found “no indication of any long-term health risks in personnel deployed to Joint Base Balad.”
But that same risk assessment found that “particulate matter concentrations were detected above the [military exposure guidelines] in 50 of 60 total samples collected and assessed for particulate matter and analyzed for heavy metals.”
“Particulate matter exposure in the U.S. Central Command region has been previously identified as a potential health concern and is being addressed in other studies,” the assessment stated.
In fact, in the courtyard of the H-6 troop housing area at Balad, where troops say the smoke was so heavy that they had to clean their rooms twice a day to get rid of the black ash that settled on everything, the Balad assessment found particulate matter levels on one day at 299 micrograms per cubic meter — six times the one-year military exposure guideline of 50 micrograms per cubic meter.
Particulate matter levels exceeded military guidelines on every day the courtyard was tested.
The Balad report goes on: “Respiratory diagnoses are more of a concern from high particulate levels, and all sites could potentially be affected by high particulate levels common in [that] area of operation.”