DoD and VA Discuss Environmental Exposure Challenges

By Peter Graves
FHP&R Strategic Communications

On Nov. 13, an assembly of some of the top physicians, epidemiologists, and researchers from across the Department of Defense (DoD), the Department of Veterans Affairs (VA), and even the United Kingdom Ministry of Defense gathered in a day long workshop to discuss the challenges of environmental exposures within the Iraqi and Afghan theaters of operation, and what was being done to address them.

The workshop was sponsored and led by the DoD-VA Deployment Health Working Group, a chartered interagency committee charged with fostering enhanced cooperation regarding the health of service members, both active and separated. This workshop was organized because many veterans have returned from duty stations in the Middle East complaining of possible health effects associated with exposure to chemicals, particulate matter, smoke, and dust. The overall purpose of the workshop was to improve communication and cooperation among DoD and VA scientists, who are responsible for health studies and other responses to environmental exposures in theater.

Although working-group members and a number of guest scientists reflected on a wide variety of exposures within Iraq, Afghanistan, and across the globe, the discussion was focused primarily on three high-profile cases within the Iraqi theater of operations. These are the 2003 exposures to sodium dichromate at the Qarmat Ali Water Treatment Plant; the 2003 Mishraq State sulfur fires; and exposures to smoke from the burn pit at Joint Base Balad. For each of these three exposure incidents, presentations were provided on the environmental investigation and on the completed and ongoing medical surveillance studies.

Participant presentations were geared towards explaining exposure situations as they are currently understood, and educating the group on various interagency resources and databases which can be utilized for additional health studies to determine the potential for long-term health effects.

The Qarmat Ali incident was covered in detail by representatives from the U.S. Army Center for Health Promotion and Preventive Medicine (CHPPM), who discussed the environmental investigation, health risk assessment, and the Defense Health Board review. Other speakers discussed the potential exposures at Qarmat Ali to members of the National Guard of four states who had been assigned there and the ongoing efforts to track these individuals to see if they indeed have suffered long-term health effects.

CHPPM officials also discussed the Mishraq State Sulfur Fire, an inferno which raged for more than a month in the summer of 2003 at the Mishraq State Sulfur Mine Plant in western Iraq. There were cases of firefighters assigned to battle the blaze who reported short-term respiratory symptoms at the time of the fire. CHPPM’s study of medical conditions after these individuals returned home determined there was little evidence of long-term health effects related to exposure to the sulfur.

Working group members also heard a synopsis of medical surveillance and health assessments conducted at the large burn pit at Joint Base Balad in Iraq. Environmental exposures to smoke produced by burning a variety of types of waste has caused short-term respiratory symptoms in members in proximity to this burn pit. It is unclear at this time if there is a possibility of long term effects from exposure to this burn pit. Further environmental and health studies are ongoing.

Participants concluded by discussing the reasons it is important to continue investigating the health effects of these and other types of environmental exposures which may be affecting American and allied forces. These included the high risk potential for long term health effects and concern among service members and veterans. While difficulties exist in identifying and tracking the potentially exposed service members and quantifying the data, all participants agreed improved coordination between the DoD, VA, and the Armed Services would continue to be essential for a successful outcome.