Gulf War Syndrome II: Iraq Burn Pits

Written by Kelly Kennedy, Army Times Staff writer

(Washington – Army Times) - As Wendy McBreairty hiked up a 20-foot bluff in her hometown of Cheyenne, Wyo., her thigh muscles felt heavy, as if she had been climbing for hours.

She breathed deeply, trying to fill her lungs but, as usual, she felt as if she could not get enough of the clear, cold air. Fatigue overwhelmed her, just as it does every other day of her life.

The 32-year-old Air National Guard staff sergeant sat on a rock, leaned toward the setting sun, and pondered her future.

“I had a lot of plans,” she said, biting her lip and wiping back tears. “I wanted a 20-year career in the military and I don’t see how I’m going to be able to do another 13. I’m working on my master’s degree — I’ll get that done, but I don’t know if it will do me any good.

“I don’t plan on having kids anymore.”

The root of her radical change in plans, she and her doctor believe, is the open-air burn pit at Joint Base Balad, Iraq. Before its Oct. 1 closure, the pit spanned 10 acres, consumed a wide array of potentially toxic materials and spewed a near-constant plume of thick black smoke that could be seen from miles away.

When McBreairty got back from Iraq in 2004, she desperately tried to understand what was causing her symptoms: shortness of breath, muscle fatigue, muscle spasms, fatigue and dry eyes. She found that others had similar, often equally puzzling, problems. Among the 40 people in her shop alone, five have neurological or respiratory issues.

One thing they had in common was that they all lived in the housing area at Balad known as H6 during their tours of duty in Iraq. H6 sat a mile southeast of the burn pit, and on many days was downwind of the plume.

Burn pits operate on U.S. bases throughout Iraq and Afghanistan, and troops in both theaters have reported respiratory problems, cancers, neurological diseases, heart problems and other issues that they believe are linked to exposure to smoke from the pits. Cases of respiratory illnesses among active-duty troops have risen steadily since 2001.

More than 400 veterans have contacted Disabled American Veterans, which is compiling a database of troops who believe they are ill from burn-pit smoke.

Of those, 39 say they lived in H6. Fifteen of the 39 have been diagnosed with asthma; 18 have undiagnosed breathing problems. Five have chronic cough, seven have chronic obstructive pulmonary disease, five have constant headaches, five suffer from sleep apnea, two have brain tumors and 13 have cancer. Several have multiple symptoms.

H6 houses about 1,000 people at a time in two-person trailers and eight- to 10-person dorms. In one way, it was considered a good place to live because it was thought to be a less likely target for enemy mortar rounds.

But H6 sat closer than any other housing area to Balad’s burn pit at the northeast corner of the base. At one time, the raging plume of smoke and flame devoured 240 tons daily of every imaginable form of trash — plastics, petroleum, paint thinner, even amputated limbs and other medical waste.

And while Defense Department officials say it is now shut down, replaced by three cleaner-burning incinerators, another 50 pits in Iraq and 34 in Afghanistan are still in operation — compared with a total of only 27 incinerators in the two theaters.

Dust, ash and chemicals

At Balad, the burn-pit smog seemed particularly attracted to H6. A health risk assessment conducted in 2007 by Army medical experts noted that H6 saw its “highest level of contaminant concentrations” when prevailing winds were out of the north, which is about 21 percent of the time.

In the H6 courtyard, particulate matter with a diameter of 10 micrometers or less — about 1/30th of a human hair — reached a concentration of 221 micrograms per cubic meter on one day of testing. Military exposure guidelines for such particulates say such levels shouldn’t go above 50 micrograms per cubic meter, although in reality, most desert areas top that level during dust storms.

At Balad, only a mortar pit and guard tower right next to the burn pit came even close to the concentrations measured in H6 housing — and the particulate matter there included chemical-laden ash.

As particulate matter grows smaller than 10 micrometers — as it does in a fire — it becomes even more dangerous because it can settle further into the lungs.

Johann Engelbrecht of the Desert Research Institute, who in December was awarded a $1.2 million Defense Department contract to study the effect of desert dust on troops, found in a 2008 study that fine particulate matter at Balad and 14 other deployment sites is well above both World Health Organization and U.S. military standards.

The military’s safety standard for a one-year period is no more than 15 micrograms of fine particulate matter per cubic meter per day. Balad averaged 56 micrograms per cubic meter.

“This study characterized three main air-pollution sources: geological dust, smoke from burn pits, and until-now-unidentified lead-zinc smelters and battery-processing facilities,” Engelbrecht wrote.

The Environmental Protection Agency links fine and superfine particulate matter with increased respiratory symptoms, decreased lung function, aggravated asthma, chronic bronchitis, irregular heartbeat, nonfatal heart attacks and premature death in people with heart or lung disease — which is why the EPA has pushed for a ban on backyard burning of any materials, including yard rubbish such as leaves and branches.

That is also why retired Air Force bioenvironmental engineer Lt. Col. Darrin Curtis is not surprised by the problems many troops say they’re having: He predicted it.

In fact, he knows about it firsthand — he lived in H6 himself during his tour at Balad.

“In my professional opinion, there is an acute health hazard for individuals,” he wrote in an oft-quoted memo that he sent up the chain of command in 2007. “There is also the possibility for chronic health hazards associated with the smoke.”

His memo detailed the long list of toxins produced by the burning plastics, Styrofoam, paper, wood, rubber, petroleum products and chemicals in the Balad burn pit.

He also noted that the military’s own regulations state that burn pits are meant to be an initial, short-term waste disposal option, not to be used for more than a few months before being replaced by incinerators.

Most of the burn pits in Iraq and Afghanistan have operated since the wars began.

“I saw a lot of smoke,” Curtis told Military Times. “The smoke, especially at night, would sink right to the ground and hover. It was just thick, and it would settle over H6.”

Collecting data ‘impossible’

Curtis was concerned enough to set up sampling equipment to check for chemicals, collect dioxin levels, and measure the amount and fineness of the particulate matter to which he and other troops were exposed.

Defense officials often quote these data as proof that troops were not exposed to enough toxins to cause harm. But Curtis said he had problems getting the collection points to work properly because he had to guess at the wind patterns and which way the smoke would blow.

“It was very difficult to collect data,” he said. “I think it’s more than difficult — it’s impossible.”

Army 1st Sgt. Lynette Streitfield, diagnosed with asthma and chronic bronchitis after a tour at Balad, said that when she lived in H6, she saw Curtis’ equipment set up outside the barriers that ringed the housing area. Inside the barriers, smoke weaved in and out of the trailers, trapped by the concrete walls. But as she emerged from the barriers, she saw clear air around Curtis’ equipment.

“That’s probably my fault,” Curtis acknowledged. “We had to set up the equipment where there were power sources.”

The issues Curtis predicted and that service members report are in line with what experts say they would expect to see after people have been exposed to large amounts of smoke, as well as with what a doctor hired to examine soldiers complaining of shortness of breath found when he biopsied their lungs.

Many troops who have spent time near burn pits talk about similar, odd symptoms — a crackly or deeper voice, waking in the middle of the night because they’ve stopped breathing, constant headaches, a general sense of fatigue, and an inability to pull enough oxygen into their lungs. Neurological complaints include numbness and, in two cases in one unit, paralyzed facial muscles.

‘Just don’t feel right’

“People say they just don’t feel right,” said Air National Guard Maj. Jerry Molstad as he sipped a beer after a weekend drill day at Fort Carson, Colo., last fall. He and Master Sgt. Jonathan Hilliard fiddled with a pulse oximeter, which can quickly tell if their oxygen blood saturation levels are low — and they are.

Both are obsessive about the tiny machines since returning from their tours at H6 housing in January 2009.

“I’m a volunteer firefighter,” said Molstad, 52, a physician assistant in the Guard. “You know you don’t go into a burning house without a pack.”

At Balad, he said, “They had security guards pulling 12-hour shifts right over the burn pit with no protection.”

He said six of the 25 people who deployed with his aeromedical unit returned home sick.

That “really raised my eyebrows,” he said, adding that he’s living it himself.

“I feel short of breath just talking to you,” he said.

His voice has turned gravelly, he has problems breathing and, for the first time in his life, he has begun snoring. A nonsmoker, he worries that he has developed chronic obstructive pulmonary disease. X-rays taken after he returned show the bronchi in his lungs are more prominent than they should be, which suggests early COPD. “I have an X-ray from 2005 that looks totally different,” he said.

Tests later revealed a mass in his abdomen, causing him to fear a more immediate issue: cancer. He’s still waiting for the results.

He pulled out a photo that he took outside the door of his trailer at H6 at midday — but it looks like night. “I wore my gas mask all day that day,” he said.

But he could not fully protect himself from the daily dusting of soot that covered everything inside his trailer, he said.

“What did I immerse myself in?” he said. “It’s haunting.”

After the drill weekend ended, Hilliard returned to the home he fears he will lose if his symptoms become worse — in the old mining town of Victor, Colo., with oxygen-thin air about 10,000 feet above sea level.

“I was working out at Balad — spin class three days a week,” he said. “All of the sudden back here, I’m severely short of breath with a moderate workout.” He failed his most recent military physical fitness test “heinously.”

Hilliard spent 30 years as a career firefighter and said he could recognize what was being burned at Balad by the smell: Plastic. Styrofoam. Tires.

He said the pit actively burned only during the day; at night, the blaze was allowed to go down in intensity.

In his firefighter training, he learned that federal air studies have found the smoldering stage of a fire is twice as toxic as when it burns at its hottest, when more material is consumed.

“In the smoldering phase, it’s just nasty,” he said.

Dashed dreams

McBreairty said she was healthy before she served at Balad in 2004 with the New Mexico Air National Guard, loading bombs on F-16s.

She has since been diagnosed with multiple sclerosis.

Fatigue came first. Then muscle spasms. Her jaw hurt. Her arm hurt if someone brushed it. Her joints ached. She had headaches.

Tests all came back normal.

“By the middle of 2007, I thought I was losing my mind,” she said.

Finally, an MRI showed brain lesions — the telltale sign of MS.

Almost immediately, her dreams of working as a sheriff’s deputy disappeared. She stopped playing softball. She gave up plans to become a military officer.

“I told my neurologist about the reports that had come out about the burn pits,” she said. “She was just amazed they were burning the stuff that they were. These are biohazards.”

McBreairty pulled a letter from a stack of medical paperwork on her parents’ kitchen table.

“I received the fax transmittal from the Department of the Air Force regarding the burn-pit hazards,” wrote Mary Kerber, McBreairty’s neurologist at Cheyenne Medical Specialists. “We believe that there are environmental triggers that can cause the manifestation of multiple sclerosis. … As we learn more about multiple sclerosis, we may be able to identify some of the environmental triggers and there may have been some environmental hazards associated with the open burn pit that could have triggered the manifestation of your disease.”

Knowing that someone believes her offers some comfort. But it’s not enough, she said.

“Stopping the burn pits is my biggest concern. I don’t want to see more of my friends be sick.”