This story is part of a Stars and Stripes special report on what's ahead for the U.S. military as a new decade begins. See all the stories here.

WASHINGTON — Veterans and lawmakers have been sounding the alarm for years that burn pits could be this generation’s Agent Orange, with potential health consequences for troops and the threat of delayed care and denied disability claims by the Department of Veterans Affairs.

This year, some lawmakers are looking into legislation to declare that veterans who served in certain locations were exposed, paving the way for easier VA disability claims. And the Pentagon has been tasked to close remaining pits and provide a comprehensive list of the sites used by the military.

It can be difficult to definitively link diseases to the military dump areas piled high with everything from plastics and medicine to scrapped equipment and human waste.

Reid Guffey, 33, an Iraq War veteran, just finished chemotherapy treatment for testicular cancer after three tours overseas. For one tour, the Marine had to sleep near a burn pit at al Asad Air Base in Anbar province. When he left the military, he said his VA disability rating wasn’t high enough to cover his cancer treatments.

“I definitely have questions, I can’t say one way or another. But burn pits are definitely a concern of mine,” Guffey said. “I started doing research and saw other guys were getting sick.”

Veteran advocacy groups and some lawmakers have attributed cancers, respiratory diseases and other health issues to exposure to burn pits in combat zones, the Middle East and Africa.

“It’s unfortunate and you want to blame somebody, but at the end of the day ... it’s life,” Guffey said. “But if something is going on that’s causing this, we need to stop it now. It seems a lot of people aren’t accepting the blame.”

There’s an information gap regarding how much exposure it takes to cause long-term health damage, which illnesses are related and which service members were exposed.

“The difficulty in getting these conditions recognized is ... how do you know the service is related to the illness?” House Veterans Affairs Committee Chairman, Rep. Mark Takano, D-Calif. said.

The Defense Department banned most burn pits in combat zones amid a whirlwind of lawsuits and claims from post-9/11 veterans that they were getting sick at a young age. The military today mostly uses clean-burning incinerators downrange. But the Pentagon policy makes allowances in areas where burn pits are the only feasible way of getting rid of waste.

Congress passed the $738 billion National Defense Authorization Act for fiscal year 2020, which included two key provisions from Rep. Raul Ruiz, D-Calif., that require the Pentagon to draft a plan to eliminate all existing burn pits and provide a comprehensive list of sites to the Department of Veterans Affairs. There’s no timeline for closing active pits, and it’s not clear how many remain. A DOD report to Congress in April said there are nine still operating — seven in Syria, one in Afghanistan and one in Egypt.

In December, the Center for New American Security, a bipartisan think tank in Washington, mapped out burn pits in Kuwait, Afghanistan and Iraq using Pentagon data to document location, time period and particulate matter.

Kayla Williams, an Iraq War veteran and researcher for the project, said the military’s air quality data is unreliable because there wasn’t enough thorough testing. Researchers have noted that the DOD understandably wasn’t sending air-quality testers up mountains in Afghanistan under enemy fire to check the burn pits.

“Somebody like me — I was in Iraq in 2003,” Williams told a group of reporters in December. “There is some information here on the short-term health risks I may have been exposed to — much less on the potential long-term health risks. Virtually no information is here.”

While the maps identify burn pits on large bases abroad, they miss dozens of forward operating bases and combat outposts overseas where troops operated in small groups. The lack of data and a rigid map of exposure locations could leave troops at risk of having a greater burden of proof when they seek care or disability benefits at the VA.

As it was with Agent Orange in Vietnam, “it’s very hard for a service member to document exactly where they were at or what they were exposed to, and the farther away we get from that, the harder it is to document,” said Rep. Elaine Luria, D-Va., chairwoman of the House Veterans Affairs Subcommittee on Disability Assistance and Memorial Affairs. “Our goal would be to remove the burden of proof on the individual to prove where they were on certain dates.”

That’s where legislation could help. But there are worries over identifying areas.

“Our concern was that some might try to use this data to deny veterans’ claims,” said Joe Plenzler, communications director for the nonprofit Wounded Warrior Project, who served in Iraq. “We think it is good to require DOD to map out all known locations, with the caveat that some locations may not be accounted for, and that just because a location was not listed should not be interpreted to mean that one wasn’t there.”

The VA website says, “At this time, research does not show evidence of long-term health problems from exposure to burn pits. VA continues to study the health of deployed Veterans.”

beynon.steven@stripes.com Twitter: @StevenBeynon

ResourcesAirborne Hazards and Open Burn Pit Registry, for veterans and service membershttps://veteran.mobilehealth.va.gov/AHBurnPitRegistry Veterans eligible for the registry can also get an optional no-cost, in-person medical evaluation. Ask your VA primary care provider or call 877-222-8387 to get started with an environmental health coordinator.Burn Pits 360, a veterans’ advocacy nonprofit with its own registryhttps://www.burnpits360.org/the-burn-pits-registry2019 Annual Warrior Survey, for the first time includes results from a question about exposure to environmental hazards.woundedwarriorproject.org

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