Veterans suspect burn pits causing thousands of serious illnesses
By BEN FINLEY | The Philadelphia Inquirer | Published: October 11, 2015
PHILADELPHIA (Tribune News Service) — The smoke sometimes turned from black to green, like the olive drab of an old military uniform, as it rose from a pit of smoldering trash.
The color depended on what was burning. There was refuse from chow halls and latrines at Camp Al Taqaddum in Iraq. But contractors also bulldozed in broken computers, wrecked humvees, and medical waste.
Chris Lang, a Marine from Doylestown, slept in a tent downwind from the inferno.
"We always joked about it," he said of the Olympic-pool-size burn pit. "Like, we're going to live through this [war] but not that thing over there."
Six years later, doctors diagnosed Lang with Hodgkin's lymphoma, a cancer that attacks the immune system.
Lang, 34, is among thousands of veterans who blame an illness on open-air trash burning at bases in Iraq and Afghanistan. They believe the U.S. government has failed to take responsibility for the consequences, likening the issue to Vietnam vets' exposure to Agent Orange, the toxic herbicide.
Lang and others have fought protracted battles to win coverage, but the Department of Veterans Affairs has declined to declare a cause of their illness or acknowledge that burn-pit smoke may have played a role.
The agency has denied thousands of burn-pit exposure-related health claims, veterans advocates say. The VA maintains that research has so far failed to prove a link between exposure and long-term disease.
"In general, the VA needs some scientific basis," explained Paul Ciminera, director of the agency's Post-9/11 Era Environmental Health Program.
Major burn-pit studies are underway.
In the meantime, vets are waiting for answers. They include Cindy Aman, 37, a former National Guard member from Wilmington who has constrictive bronchiolitis, a life-threatening narrowing of the lungs.
Mike Bauder, 30, a former Army reservist from Northeast Philadelphia, has chronic skin inflammation, hives, and gastrointestinal reflux disease.
Charlene Madsen, of Philadelphia's Tacony section, lost her husband, Norm, to cancer in 2013. He was a former Army mechanic in Iraq.
There has been progress on the issue. Laws now restrict what bases can burn. And since the VA opened a registry last year to track the health of exposed vets, nearly 45,000 have signed on — including 1,700 from Pennsylvania and New Jersey. Bills in Congress would accelerate medical research.
But veterans still fear decades may pass before long-term studies confirm their claims. Researchers know too little about the smoke's impact on the body. Burn pits were rarely tested for harmful elements.
"We're looking at a long horizon," said Adrian Atizado, assistant national legislative director for Disabled American Veterans. "If we don't know exactly what they were exposed to, we're relegated to years and years and years of tracking their health."
That's what happened with Agent Orange, a toxic defoliant the military sprayed to clear the jungles in Vietnam. Researchers have spent decades studying exposed veterans. It wasn't until the 1990s, long after Saigon's fall in 1975, that the VA started to cover serious illnesses tied to the herbicide, like cancer.
The VA promises a shorter trajectory for burn pits. Some say vets shouldn't have to wait.
"We're basically taking the position that vets have to prove it — and that's not right," said former U.S. Rep. Tim Bishop of New York, who took on the issue before leaving office in January.
The anger goes beyond the VA. In a class-action lawsuit, vets claim the civilian contractor KBR (formerly Kellogg Brown & Root) — and its former parent company, Halliburton — risked their health for profit, torching hazardous materials in burn pits instead of installing incinerators to more safely burn trash.
Last month, the case entered a yearlong discovery phase, during which both sides must share evidence. At the end, a federal judge will decide whether the firm can be sued at all.
Federal law typically shields the military from liability stemming from battlefield decisions. KBR wants the same legal immunity, claiming it only followed military direction.
"Strategic military judgments pervade every aspect of this case," the defendants' lawyers argued in court filings. "The Army expressly directed the use of burn pits and, indeed, routinely used burn pits on bases where it handled waste disposal. Army commanders also selected the location of burn pits at each base and provided explicit instructions about what items could not be burned."
More than 4,000 vets, including Lang and Aman, have joined the suit. Madsen was an original plaintiff. Now his widow awaits the outcome.
"Losing my husband is hard to put into words," Charlene Madsen said. "I just want to see justice — taking care of the people who are still alive."
From August 2004 to January 2005, Lang served as a military policeman with the First Marine Expeditionary Force in Iraq. His unit swept highways for explosives and engaged in firefights during Iraq's growing insurgency, he said. Its convoy once suffered a roadside bomb's direct hit.
Lang said he usually crawled into bed in the morning as contractors reignited the pit with jet fuel, about 150 yards from his tent. "It was impossible not to be near the smoke," he said.
Bases routinely torched plastics, hazardous waste, and medical refuse, according to 2010 report from the Government Accountability Office.
Investigating at Congress' request, the GAO also found that the military lacked burn-pit guidelines until 2009 — and that even after they were implemented, some bases ignored them.
Rick Lambreth, who worked for KBR, testified at a Senate hearing that he saw burn pits dispose of "nuclear, biological, and medical waste."
Bauder, the reservist from Northeast Philadelphia, remembers sitting in a humvee outside a base in Iraq in 2004 when burn-pit smoke enveloped him.
"All of a sudden, you couldn't see your hands in front of you," he said. "The smoke was so thick there was nothing you could do to escape it."
Lang's cancer was diagnosed in 2011, six years after he came home. By then, he was a Bucks County sheriff's deputy.
His lymphoma had spread beyond his lymph nodes to his spleen and bones.
Sunita Nasta, his doctor at the Hospital of the University of Pennsylvania, told him the illness could be war-related. Her belief stemmed from a 2011 report on burn pits from the National Academy of Sciences. It reviewed rare air samples taken near a burn pit and found 47 pollutants, several linked to cancer.
The concentrations were too low to be harmful, the National Academy said. And the report found no link between burn pits and long-term disease.
But the samples were enough for Nasta. Lang was too healthy and too young for such advanced lymphoma, she said. His family lacked a history of the disease. "Given how much of the disease he had, it probably started with his prolonged exposure to the burn pit," she told The Inquirer.
Lang didn't realize other vets had complained about similar problems.
"But my wife and I did some research, and all the stories were the same," he said. "A soldier or a Marine got sick. And they described the exact same thing I saw there."
Lang filed a claim with the VA. The agency denied it, stating his diagnosis came too long — more than a year — after his service.
The cancer had kept him home for months, exhausting his sick time. He said he lost five weeks' pay. He worried he could lose his job if he got sick again.
An approved claim would guarantee coverage and compensation. But more than anything, Lang said, he wanted "the simple recognition that this was about service."
Major reports on burn pits have carried the same refrain: It's too early to tell. More research is needed.
At the heart of the problem is a lack of data. The military mostly wasn't required to monitor burn-pit smoke or the health of nearby personnel.
Another complication is Iraq's toxic dust storms.
Vanderbilt University researchers examined 38 Iraq war vets with constrictive bronchiolitis, the rare lung condition. The majority had inhaled burn-pit smoke — but even more had encountered dust storms.
"We don't have the direct data to say that burn pits vs. some other kind of exposure was more likely the cause," said Robert Miller, the study's coauthor.
But, Miller added, "the most important thing is that we admit the environment was harsh, and that there are many, many people who came back with respiratory disorders — career-ending respiratory disorders."
The nation's practice of covering a veteran's postwar illnesses took hold after World War I. Vets with tuberculosis had trouble proving the Great War made them sick. So Congress passed laws directing the VA to presume it did.
That process has become increasingly science-based. After Vietnam, laws began to require studies.
Today's science is far more advanced than it was decades ago, said Ciminera, the VA's environmental health official. But he said burn-pit studies will still take time.
"More than two million deployed," he said. "Each individual may have had different exposures, genetics, and health behaviors for how the body is going to respond [to the smoke]."
That's why Rep. Elizabeth Etsy (D., Conn.) sponsored a bipartisan bill this year to speed up research. To get the backing of Congress on VA spending on coverage, she said, "it's important to have the science behind it."
For advocates like Rosie Torres, any wait is too long. Her husband, Le Roy Torres, is an Iraq war vet who suffers from constrictive bronchiolitis.
She founded the national organization Burn Pits 360° and keeps a database of more than 4,000 veterans who have filed VA claims. Most have been denied.
"They don't want to pay out," she said.
The VA says it considers burn-pit-related claims case by case. Some vets have had to fight for coverage. Others have given up.
All want answers.
Bauder, the Army reservist from Northeast Philadelphia, initially thought an anthrax vaccine caused his chronic skin condition. In the 2000s, he filed two claims. Both were denied.
He now blames burn pits. But filing again, he said, "would be a lost cause."
Deanna Stowe, 31, a University of Pennsylvania grad student who served in the Air Force at a base in Iraq, got benefits for her rheumatoid arthritis and other ailments. But her poor health forced her out of the military.
"I wanted to make the Air Force my career," she said. "And now I'm dealing with these unexplained diseases."
Aman, from Wilmington, said she had to leave her job as a police officer because of her constrictive bronchiolitis. It took two years of fighting with the VA to get medical coverage. "I kept telling them: This isn't about the money to me, but about setting a precedent," she said.
Aman got coverage after she underwent a special lung biopsy that revealed dust and metal often found in other Iraq war vets. She believes her illness stems from a combination of exposures, including burn pits and dust storms. But beyond military service, the agency declared no cause for her illness, she said.
Lang was given the same vague explanation when he successfully appealed the denial of his cancer claim after two years. He had hoped that getting coverage would smooth the way for other vets like him.
"But they're going to have to fight the same fight," he said. "And it's going to take them years."
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