III. FINDINGS

DIAGNOSIS

Finding 1: VA and DOD did not listen to sick Gulf War veterans as to possible causes of their illnesses.

The subcommittee hearing record is replete with examples of veterans who raised legitimate concerns and backed them with real information, yet had no effect on VA research, diagnosis, treatment or compensation policies.
Randy Wheeler is one such veteran. He served in the Gulf War with the U.S. Marine Corps from August 1990 to March 1991, and according to his testimony before the subcommittee, he has experienced a rash of health problems since returning from the Gulf - including joint and chest pains, shortness of breath, headaches, severe blepharitis in both eyes, rashes and diarrhea. A private ophthalmologist has diagnosed the burning redness and pain in his eyes as chronic blepharitis and a cataract. VA doctors have refused to acknowledge and search for a real, physiological cause of his ailments.

The doctor at Eisenhower (Army Medical Center in Ft. Gordon, GA) told me that my eyes were fine ... The VA and the DOD has not helped my family nor I in any way. I continue to follow up with the VA, and I have completed the CCEP but still haven't been tested for anything that might have caused my health problems or I have not been properly diagnosed.⁽²¹⁶⁾

Kimo Hollingsworth, who served in the Persian Gulf as a Marine Artillery Platoon Commander, has gone to the VA to seek a diagnosis and treatment for his chronic headache and fatigue, severe chest, muscle and joint pain, blurred vision, memory loss, fever, bladder problems and oral discharge of what he calls "hardened chunks of dark green sputum." After a physical examination at the Veterans Affairs Medical Center [VAMC] in Washington, DC failed to turn up the cause, doctors refused to acknowledge there may be a physical source of his stress that requires further inquiry and attention. Again, VA doctors did not listen.

Despite my symptoms, the VA hospital in Washington, DC ... concluded that I was in excellent health ... I was then directed to a social worker who discussed the issue of Post Traumatic Stress Disorder. The VA also provided me a brochure outlining psychological counseling services available to Persian Gulf veterans.⁽²¹⁷⁾

Still other veterans, such as Brian Martin, were told by VA Medical Center [VAMC] personnel that they were not sick, even after they had already been diagnosed with illnesses.⁽²¹⁸⁾ Mr. Martin has been rated at 100 percent compensation, yet he told the subcommittee that upon arriving at the VAMC in Battle Creek, MI with breathing problems and severe abdominal pain, his attending physician concluded,

You're not sick. You don't need to be laying around stagnant with all the really sick people.⁽²¹⁹⁾

Veterans are not the only ones who believe they were ignored. Army Staff Sergeant Steven Wood felt his health complaints were being dismissed while he was still on active duty, under DOD.

I never found anyone in the Army who was serious about helping me - or anyone else, for that matter. I was told to suck it up and drive on ... While still on active duty, I never received any real health care. I was told to quit faking, it's all in my head, and my all-time favorite: "We do not know what's wrong with you, but you will be better in 2 weeks."⁽²²⁰⁾

Sgt. Wood grew so unnerved by the military's lack of concern that he sought treatment outside the military establishment while he was stationed overseas in April 1996. According to Sgt. Wood, the German civilian doctor "did more testing in 2 hours than the Army did in 5 years," but because the doctor was not a U.S. Army physician, his diagnosis went unheeded without so much as a cursory glance. Instead, the Army neurologist responded:

`I do not like you Gulf vets that say you're sick. I was there, and I'm not sick.' This doctor then proceeded to tell me she felt I had no neurological problems before even examining me and she flatly refused to even read the German doctor's findings.⁽²²¹⁾

Other veterans, including Major Barry Kapplan, Staff Sergeant Chris Kornkven, Reserve Navy Captain Julia Dyckman, Major Michael Donnelly, Marine Major Randy Hebert, and Petty Officer Nick Roberts, have relayed similar stories of having their symptoms and concerns either ignored or dismissed as irrational and therefore insignificant.⁽²²²⁾
The Central Intelligence Agency [CIA], the most highly trained information-gathering arm of the U.S. Government, displayed a similar unwillingness to listen to veterans who suspected a physiological cause of their health problems. When asked why no one expressed any interest in information volunteered by Persian Gulf War veterans, Sylvia Copeland of the CIA's Persian Gulf War Veterans Illnesses Task Force responded that the pursuit of that information lies outside of the Task Force's job description.

We are not in the business of interviewing U.S. soldiers. That is DOD's job. Going over troop logs, interviewing soldiers is not one of our responsibilities. ⁽²²³⁾

Patrick Eddington, a former CIA analyst, paints a darker picture. He suggests the CIA went out of its way to deliberately ignore and exclude the opinions of U.S. veterans from its official investigation.

There is absolutely no question that the CIA made a concerted effort to exclude entire classes of information from its inquiry ... The CIA has had, throughout its entire existence, a specific component that is designed to do nothing but contact American citizens about their experiences overseas and their travels overseas. So for the CIA to refuse to talk to American veterans about this issue is a complete departure from standard operating procedure.⁽²²⁴⁾

Either way, Ms. Copeland acknowledged the CIA was aware of DOD's research.

DIA [the Defense Intelligence Agency] did the research, looked at all the intelligence information and we had meetings together on chemical issues and they would brief us on their findings ... Then we synthesize that with all of our intelligence information.⁽²²⁵⁾

These combined statements demonstrate a systematic failure to incorporate evidence of toxic exposures into so-called "Gulf War Illness" research, diagnosis, and treatment.
VA Under Secretary for Health Dr. Kenneth Kizer offered only circumstantial proof the Department listened to sick Gulf War veterans regarding possible causes of their illnesses. When asked if VA physicians made a predetermination that there was no scientific basis for many veterans' health complaints and consequently refused to pursue their suggestions, Dr. Kizer avoided the question --saying only that the investigation innto chemical warfare agents was:

delayed and [its] ... focus given a lower priority because of information that had been provided by DOD.⁽²²⁶⁾

The dismissal of veterans' concerns also occurred at the diagnosis stage. A followup report by the VA's Office of the Medical Inspector [OMI] supports this conclusion.
First, data from the OMI's analysis of the Persian Gulf Registry Health Examination Program show VA physicians had good reason to pursue contamination hypotheses, given the extremely high rates of veterans reporting such exposures. According to the final report:

In 1992 Physician Registry staff documented that 93 percent of the Persian Gulf War veterans reported that they had been exposed to 1 or more of the 12 contaminants. This percentage declined to a low of 87 percent in 1993, and increased to a high of 98 percent by 1996. ^{(227) (228)}

Second, there is reason to believe the percentage of veterans reporting exposures might have been even higher. The study states that while Registry physicians had been instructed by program officials to ask veterans about possible exposure to these contaminants, the list of contaminants was left off the Persian Gulf Registry Code Sheet from 1992 to 1995, making it easy, if not likely, for physicians to omit this task.⁽²²⁹⁾
Third, the implementation of the Registry protocol was sloppy and inconsistent.

Registry physicians had been instructed ... to record their findings in the Progress Notes of the CHRs [Consolidated Health Records]. The responses were to include negative as well as positive responses ... The OMI data collectors found large variations in compliance with the assigned task, that is, recording positive and negative responses to queries about possible exposure to specific contaminants in the Progress Notes. The variations in compliance existed among physicians at a single VA medical center and among different VAMCs.⁽²³⁰⁾

The inability to implement this aspect of the diagnostic protocol properly and uniformly is especially significant because it renders the resulting data virtually useless and indicates an extremely casual attitude toward the pursuit of this knowledge.
The notion that VA employees sometimes disregard or fail to implement protocols has been documented elsewhere as well. Congress commissioned the U.S. General Accounting Office [GAO] to determine the extent to which VA followed its guidelines for evaluation and treatment, with damning results. After conducting a lengthy investigation that included interviews with officials at VA headquarters, VA's Atlanta Veterans Integrated Services Network office, medical centers in Washington, Atlanta and Birmingham, referral centers in Washington and Birmingham, veterans' service organizations, and dozens of Persian Gulf veterans, and a review of a sample of medical records, GAO noted various discrepancies between VA protocols and action. Among the problems cited were: failure to give undiagnosed veterans additional baseline laboratory tests and consultations; failure to evaluate veterans suffering from undiagnosed illnesses at VA's referral centers;⁽²³¹⁾ and failure to provide personal counseling between veterans and their physicians to evaluate the registry exam process.⁽²³²⁾ The results led Stephen Backhus, Director of Veterans' Affairs and Military Health Care Issues, to conclude:

On the basis of our review of medical records and discussions with program officials, including physicians, it does not appear that VA's guidance is being consistently implemented in the field.⁽²³³⁾

Finally, a former VA health official said many physicians displayed an unwillingness to consider veteran's accounts of possible toxic exposure when prescribing treatment. Dr. William Baumz-weiger worked at the VA in west Los Angeles where he witnessed a pervasive lack of interest in accounts of potential toxicity.

With the constant denial that there was any agent in the Gulf and with the feeling that you have to have acute toxic symptoms to have problems, no one really pursued it as the leading hypothesis ... I do not think there was an agency-wide policy against there being Gulf War syndrome or an agency-wide conviction that organophosphates did not matter. I think this is something that just crept into parts of the structure of the organization.⁽²³⁴⁾

As many people have attested, warnings were sounded. The problem stems from the refusal to listen to them. Taken as a whole, the body of evidence suggests what veterans have feared all along - the existence of a systematic and chronic disregard on the part of physicians and other personnel at the VA, DOD, and the CIA for their concerns regarding the severity and possible sources of their maladies. What makes this blatant disregard even more abhorrent is the fact that it seems to have permeated the system despite its potential to worsen the already deteriorating health of U.S. veterans and their families.

Finding 2: The presence of a variety of toxic agents in the Gulf War theater strongly suggests exposures have a role in causing, triggering or amplifying subsequent service-connected illnesses.

For the past 6 years, many veterans have been saying they believe their illnesses are the result of direct exposure to toxic agents in the Gulf War theater. Over those years, investigators have amassed a mountain of evidence, primarily inferential or circumstantial, that this is, in fact, the case. The presence of chemical weapons and other toxins is no longer in question, thanks in part to a belated admission by the Pentagon. It is also supported by eyewitness accounts of veterans who heard, saw, tasted, and felt what they believe to be various incidents of toxic exposure. Finally, veterans experienced symptoms consistent with current scientific conclusions regarding the role various toxins play in causing, triggering, or accelerating chronic problems.
Veterans, scientists, and researchers have long suspected the existence of a variety of toxic agents in the Persian Gulf during the war. The suspected toxins include: chemical and biological warfare agents, organophosphates found in pesticides and insect repellents, leaded diesel fuel, depleted uranium, oil well fire smoke, leaded vehicle exhaust, contaminated drinking water, shower water, and clothing, parasites, and pyridostigmine bromide and other drugs to protect against chemical warfare agents.⁽²³⁵⁾
Dr. Theodore M. Prociv, former Deputy Assistant to the Secretary of Defense for Chemical and Biological Weapons told the U.S. Senate Committee on Banking, Housing and Urban Affairs that each of the nearly 14,000 M8A1 detector alarms deployed in the theater went off an average of two or three times a day.⁽²³⁶⁾ Given the noise the alarms must have made, most veterans had at least some reason to believe they were in a toxic environment.
For others, the clues were more numerous and specific.
Major Randy Lee Hebert of the Marine Corps believes he was exposed to chemical agents on February 24, 1991, or Ground Attack Day, based on what he heard, was told, and felt. Shortly after directing his vehicle to Lane Red One following a chemical alarm, Major Hebert, who was not wearing protective gear, was told a chemical mine had soiled the lane.

I learned after the war that the chemical mine detonated in Lane Red One was confirmed for the nerve agent Sarin and also for the agent Lewisite Must Gas by FOX vehicle in the lane. I also learned that two Marines in an AMTRAC received chemical burns, and that the chemical mine confirmation was reported by the regimental commander of the Sixth Marines.⁽²³⁷⁾

Major Hebert recalls he "felt funny" at the time. His health problems started less than 3 weeks later, and by the fall of 1994, he had experienced an array of symptoms, including throat muscle constriction, lumps, rashes, and atrophy in his right arm and hand. As noted in the Background section of report, he has since been diagnosed with amyotrophic lateral sclerosis [ALS], or Lou Gehrig's disease, which he attributes to long-term chemical
exposure.⁽²³⁸⁾
For veterans such as Sgt. Steven Wood, the awareness of a toxic presence was triggered by a visual clue.

While part of a convoy leaving Kuwait and heading back into Iraq, my driver and I stumbled across ... an artillery round that was roped off with yellow engineer tape ... Upon closer examination I saw it was a sort of greenish-blue in color, with green and yellow painted bands ... Later that same day ... I now had time to look in my manuals for the markings I had seen earlier on the shell. I was shocked to see it was a perfect match for a Soviet nerve agent.⁽²³⁹⁾

Still others have noted signs that were more overt. Many veterans sensed the approximately 700 oil well fires the Iraqis set throughout Kuwait⁽²⁴⁰⁾ had contaminated the air and water, as well as veterans' bodies. Sub-committee witnesses commented that the oil seemed to get into their lungs and skin, making them smell of, discharge, and taste kerosene at every turn.⁽²⁴¹⁾
However, the most compelling testimony comes from chemical detection experts Army Major Michael Johnson and Marine Gy/Sgt. George Grass. Johnson said his unit confirmed the presence of H-Agent Mustard using the sophisticated FOX Reconnaissance Vehicles, and that their results were supported by additional CAM tests. At the same hearing, Gy/Sgt. Grass reported registering positive readings for not one but three chemical agents: S-Mustard, HT-Mustard, and Benzine Bromide. Grass added any doubt he may have had as to the accuracy of the readings was eradicated when he noticed the international symbol for poison - the skull and crossbones - emblazoned on yellow tape, boxes of ammunition, and posted signs.⁽²⁴²⁾
Dr. Jonathan Tucker, director of the chemical and biological weapons nonproliferation project at the Monterey Institute of International Studies, concluded based on his research:

The sheer number and detail of [declassified military intelligence] reports suggests that Iraqi chemical weapons were indeed present in Kuwait before the Gulf War. The CIA, for its part, claims that Iraq ... withdrew them before the start of the air war in January 1991. Yet it is not logical that Iraq would renounce a potent weapon in the face of a major ground invasion, and then tie up its logistics moving thousands of chemical munitions out of Kuwait. No evidence in the public domain indicates that such a withdrawal took place. On the contrary, according to Charles Duelfer, Deputy Chairman of the UN Special Commission, Iraq transported more than 2,000 rockets filled with nerve gas from the production plant at Al Muthanna** in central Iraq to the bunker complex at Khamisiyah** during the second week of January 1991.⁽²⁴³⁾

Dr. Tucker's conclusion that toxic agents - and specifically chemical warfare agents - were indeed present in the Gulf War theater echoes those of French and Czech detection experts and James Tuite, director of the Gulf War Research Foundation and a former Senate staffer in charge of investigating Gulf War illnesses. However, the detection teams and Tuite take the debate even further.
According to the foreign specialists, chemical warfare agents were not just present in the Gulf, but were released into the atmosphere where Coalition forces could have been exposed to them. The New York Times reported that French and Czech detection specialists, who are considered the best in the world, have been saying since 1991:

... that nerve gas detected in the early days of the war had been released from Iraqi chemical plants bombed by United States
forces.⁽²⁴⁴⁾

Meanwhile, Tuite uses satellite images to show chemical warfare agents were not simply emitted into the air, but were emitted in the direction of Coalition troops. Tuite presented the subcommittee with pictures taken by the National Oceanic and Atmospheric Administration [NOAA] before and after the January 19, 1991 bombing. The images were recorded on AVHRR channels 1 and 2, which measure visible activity, and channel 4, which measures thermal and infrared activity, and show both the direction and nature of a thermal and visible plume. According to his analysis:

The images directly contradict several DOD and CIA positions about the direction the fallout moved and the stated position that U.S. forces were not exposed to chemical warfare agents `in any widespread way.'⁽²⁴⁵⁾

After years of denial, the Pentagon finally acknowledged there were some exposures in the wake of the war. On July 24, 1997, DOD, in conjunction with the CIA, confirmed 98,900 United States servicemen and women were "presumed exposed" to some level of chemical warfare agents as a result of the detonation and destruction of Iraqi ammunition bunkers at Khamisiyah. ⁽²⁴⁶⁾
In its Report on Intelligence Related to Gulf War Illnesses, the CIA's Office of Weapons, Technology and Proliferation confirmed:

Nerve agent was released as a result of inadvertent United States postwar demolition of chemical rockets at a bunker and probably at a pit area at the Khamisiyah Ammunition Storage Area in Iraq.⁽²⁴⁷⁾

The CIA based this conclusion on a comprehensive review of intelligence documents that suggested Khamisiyah had been used as a chemical weapons depot, as well as evidence collected by the United Nations Special Commission [UNSCOM] during a May 1996 inspection. The retrieved items included: remnants of 122-mm rockets believed to have contained a combination of Sarin and GF at Bunker 73; several hundred mostly intact 122-mm rockets containing nerve agent detected with "Chemical Agent Monitor [CAM] at a pit area about 1 km south of the main storage area; and over 6,000 intact 155-mm rounds containing mustard agent in an open area several kilometers west of Khamisiyah.⁽²⁴⁸⁾
The Pentagon had initially estimated only 400 soldiers would be affected, but it revisited that estimate after the release of computer models showing the nerve gas cloud traveled southward, covering parts of southern Iraq, Kuwait, and northern Saudi Arabia where approximately 98,900 United States troops were stationed.⁽²⁴⁹⁾ Officer Kapplan was one of those troops and remembers the change in the air:

We had the smoke coming from the left, smoke coming from the right from the oil fires and we were downwind of the chemical munitions being blown up, approximately 30 to 40 kilometers downwind of this operation.⁽²⁵⁰⁾

While the Pentagon has only officially admitted the existence of presumed exposures during the detonation at Khamisiyah, Dr. Bernard Rostker, Special Assistant for Persian Gulf War Illnesses at DOD, concedes additional incidents involving chemical agents and other toxins cannot be ruled out.

There is a whole range of potential chemical exposures, plus some cross-cutting papers that we're producing on FOX vehicles and other things that cut across. ⁽²⁵¹⁾

For instance, Dr. Tucker believes chemical agents were not released solely as a result of United States bombing of Iraqi ammunitions bunkers, but may also have been actively deployed on occasion.

The declassified operations logs corroborate numerous veteran reports of detecting low levels of chemical warfare agents during the ground war, including Sarin, lewisite and Mustard Gas. Many of these detections were made with analytical methods that are highly reliable and have a low false alarm rate. Thus, while adverse weather conditions and the speed of the coalition advance precluded the large scale use of Iraqi chemical weapons, there is strong evidence for sporadic, uncoordinated use. ⁽²⁵²⁾

As for positive confirmation for the presence of other toxins, there is no shortage of evidence:

• According to GAO, the CIA has determined Iraq possessed several biological weapons agents at the time of the war, including anthrax, botulism, and aflatoxin.⁽²⁵³⁾
• Dr. Garth Nicolson stated undiagnosed veterans have tested positive for the presence of the microorganism Mycoplasma fermentans which can cause dangerous infection.⁽²⁵⁴⁾
• Depleted uranium [DU] was heavily used by DOD as both a means of destroying enemy tanks and protecting our own.
• The Defense Science Board confirmed Iraqis set more than 700 oil well fires in Kuwait, which may cause illness through petroleum inhalation, ingestion, and skin absorption.⁽²⁵⁵⁾
• Fear of poisoning from the chemical agent soman drove the military to obtain a waiver from FDA allowing them to order immunizations using experimental drugs and vaccines⁽²⁵⁶⁾ which may become toxic when used under certain conditions.
• Finally, the insect-ridden environment in the Gulf caused veterans to become dependent on pesticides and Government-issued insect repellents of dangerous concentrations.⁽²⁵⁷⁾

By all accounts - official, scientific, and first-hand - the Gulf War theater was not just a warzone; it was a cesspool of toxic substances. While the direct scientific proof linking toxic exposures in the Gulf to the onset and exacerbation of what has collectively come to be known as "Gulf War Illness" has yet to be indisputably established, all of the pieces are there. What makes the presence of toxins in the Gulf relevant and a causal link most likely is the timing, nature, and scope of the undiagnosed illnesses that ensued are consistent with the known effects of similar exposures in other settings.
Veterans complaining of so-called "Gulf War Illness" noticed their symptoms following incidents of presumed exposure, which is consistent with a causal relationship to their experiences in the Gulf. The onset of the symptoms was immediate in some cases, and delayed in others, but they were always subsequent to their Gulf War service. Had any of the servicemen and women been ill before the war, it is highly unlikely that he or she would have been deployed to the region. In fact, Dr. Gordan, who has treated more than 500 veterans, says nearly all of them reported "very good to perfect" health before deployment, versus "poor to fair" health afterward.⁽²⁵⁸⁾
To the extent to which they are able to ascertain, scientists have confirmed that the nature of the symptoms associated with "Gulf War Illness" is also consistent with presumed exposures during the war. Put conversely, neither the VA nor DOD has found evidence that these undiagnosed symptoms were not caused by one or several of the toxins that were present in the theater. The only argument against a causal link is the fact that while many veterans are sick with undiagnosed illnesses, most are not. However, as Dr. Kenneth Olden, director of the National Institute of Environmental Health Sciences, explained:

We've known for a long time that when several hundred people are exposed to the same environmental toxicants, some people get sick and others don't. ⁽²⁵⁹⁾

Olden and other Federal researchers are now pursuing research that would suggest the answer lies in the genes that control human susceptibility to toxic chemicals and other poisons.
Finally, the scope of so-called "Gulf War Illness" is also consistent with a causal relationship. Some veterans have seen members of their immediate and extended families become ill, either upon coming into contact with them or articles they sent back from the Gulf War theater. As previously noted in the Background section, Major Barry Kapplan's wife Nancy told the subcommittee she and her four children handled her husband's wet and stained clothing, army gear and war souvenirs, only to experience continual chronic infections, with one child becoming very ill.⁽²⁶⁰⁾
According to Dr. Claudia Miller, Assistant Professor of Environmental and Occupational Medicine at the University of Texas Health Science Center, the experience of the Kapplan family is consistent with those of many agricultural workers who come into contact with clothing that has been saturated with organophosphates - the same kind of compounds which were present in many pesticides and insect repellents used in the Gulf. So far, the clothing and equipment have tested negative for organophosphates, but as Dr. Miller notes:

They may degrade after a period of time and it has been 5 years since the war, so I think there are so many uncertainties.⁽²⁶¹⁾

A second example may be seen in the unusually high number of cases of ALS among Gulf War veterans. While DOD's Dr. Rostker says the nine confirmed cases of ALS are what scientists would expect to find given the population of Gulf War veterans,⁽²⁶²⁾ Dr. Robert Brown notes that analysis does not take account the relatively young age of veterans. Given the fact that the average age for ALS onset is 55, Dr. Brown says the number of ALS cases among Gulf War veterans, who are typically between 18 and 40 years old, would appear "excessive."⁽²⁶³⁾
A new study by Dr. Will Longstreth at the University of Washington School of Medicine in Seattle once again suggests a causal link between ALS and the presence of toxic agents. According to the study, exposure to agricultural chemicals - including pesticides - may increase men's chances of developing the degenerative disease. Researchers say men whose histories showed high exposures to these chemicals are at 2.8 times more risk than those who were never exposed.⁽²⁶⁴⁾
The existence of a variety of toxic agents in the Gulf is well-established, and confirmed by a host of witnesses, documents, and facts. While the research has yet to cement the link between toxic exposures and delayed, chronic illnesses, the timing, nature, and frequency of undiagnosed illnesses among Gulf War veterans strongly suggest such a link does exist and will, given the appropriate interest, funding and support, be confirmed.

Finding 3: Gulf War troops were not trained to protect themselves from the effects of exposure to depleted uranium dust and particles.

Depleted uranium [DU] maintained a pervasive presence in the Gulf War theater. In the form of armor-piercing penetrator rounds, DU, upon reaching enemy targets, ignites and becomes a toxic agent that could poison anyone who came into contact with it, including U.S. troops. The threat might have been minimized had Gulf War servicemen and women been trained to protect themselves against such exposure, but as numerous veterans, Defense and GAO employees have attested, the military establishment did not prepare troops for the dangers they would encounter or the risks they would incur.
DU penetrator rounds are credited with destroying more than 1,400 Iraqi tanks, in addition to other equipment and weapons storage facilities during the Persian Gulf War.⁽²⁶⁵⁾
Veteran Michael Stacy's eyewitness testimony confirms the military depended on DU as a preferred weapon of war, and used it to destroy everything from tanks to light-armored vehicles to bunkers.

We wanted to shoot the good stuff and as much as possible. We were at war, with the best equipment out of all the Coalition Forces - no law, no rules, engage at will ... As you can well expect, we were constantly in contact with this ammo.⁽²⁶⁶⁾

When a DU round hits a hard target such as a tank, most of it burns up, spraying uranium shrapnel and pulverized uranium dust into the air, where it may be transported up to 25 miles by high winds.⁽²⁶⁷⁾
According to Leonard Dietz, a retired General Electric physicist and DU expert, at least 300 tons of DU munitions were fired over a period of 4 days of ground fighting. He says that if only 2 percent of the uranium became aerosolized upon impacting the tanks, it would generate at least 6 tons of depleted uranium aerosol particles.

This is a huge amount, much of which would have become airborne over the battlefields. This amount in 4 days is more than 10,000 times greater than the maximum airborne emissions of depleted uranium allowed in the air over Albany in 1 month.⁽²⁶⁸⁾

Another large emission of DU resulted when a United States Army ammunition depot and motor pool exploded in Doha, Kuwait in July 1991, oxidizing some 9,000 pounds of DU rounds and vehicle armor to powder.⁽²⁶⁹⁾
When oxidized particles are ingested or absorbed through the skin via contact with burned out tankers or the uniforms of wounded soldiers, DU can present a serious health hazard. To explain its high toxicity, Dietz referred the subcommittee to the Handbook of Chemistry and Physics:

Chronic exposure to small concentrations of uranium is known to cause kidney failure. Depleted uranium is more than 99 percent Uranium-238, just a single isotope, which is always accompanied by two decay daughters that emit penetrating particles and gamma rays. ⁽²⁷⁰⁾

Mounting scientific and circumstantial evidence suggests veterans were not just surrounded by DU, but were in fact exposed to it. This has long been the contention of veterans such as Michael Stacy, who found himself in "more than one friendly fire incident" involving tanks with DU armor.⁽²⁷¹⁾ On June 26, 1997 Bernard Rostker of DOD confirmed 29 combat vehicles were contaminated in this manner, with possible additional exposures resulting from the Doha ammunition dump explosion.⁽²⁷²⁾ Out of the 33 veterans who were in Army vehicles struck by DU rounds and are now being evaluated, 16 have DU shrapnel in their bodies.

The Health Surveillance Program has shown that those who have retained shrapnel identified radioactively are excreting increased amounts of uranium, indicating that the metal particles are not entirely inert.⁽²⁷³⁾

Unaware of the toxic dangers they faced from DU exposure, U.S. troops did not know that they needed to take special precautions to protect themselves, nor what those precautions might entail.⁽²⁷⁴⁾ As a result, many veterans such as Paul Canterbury did not bother putting on MOPP gear when they were in and around burned-out tanks and other contaminated areas,⁽²⁷⁵⁾ while some even slept on the tanks' blowout panels, exposing themselves to DU toxins over extended periods of time.⁽²⁷⁶⁾
After the ammunition fire in Doha where approximately 3,500 troops were based, some servicemen reported cleaning up the site using nothing but brooms and their bare hands. According to Dietz:

This is something that would make a qualified, radiological worker shudder.⁽²⁷⁷⁾

Considering all the information Pentagon had available at the time, there is no reason U.S. servicemen should have been allowed to engage in such high-risk behavior. Veteran Michael Stacy says the Army had documented the hazards more than a year before the war.

In a report from the U.S. Army Ballistics Research Lab, dated December 1989, test results showed that soldiers who came into contact with contaminated vehicles could inhale resuspended, depleted uranium dust or ingest depleted uranium via food intake, cigarette smoking, et cetera prior to not washing hands and face.⁽²⁷⁸⁾

In a July 1997 conversation with subcommittee staff, Rostker stated DOD had not properly prepared Gulf troops for the DU dangers they would encounter - the same conclusion GAO reached in 1993.⁽²⁷⁹⁾ Rostker said the Pentagon was working on producing newer, universal masks as well as taking other steps to prevent future troops from facing a similar fate.⁽²⁸⁰⁾
As noted in the "Background" section of this report, Dr. Michio Kaku believes history will show Gulf War illnesses to be the result of a variety of factors, but DU will bear "a large portion of the blame."⁽²⁸¹⁾ The post-war experiences of veterans who were among the most at-risk of DU exposure suggest the same conclusion. Canterbury has been diagnosed with hypertropia, large vertical muscle imbalance, and esophoria, while Stacy suffers from multiple undiagnosed illnesses including respiratory problems, sinus problems, and severe memory loss.⁽²⁸²⁾

Finding 4: Pyridostigmine bromide [PB] can have serious side effects and interactions when taken in combination with other drugs, vaccines, chemical exposures, heat and/or physical exercise.

[NOTES]

216. Testimony of Randy Wheeler, Human Resources and Intergovernmental Relations Subcommittee hearings, Nos. 1-4, pp. 18-19.
217. Testimony of Kimo Hollingsworth, Human Resources and Intergovernmental Relations Subcommittee hearings, Nos. 1-4, pp. 28-29.
218. Statement of Brian Martin, Human Resources and Intergovernmental Relations Subcommittee hearings, Nos. 1-4, p. 11.
219. Ibid.
220. Testimony of Steven Wood, Human Resources Subcommittee hearings, No. 2, pp. 45-46.
221. Ibid.
222. See supra notes 12-31, 36-39.
223. Testimony of Sylvia Copeland, Human Resources and Intergovernmental Relations Subcommittee hearings, Nos. 1-4, p. 416.
224. Testimony of Patrick Eddington, Human Resources and Intergovernmental Relations Subcommittee hearings, Nos. 5-6, p. 147.
225. Testimony of Sylvia Copeland, Human Resources and Intergovernmental Relations Subcommittee hearings, Nos. 1-4, pp. 423-424.
226. Testimony of Kenneth Kizer, Human Resources Subcommittee hearings, No. 1, p. 174.
227. Final Report: Persian Gulf Registry Health Examination Program: Assessment of Exposure History, Office of the Medical Inspector, Veterans Health Administration, VA (May 5, 1997) p. 5.
228. A veteran was counted only once regardless of the number of contaminants to which he or she had been exposed.
229. See supra note 227, p. 7.
230. Ibid.
231. Only 390 out of 15,000 referrals were evaluated.
232. Statement of Stephen Backhus before the VA Subcommittee on Health, 105th Cong., 1st sess., GAO/T-HEHS-97-158, p. 4-5 (1997).
233. Ibid.
234. Testimony of William Baumzweiger, Human Resources and Intergovernmental Relations Subcommittee hearings, Nos. 1-4, pp. 530, 536.
235. See supra note 73.
236. See supra note 2, p. 16.
237. Testimony of Randy Hebert, Human Resources and Intergovernmental Relations Subcommittee hearings, Nos. 5-6, p. 107.
238. Ibid.
239. Testimony of Steven Wood, Human Resources Subcommittee hearings, No. 2, p. 45.
240. See supra note 111.
241. See supra notes 115-121.
242. Testimony of George Grass, Human Resources and Intergovernmental Relations Subcommittee hearings, Nos. 5-6, pp. 2-4, 6-9.
243. Testimony of Jonathan Tucker, Human Resources Subcommittee hearings, No. 2, p. 262.
244. See supra note 49.
245. Report on the Fallout From the Destruction of Iraqi Chemical Warfare Agent Research, Production, and Storage Facilities into Areas Occupied by U.S. Military Personnel During the 1991 Persian Gulf War, James J. Tuite III, Gulf War Research Foundation (September 19, 1996) Human Resources and Intergovernmental Relations Subcommittee hearings, Nos. 5-6, p. 63.
246. Modeling the Chemical Weapons Agent Release, U.S. Central Intelligence Agency [CIA], Persian Gulf War Illness Taskforce (July 24, 1997).
247. Report on Intelligence Related to Gulf War Illnesses, CIA, Human Resources and Intergovernmental Relations Subcommittee hearings, Nos. 1-4, p. 390.
248. Ibid., p. 391.
249. See supra note 45.
250. Testimony of Barry Kapplan, Human Resources and Intergovernmental Relations Subcommittee hearings, Nos. 1-4, p. 327.
251. Testimony of Bernard Rostker, Human Resources Subcommittee hearings, No. 2, p. 252.
252. See supra note 244.
253. See supra note 88.
254. Testimony of Garth Nicolson, Human Resources Subcommittee hearing of June 26, 1997 (original transcript, p. 149, in subcommittee files).
255. See supra note 111.
256. See supra note 130 and accompanying Background text.
257. Testimony of Robert Haley, Human Resources Subcommittee hearings, No. 1, pp. 238-239.
258. See supra note 160.
259. See supra note 170.
260. Testimony of Nancy Kapplan, Human Resources and Intergovernmental Relations Subcommittee hearings, Nos. 1-4, pp. 335-337, 343.
261. Testimony of Claudia Miller, Human Resources and Intergovernmental Relations Subcommittee hearings, Nos. 1-4, p. 532.
262. See supra note 33.
263. See supra note 34.
264. Reuters, "Gehrig's Disease Tied to Chemicals" (June 24, 1997).
265. See supra note 97.
266. Testimony of Michael Stacy, Human Resources Subcommittee hearing of June 26, 1997, original transcript, p. 53-54 (in subcommittee files).
267. See supra note 106.
268. Testimony of Leonard Dietz, Human Resources Subcommittee hearing of June 26, 1997, original transcript, p. 125 (in subcommittee files).
269. See supra note 99.
270. See supra note 268, pp. 125-126.
271. See supra 266, p. 46.
272. Testimony of Bernard Rostker, Human Resources Subcommittee hearing of June 26, 1997, original transcript, p. 184-185, (in subcommittee files).
273. Ibid., p. 85.
274. See supra note 266, p. 46.
275. Testimony of Paul Canterbury, Human Resources Subcommittee hearing of June 26, 1997, original transcript, p. 29 (in subcommittee files).
276. See supra note 266, p. 46.
277. See supra note 268, p. 128.
278. See supra note 266, pp. 45-46.
279. See supra note 110.
280. Bernard Rostker also told the subcommittee that DU has been the target of an Iranian-run disinformation campaign because of its high effectiveness. He says United States intelligence agencies have intercepted diplomatic traffic in and from Iraq. Iraqi embassies were reportedly told to downplay the health hazards associated with low-level chemical exposure and play up the notion of DU as the more severe toxin. See supra note 272, pp. 189, 226.
281. See supra note 108.
282. See supra note 266, p. 47.