NOTE: * UNEDITED *
PRESIDENTIAL ADVISORY COMMITTEE ON
GULF WAR VETERANS' ILLNESSES
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PERSIAN GULF INVESTIGATION TEAM AND RISK FACTORS
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AUGUST 6, 1996
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The meeting convened at Adam's Mark Hotel,
1550 Court Place, at 8:30 a.m., Andrea Kidd Taylor,
COMMITTEE MEMBERS PRESENT:
Dr. Andrea Kidd Taylor, Chair
PUBLIC COMMENTERS PAGE
Scott Russell 5
Mike Norberg 17
Michael Lanning 35
Jim Van Houten 40
Michelle Juarez 49
Susan Meyer 54
Edmee Hills 63
Kevin Jenson 65
David Oliver 73
Frederick Hosterman III 79
Gilbert Roman 87
Jim Adams 95
James Jones 103
Dick Walker 206
Jack Merlin Modig 213
Jose Martinez 318
Persian Gulf Investigation
Team (Department of Defense)
Col. Edward J. Koenigsberg 108
Lt. Edward T. Moldenhauer 116
Dr. George Voelz 217
Dr Stephen P. Shelton 235
Dr. David Hickman 248
Oil Well Fire Smoke and Particles
Dr. Jack Heller 274
Dr. Joe Mauderly 289
2 (8:30 a.m.)
3 DR. TAYLOR: Good morning. This meeting
4 is officially called to order. I am Dr. Andrea Kidd
5 Taylor. I am an industrial hygienist and occupational
6 health policy analyst at the United Auto Workers'
7 Health and Safety Department in Detroit, Michigan.
8 I would like for the other committee
9 members and the others sitting at the head table to
10 introduce themselves, starting to my right. Holly?
11 MS. GWIN: I am Holly Gwin on the
12 committee staff.
13 MAJOR KNOX: I am Marguerite Knox. I am a
14 member of the committee and I am a Gulf War veteran.
15 I am nurse practitioner and I was stationed at King
16 Khalid Military City during the Gulf War.
17 MR. MCDANIELS: I am Tom McDaniels, on
18 committee staff.
19 MR. BROWN: I am Mark Brown. I am a
20 chemist and toxicologist and I am on the committee
22 MAJOR CROSS: Tom Cross, major in Marine
1 Corps Reserve and I was a Gulf War veteran with the
2 Second Marine Division.
3 DR. TAYLOR: We will start off with our
4 public comment. Scott Russell.
5 MR. RUSSELL: Good morning, ladies and
6 gentlemen. Thank you for the --
7 DR. TAYLOR: Excuse me. Can you use the
8 mike here?
9 MR. RUSSELL: The podium?
10 DR. TAYLOR: Yes, thank you.
11 MR. RUSSELL: All right. Once again, good
12 morning, ladies and gentlemen. Thank you for the
13 opportunity to speak. I was with the First Battalion,
14 6th Marine -- 2nd Marine Division. I was with
15 [unintelligible] platoon. I was a sniper in the Gulf.
16 I went to the Gulf and I was there August 6 and I
17 didn't leave until the next year, April 18.
18 I just want to touch on a few things that
19 concern me today. And number one and foremost is less
20 than -- it was late May. I woke up with a sore throat
21 and I have already been diagnosed with PTSD and Gulf
22 War Illness. Woke up with a sore throat.
1 Went to the VA. They gave me an IV, x-
2 rayed my chest. They didn't think it was any big
3 deal. Sent me on my way. Less than two hours later,
4 I was found by my grandmother and I was in a coma. I
5 spent four days in a coma the first time. Came out of
6 it, then I went in for another 46 days -- in a coma.
7 I was very combative during this. Really
8 don't remember a bunch. They had told my family I had
9 about a 10 percent chance to live. What made this so
10 unusual is that they ran over 40 -- excuse me, over
11 400 tests for things ranging from sexually transmitted
12 diseases to the bubonic plague, etc., etc.
13 They even sent fluid samples, blood,
14 urine, and stool to CDC Atlanta and they couldn't find
15 anything. Just one day, by happenchance, I just woke
16 up out of that, after the 50 days. Had to learn to
17 re-walk after that deal. Still going through physical
18 therapy and they still couldn't find the thing that
19 caused it.
20 The doctors at Swedish Medical Center here
21 in Denver had never seen anything like this. My whole
22 lungs had shut down. They had to do a tracheotomy on
1 me. They had me on the respirator. They did a heart
2 catheter on me. They did a spinal tap on me. They
3 never could find anything wrong and they had never
4 seen anything like it.
5 Now, when I was in the Gulf, I was exposed
6 to the inoculations, I am sure that you probably know
7 more about. Oil-well fires are what really concerns
8 me and the insects. The deal with the oil-well fires
9 is -- it is in my service record book on page 11, "We
10 are in the middle of 500 oil-well fires." And the
11 only thing that they gave us was a white t-shirt and
12 put it over your face. And that is what we were
14 Now, the thing that I want to bring up
15 about that is, when they brought in the civilian
16 contractors to put out these oil-well fires, they had
17 self-contained breathing apparatus. They had full
18 chemical suits. They had everything.
19 And if they knew there was something to be
20 concerned about, you would have thought that the
21 military would have either moved us out of that
22 position, because this was after the cease-fire
1 started. The military should have moved us out of
2 that position or given us the proper gear for those
4 With the shots, we took several series of
5 shots, several pills. The one that concerned me about
6 the shot was the anthrax vaccine that they gave us
7 because once they gave us that, everybody got sick:
8 nausea, headache, vomiting, general soreness.
9 And we did not know that some of these
10 shots were never tested before, that they were just
11 given to us. That is something that I read in the
12 press. Now, with the VA system, I generally for
13 myself have found that the doctors are caring. They
14 want to know what is going on but there is no way of
15 disseminating information to these people.
16 I see the doctors a lot and they will flat
17 out tell you, I know almost next to nothing about this
18 Gulf War Illness. All I know is what I have maybe
19 read in a magazine or something like that or seen on
20 the news.
21 So there should be some way that they
22 could disseminate this information to the doctors and
1 nurses, nurse practitioners, whatever you have. Or if
2 there is a way, they are not using it. I don't know
3 if there is something like that set up.
4 I believe that the service connection for
5 the Gulf War vets, first off, it needs to be sped up
6 greatly. Second off, I would like to see it -- like,
7 my Gulf War case went all the way to, I believe it was
8 Arizona. And it was a totally hands-off thing
9 because, you know, we can't drop everything and go to
10 Arizona and take care of it.
11 I think that all these Gulf veterans will
12 agree with me that we served our country proudly. We
13 served our country bravely and we deserve some rights.
14 We deserve some answers. We need to get the
15 information to the right people. All I am asking for
16 is to have the same opportunities -- have the same
17 rights given to me that someone who didn't serve in
18 the Gulf would get.
19 I have joint pain every morning. I have
20 back pain since -- and I have shakiness, memory loss,
21 all that good kind of stuff. And I think that we owe
22 it to our Gulf War vets to get some employment help
1 for the ones who can work.
2 It is a simple matter of economics I have
3 seen, is that people don't want to hire Gulf War
4 vets -- companies don't. They don't flat out tell you
5 that. They have seen the news. They have heard the
6 news. They know these people are sick and they don't
7 want to go ahead and get these people for insurance
8 reasons, sick leave time, etc.
9 And I think something needs to be done
10 with the employment situation. And just some basic
11 answers other than, Well, we are working on it, It
12 could be the shots, oil-well fires, insects, gas. I
13 will say we had chemical detection kits and chemical
14 detection alarms over there. And I served in combat
15 in Panama and ran 58 missions in the Gulf -- sniping
16 missions -- and I went to a desert warfare school --
17 jungle warfare school, all that, in Fort Sherman,
18 Panama, and Twenty-nine Palms, California, and
19 never -- not once -- did a chemical detection alarm
20 give a false reading -- just go off.
21 Yet when we were in the Gulf, they were
22 going off. And we knew that they were -- we were
1 donning full MOC gear, full MOC protection, M-O-C.
2 Yet when we got back home, we were told, Oh, the
3 alarms were faulty.
4 And not once have I ever seen an alarm go
5 off for no reason. They were kits that work and they
6 are kits that do work and we had us some hand chemical
7 detection kits that were testing positive for a nerve
8 agent. And all it will tell you, if it is a nerve --
9 just tell you what kind of agent it is. It won't
10 identify the agent.
11 With all the destruction going on over
12 there and will Saddam's past background -- he would
13 have used gas. I think he did use gas. And I think
14 probably we blew up some gas stockpiles.
15 DR. TAYLOR: Mr. Smith, we are running out
16 of time. So I would like to leave a little time for
18 MR. RUSSELL: Yes. I am finished.
19 DR. TAYLOR: Are there any questions from
20 the committee members?
21 MR. RIOS: Yes. Let me ask you, Mr.
22 Russell, what is the status of your claim -- VA claim?
1 MR. RUSSELL: I finally ended up with 20
2 percent for the Gulf War Illness and -- but I got 100
3 for PTSD. So my claim has been solved and it was
4 done -- I believe it took about 18 months after I
5 filed. It took about 18 months for them to go ahead.
6 But I only got 20 for the Gulf War Illness.
7 DR. TAYLOR: Any other questions?
8 MAJOR CROSS: Prior to becoming ill, had
9 you signed up on the Persian Gulf Registry?
10 MR. RUSSELL: I was on the registry and I
11 do get their little newsletters.
12 MAJOR CROSS: As I kind of hear -- what
13 you are saying is your treatment through the VA
14 system, it sounded a little bit slow but it may have
15 been adequate. You will probably hear later on of
16 more horror stories because yours doesn't really
17 sound --
18 MR. RUSSELL: Yes.
19 MAJOR CROSS: Is that a true assessment?
20 MR. RUSSELL: I think I have been real
21 lucky with the doctors at the VA that I have. I am
22 sure -- because I have heard the other stories and I
1 am sure we are going to hear other stories. I have
2 been real lucky with the doctors and the nurses that
3 I have had contact with.
4 They want to help. They know something is
5 wrong. But they are just not getting the proper
6 information, I don't believe. And I don't know if
7 there is something set up for them to be getting the
8 information about this and they are not using it or
9 exactly how that is panning out.
10 DR. TAYLOR: Yes.
11 MR. BROWN: Mr. Russell, you mentioned
12 that you are specifically concerned about the oil-well
13 smoke -- the oil fire smoke.
14 MR. RUSSELL: Yes, sir.
15 MR. BROWN: Can you tell us what happened?
16 Did you get sick while in the Gulf from exposure? Did
17 you have a reaction to the smoke when you were in the
19 MR. RUSSELL: I didn't personally get ill
20 at that time but members of my sniper team did. And
21 it was unlike anything I have seen before. It was --
22 when they started popping oil wells, blowing the oil
1 wells and I went through all of Kuwait and I ended up
2 in southern Iraq. And when they blew it, it went
3 from -- they blew it about noon and it was -- totally
4 brightened the desert and everything but when they
5 blew the oil-well fires, it was unlike anything I ever
6 seen in my life. It was like being in a locked closet
7 in the dark.
8 But I didn't physically get ill but
9 members of my team did. And I think that they knew
10 there was something to that because they put on page
11 11 of the service record book that, "Unknown health
12 risks are not known at this time." So I think that
13 they probably had a good idea there was going to be
14 repercussions from that.
15 MR. BROWN: Thank you.
16 MAJOR KNOX: Let me just ask you something
17 about the alarms. You mentioned that there were
18 alarms that went off. Are you MBC trained? Do you
19 get that in --
20 MR. RUSSELL: Yes. I went through MBC
21 training at MBC school at Quantico, Virginia. And
22 then I went through it again -- went through it twice.
1 The second time I went through it, I went through at
2 Camp Lejeune, North Carolina.
3 MAJOR KNOX: And so did you have a
4 specific Marine that tested for chemicals at the time
5 and have you spoken with him?
6 MR. RUSSELL: It was me.
7 MAJOR KNOX: It was you?
8 MR. RUSSELL: It was me. Yes. I was
9 with -- attached to the 1st Battalion, 6th Marines.
10 I was a sniper. I had chemical detection kits and the
11 battalion as a whole had an alarm that would sound.
12 MAJOR KNOX: So you were the MBC officer
13 for your battalion?
14 MR. RUSSELL: I was one of them. We had
15 one officer that actually did it and we had two people
16 in each platoon that were capable of doing it also.
17 MAJOR KNOX: And on your kit, you tested
18 for nerve agent?
19 MR. RUSSELL: Tested positive for nerve
21 MAJOR KNOX: And do you -- was that more
22 than once or do you recall any specific dates for
2 MR. RUSSELL: Well, since the chemical
3 detection kits were at a premium, as you can know,
4 every time a regular alarm would go off, we wouldn't
5 pop the chemical detection kit. We would just don
6 full MOC gear and go that route and wait it out until
7 the alarm stopped.
8 Then we took artillery a couple of times
9 and I don't think that we were ever shelled with
10 chemical -- direct chemicals. We may have been. Some
11 people claim that -- in the battalion that I talked to
12 later, claimed that the duds were emitting a hissing
13 sound but I personally didn't witness it. But I had
14 it on good faith that it probably occurred that way.
15 MAJOR KNOX: Let me just ask you one more
16 thing about your health. You said you were in a coma
17 for four days and then you mentioned 50 days.
18 MR. RUSSELL: Right -- 46 days. It was a
19 total of --
20 MAJOR KNOX: But you were hospitalized for
21 a total of 50 days?
22 MR. RUSSELL: Oh, more than that. Yes.
1 I think I was -- it must have been about 70 days I was
2 hospitalized. I did most of it ICU at Swedish Medical
3 Center, just because that was the quickest -- closest.
4 And then when they finally stabilized me, I did, like,
5 the last 15 or 20 at the VA.
6 DR. TAYLOR: How soon was this after your
7 service in the Gulf that you were hospitalized?
8 MR. RUSSELL: For the coma?
9 DR. TAYLOR: Yes.
10 MR. RUSSELL: The coma just happened.
11 Just happened this year.
12 DR. TAYLOR: Any other questions? Thank
14 MR. RUSSELL: Thank you for the
15 opportunity to speak.
16 DR. TAYLOR: Mike Norberg?
17 MR. NORBERG: I don't have really anything
18 to say other than, I have not, I mean, had anyone be
19 able to answer any of my questions. A little history
20 on me: I spent eight years in the Navy. My -- before
21 I reported to the Persian Gulf, I was healthy and
22 strong enough to attend Navy SEAL training for a year.
1 Shortly after I left there for a hernia,
2 I deployed to the Persian Gulf and I, you know, I
3 ended up coming back from that, like, August of '91.
4 Not long after that is when I started getting these
5 symptoms: dizziness, headaches, diarrhea, fatigue.
6 At that time, you know, I went in and
7 initially saw the doctor. And then shortly after
8 that, I transferred here to the Naval Space Command
9 out at Buckley. I was trained to do the job at
10 Buckley and almost immediately upon finishing
11 training, I was enrolled in the Persian Gulf work-up
12 at Fitzsimmons and promptly removed from active status
13 working at Buckley so I could not do my job.
14 I -- that physical lasted, like, six
15 months at Fitzsimmons. No one, at any time, could
16 tell me anything other than, You are normal.
17 Shortly after that, I got out. Filed a
18 claim with the VA. I have since taken two physicals
19 at the VA hospital, which you are supposed to get the
20 results of. I have called several times and they have
21 never had a record of me taking any physicals over at
22 the VA hospital.
1 Same as him, my claim was sent to Phoenix,
2 Arizona but the only way I can contact them is through
3 the VA building here. When I call this VA building,
4 I have never had any question answered other than, I
5 don't know.
6 Whenever I have a question, they go, Well,
7 you are going to have to write to Phoenix. If you
8 don't get a response in 60 days, call us and then we
9 will call and get your response.
10 You know, and I would ask the question,
11 Well, why can't you just do that now?
12 Well, that is not the way things work.
14 And I mean, even still today, we just
15 called last week. My claim was still pending and we
16 were told that the reason why they had sat on it for
17 this long is they didn't have any standards as far as
18 how to grade the disability.
19 So as if, according to them, like last
20 Thursday is when they were going to start actually
21 processing the claims. I mean, I think that is kind
22 of ridiculous, you know? As far as now, you know, the
1 only other explanation I have gotten from anyone is
2 that my symptoms are normal.
3 And I don't think being 27 years old, I
4 should have to take 18 Immodium AD every morning for
5 diarrhea before I go to work. I shouldn't have to
6 carry a bottle of Tylenol with me. I shouldn't have
7 to spend two, three days at a time awake from muscle
8 cramps that I can't sit still for more than two or
9 three minutes at a time.
10 That is not normal. I mean, I don't know
11 where the doctors went to school, but it is not
12 normal. But that is the only answer I have ever been
13 given, I mean, throughout this whole ordeal. And that
14 is pretty much it. I mean, that is all we have got.
15 DR. TAYLOR: Any questions? Can you
16 answer some questions?
17 MR. NORBERG: Okay.
18 MS. GWIN: I would like to -- Mr. Greg
19 Leonard from the Department of Veterans' Affairs is
20 here today if you would like to talk to him about any
21 claim questions that you have -- or anybody else here.
22 MR. NORBERG: You know and as far as how
1 it affects me now, I mean, there is not -- you can't
2 be very spontaneous with those symptoms. I can hardly
3 take my wife to dinner without having to worry about,
4 where is the nearest bathroom? I got to sit near, you
5 know, a bathroom so if mid-way through the dinner, if
6 I have to run to the bathroom to throw up, I mean, I
7 can do that, you know.
8 And there has been numerous times when we,
9 you know, we even had to leave halfway through dinner
10 because I started feeling sick, you know. So I would
11 have to either go outside or to the bathroom and I
12 mean, that kind of ruins it. There is no such thing
13 as that anymore.
14 DR. TAYLOR: What was the length of your
15 service in the Gulf and where were you located?
16 MR. NORBERG: I was aboard the USS Nimitz
17 from roughly March of '91 through August of '91 so it
18 was at the tail-end. And the main function I did
19 there was working for the admiral's staff and I did
20 some time in the helicopters, running some programs
21 with that.
22 DR. TAYLOR: Were there particular
1 exposures that you noted while you were there or
2 anything other --
3 MR. NORBERG: Nothing other than, I mean,
4 really smoke, you know. Once, you know, once in the
5 helo, it wasn't very apparent, you know, on the water
6 in the Gulf but once you got in the helo and were up
7 at 5,000 feet, you know, I mean, you could definitely
8 tell you were in a, you know, a thick cloud of smoke
9 but other than that, no.
10 I mean, I spent a total of probably three
11 weeks in Dubai, Saudi Arabia but so did the whole
13 DR. TAYLOR: Any other questions?
14 MAJOR KNOX: Sir, did you receive vaccines
15 before you went? Do you know what vaccines you took?
16 MR. NORBERG: No, I don't. It was one of
17 those last-minute things where I had to run over, you
18 know, to the, you know, medical facility because it
19 was one of those things that, like, Okay, you are
20 going. You are leaving in a week.
21 So I had to take care of everything in,
22 like, that week's time as well as vaccines.
1 MAJOR KNOX: How about the pyridostigmine
2 bromide tablets? Did you take that?
3 MR. NORBERG: Not to my knowledge. No.
4 I did not, that I can remember.
5 MAJOR KNOX: And were you discharged
6 medically from active duty?
7 MR. NORBERG: No. I was not.
8 MAJOR KNOX: So you chose to get out on
9 your own?
10 MR. NORBERG: Right.
11 MAJOR KNOX: And what VA have you been
12 seen at?
13 MR. NORBERG: The one out on Union
14 Boulevard is where I actually filed the claim and then
15 the two separate physicals were at the VA hospitals
16 over off of -- Colorado and -- Kalamath Avenue.
17 MR. BROWN: Mr. Norberg, it sounds like
18 you have had at least a couple of physicals from at
19 least the VA hospitals. Have you had any other
20 physicals? Have you seen any other doctors and have
21 you had any satisfactory diagnoses or any diagnosis at
22 all or --
1 MR. NORBERG: Not at all.
2 MR. BROWN: They just say -- doctors that
3 see you just say, Oh, you --
4 MR. NORBERG: Everything is normal. I
5 had -- like I said, before I got out, I had a really
6 extensive physical at Fitzsimmons and I mean, you
7 know, I must say that, I mean, I have taken dive
8 physicals, jump physicals, flight physicals and I
9 mean, that was by far and away the most extensive
10 physical I have ever taken.
11 But as far as any doctor sitting me and
12 down and, you know, This is why you have bad
13 headaches, or, This is why you have to take 18
14 Immodium every day before you go to work, I mean, no
15 one has said anything.
16 MR. BROWN: They don't give you diagnoses
17 like irritable bowel syndrome or something like that?
18 MR. NORBERG: Not at all. So since, like
19 I said, the two physicals at the VA and we are now,
20 you know, currently seeing our doctors through, you
21 know, our own health care, you know. But they are
22 pretty much the same thing.
1 I mean, no one really knows that much
2 about it. I mean, there is not a whole lot of medical
3 research, to my knowledge, anyway.
4 MR. BROWN: Thank you.
5 DR. TAYLOR: Any other questions? Thank
6 you. Is Cara Whitford -- Cara Whitford? She is not
7 here. Lieutenant Colonel Kelly?
8 LT. COL. KELLY: Good morning, Doctor.
9 DR. TAYLOR: Good morning.
10 LT. COL. KELLY: I appreciate the
11 opportunity. I was kind of a stand-in, I guess, for
12 others that couldn't make it today.
13 I would like to start out by saying that
14 I am West Point graduate, Class of '73. I studied
15 chemistry so I probably know a little bit about
16 chemical reactions -- maybe not to the same degree as
17 the folks of the panel.
18 When I entered in '69, I had a clean bill
19 of health. I did have appendicitis, cardiac cath,
20 orthoscopic surgery, reconstruction. This was all
21 prior to Desert Storm. But during Operation Just
22 Cause, and I was on the first aircraft to see Desert
1 Storm, served about 30 weeks. So I started about the
2 4th of August until about the 15th of April. And I
3 have even been to -- last year, I was in Croatia.
4 I am an engineer and I specialize in
5 contingency engineering. And I was a -- the assistant
6 corps engineer for General Luft in the 18th Airborne
7 Corps so a lot of the problems that have been
8 discussed, i.e. how do you cross a -- flame trenches,
9 essentially, I had to start thinking on how we were
10 going to do that early on in the war.
11 I did register for this exercise, I would
12 say, early '94. I did not know after I registered
13 that there was going to be a follow-up in terms of a
14 Phase 1. In between the time that I signed up and I
15 had, let's say, the beginning of the Phase 1, I was
16 given a diagnosis of melanoma and consequently, I had
17 a 12-hour operation about a year and a half ago.
18 On the Persian Gulf side, my major problem
19 has been memory loss, fatigue, joint pain -- muscle
20 pains and episodic GI upset. In terms of the Phase 1,
21 I started that in January of '95. I had a physical
22 towards the later portion of '94 on the 7th of
1 November, which on the pulse, I was given 211, 211 on
2 the -- so again, that is the 7th of November, after I
3 have had the melanoma.
4 On the 23rd of February, again I had
5 another physical. And at that point in time, I was --
6 on my pulse was 312, 312. On the 30th of March, '95,
7 I concluded the Phase 1 of my set and with the doctor
8 saying that I should not go to the next phase.
9 On the 5th of April, '95, I went back to
10 land school and again, there, it was discovered that
11 yes, I did have an abnormal psychiatric condition. I
12 had a mild to moderate impairment of verbal and visual
13 memory. So I guess as I look back in terms of what
14 was going on, I don't think I have got a personal
15 agenda as to the Persian Gulf or what happened because
16 my eyes are maybe not as good in terms -- or, worse on
17 the melanoma side than it is probably on the Persian
19 But my experience with cancer has
20 underlined the importance of contribution and that is
21 kind of like why I am here today. First of all, in
22 terms of -- I have briefly reviewed the agenda --
1 findings on your internal report. I would like to
2 have a few comments.
3 One, on the average side of the house, at
4 least from the active side, I think first of all,
5 senior officers and NCOs are more likely to keep their
6 medical problems close-hold until it is either safe to
7 come out in terms of their command or promotion
8 potential being identified.
9 Once they have figured out that, No, I
10 won't get command, or, No, I won't get promotion, then
11 all of a sudden you have got these problems coming out
12 and/or medical problems persist to the point that they
13 present themselves -- that they are too noticeable.
14 On the medical and clinical issues,
15 similar to some of the gentlemen that have been before
16 me and I am sure some of the gentlemen after me -- and
17 ladies -- is that as I had to take the anthrax
18 vaccine, we were told that the fact that we were
19 taking it was secret and that we weren't supposed to
20 tell anybody. And I -- to this day, I am not sure why
21 it was secret.
22 On the active side of the house, there is
1 a lot of confusion in terms of not only on the
2 patient's side but also on the medical provider's
3 side. When I went to -- I was Med-Evac'd to
4 Fitzsimmons for the melanoma. At that particular
5 point in time, I said to the -- to my ear, nose and
6 throat doctor, Dr. Yashita, I said, Well, if I am
7 going to be in here for a period of time, I said, I
8 would like to have the Gulf War series done at the
9 same time so we could do that.
10 And Dr. Yashita didn't know how to do that
11 and consequently when I got to the point in time
12 that -- I was at Fitzsimmons for about six weeks.
13 When they did get over to the ward that they have,
14 they said that I didn't have enough time to adequately
15 do this and so I should go back and have these tests
16 done overseas.
17 Ergo, I went back and started the Phase 1
18 on the 6th of January. And again, then we got into
19 the problems of, How much is this going to cost? And
20 everybody beginning to find out just exactly how
21 expensive this was and everybody tried to pass the
22 responsibility of conducting whatever had to be done
1 back to the initial health care provider at your
2 particular location.
3 I was located in the Netherlands and every
4 time I had to go to land school , it was roughly about
5 a three-hour drive.
6 DR. TAYLOR: Okay. We are running out of
7 time. We would like time for questions. Are there
8 any questions?
9 MR. RIOS: Yes. How long have you been
10 suffering from melanoma?
11 LT. COL. KELLY: Again, sir, it was -- I
12 had a biopsy done two years ago this day and I said --
13 the word never got back to me. It would roughly about
14 three weeks later until I got the word that I had
15 melanoma and about a month later, I was Med-Evac'd to
17 DR. TAYLOR: Any other questions?
18 MAJOR KNOX: Yes. I have a couple. It
19 concerns me still about active duty personnel not
20 feeling free to come forward and have their physical
21 exam. Dr. Steven Justice had assured us time after
22 time that active duty soldiers can do that.
1 Can you give us any examples or tell us
2 how we could go about making recommendations to make
3 that process better?
4 LT. COL. KELLY: Well, ma'am, the whole
5 idea why senior officers and senior COs -- when I say
6 senior officers, I can only talk about lieutenant
7 colonels and --
8 MAJOR KNOX: Right.
9 LT. COL. KELLY: -- majors. I can't talk
10 about colonels and generals. But I have got Sgt.
11 Major Johnson, who was in the same unit that I was
12 with, the
13 G-3, we are in the same unit right now. When I told
14 him about this committee today, he has not gone
15 through the issue of -- you know, he recognizes that
16 he has problems and he is going to retire and they
17 have been -- they have told him to push him off to --
18 you know, this is what he told me, Have the veterans
19 take care of you.
20 As it relates to senior NCOs and officers,
21 the pulse, when you go before any sort of a selection
22 process, be it for command or schooling or whatever,
1 there is your pulse identifier up in the upper -- this
2 is a picture of your OR-8. In the upper right-hand
3 corner is kind of like what you are medically.
4 Now, I have known lieutenant colonels to
5 purposely keep information away or they have doctored
6 whatever they need to do in order to keep what we call
7 the picket fence. And that is the way it is. Because
8 it is a discriminator.
9 MAJOR KNOX: So have you -- you are still
10 active duty at this time. Is that correct?
11 LT. COL. KELLY: Yes, ma'am.
12 MAJOR KNOX: And so you have already been
13 before the selection board and you said that you had
14 two 3s. Is that correct? Did I get that right?
15 LT. COL. KELLY: No, ma'am. In case in
16 point is, my pulse here is dated 8/8.
17 MAJOR KNOX: 1988?
18 LT. COL. KELLY: Yes, ma'am.
19 MAJOR KNOX: How is that?
20 LT. COL. KELLY: Well, ma'am, that is the
21 way it is.
22 DR. TAYLOR: Any other questions?
1 MAJOR CROSS: Colonel, have you decided to
2 continue on active duty or are you inclined to retire?
3 Because I believe you probably have enough years --
4 and then fight with the VA or what is your intention?
5 LT. COL. KELLY: Well, here is the story.
6 I have got 23 years in. I can retire any time. But
7 if I was to go outside right now and ask for --
8 anybody will give me insurance, they won't touch me.
9 Hopefully, they will touch me soon. Most insurance
10 companies wait until five years, and then they will,
11 you know, say, Yes, we will insure you.
12 So if I was to leave right now, I do put
13 things at risk -- for the family. And so I am taking
14 maybe the lesser of two evils hanging around as long
15 as I can.
16 MAJOR KNOX: But Col. Kelly, after 23
17 years in active duty, you would be entitled to health
18 benefits through --
19 LT. COL. KELLY: Yes, ma'am. But I would
20 think that the -- first of all, in terms of being
21 retired and active, I think that there is a tremendous
22 advantage being active than retired. My father is
1 retired. My father-in-law is retired, so I --
2 MAJOR KNOX: Right. Active duty, I know,
3 get first choice.
4 LT. COL. KELLY: Yes, ma'am. And I would
5 have to say that if it hadn't been for my melanoma, I
6 don't think that the issues in terms of my mild to
7 moderate impairment would have come to the attention.
8 I think that, you know, there is -- I don't think
9 there is consistency in the medical care community as
10 a place to different providers, you know -- what I am
11 saying here is, I have had two different doctors in a
12 period of three months give me two different --
13 entirely different profiles.
14 And one doctor said, you know, There is
15 nothing wrong with you. I don't have a problem with
16 the memory loss. It was because of the melanoma that
17 they suspected that may have problems -- that may have
18 had something in the head. And so I was tested two or
19 three days up at land school and it was uncovered.
20 So I don't have as much credulence to some
21 of the people that are performing some of the exams.
22 Now, when I mentioned the fact that land school was
1 trying to push off the problems down towards the two
2 medical clinics or whatever, the difference here is
3 you are seeing that the two medical clinics, you have
4 got captains and a major, maybe, addressing the issue
5 whereas at land school you have got lieutenant
6 colonels and colonels that are probably a little bit
7 more experienced.
8 DR. TAYLOR: Okay. We will have to stop
9 at this time and move on. Thank you very much.
10 Michael Lanning?
11 MR. LANNING: Good morning.
12 DR. TAYLOR: Good morning.
13 MR. LANNING: I am a medically retired
14 Persian Gulf vet from the United States Air Force. I
15 was assigned to the 401st Tactical Fighter Wing, Doha
16 Air Base, Qatar. I was -- I spent 11 years, eight
17 months, and 29 days on active duty. I was medically
18 retired in September of 1994.
19 After the Gulf War, I finished my tour in
20 Japan and went to Korea. During that time in '91 and
21 '92, I complained about chronic fatigue -- complained
22 about fatigue. I didn't know anything about the
1 Persian Gulf illness being in the Pacific because
2 Stars & Stripes does not put publicity on that.
3 I didn't get really sick until June of
4 1993 when F.D. Warren Air Force Base -- when I came
5 back to the States -- diagnosed me with
6 cytomegalovirus hepatitis. After that, they diagnosed
7 me with sleep apnea, irritable bowel, reactive airway
8 disease, and sinusitis.
9 They voided me out for all those things in
10 September, 1994. And between August and October of
11 1994, I went to Fitzsimmons for the DOD Persian Gulf
12 exam. In September 12, 1994, after I got by DD-214,
13 my discharge retirement paperwork, I put in for my VA
14 comp and pen paperwork. I still haven't received a
15 rating. It has been 22 and a half months.
16 My son has had seizures last year and
17 fevers that cannot be controlled with anything but
18 ibuprofen. I took him to F.D. Warren Air Force Base.
19 They sent him to Children's Hospital. They couldn't
20 do anything for him. I sent him to a civilian doctor
21 under CHAMPUS. They gave him sulfur. He hasn't had
22 a fever since except one time and it could be
1 controlled with Tylenol.
2 He is having problems with hyperactivity.
3 I sleep all the time. And with my sleep apnea, I have
4 had a doctor -- an environmental doctor in Denver
5 diagnose me with multiple chemical sensitivity. He
6 has also -- did a liver detox panel even though my
7 liver functions are normal.
8 I have problems getting rid of toxins in
9 my body. Also, the liver function -- the detox panel
10 says I have toxins in my blood and they didn't
11 identify the type of toxins. The VA has also
12 diagnosed me with PTSD, atypical connective tissue
13 disorder and I went for my VA exam in West Los Angeles
14 in spring of last year.
15 DR. TAYLOR: Okay. Questions? During
16 your service in the Gulf, where were you stationed and
17 do you remember any major exposures at the time?
18 MR. LANNING: I was assigned to Doha Air
19 Base, Qatar. We had numerous SCUD attacks where we
20 were at. I took -- unlike the Army, who took -- most
21 of them took pyridostigmine bromide for a week. We
22 took it for three months, from January to March. And
1 we were exposed to oil fires in Qatar, too. And I
2 developed severe nasal problems from the oil smoke and
3 I also forgot to mention that the VA has also
4 diagnosed me with having a 5-mm nodule in my right
5 lung and they don't know what it is.
6 DR. TAYLOR: Did you experience any of
7 your symptoms while stationed in the Gulf?
8 MR. LANNING: I got severely sick from the
9 P-tabs. I got breathing problems from the oil smoke
10 and everything while I was over there. And after
11 that, I had mild to intermediate fatigue up until I
12 developed hepatitis in June of '93 and that is when
13 all my other symptoms developed.
14 MR. RIOS: You said that in 1994, you were
15 medically discharged from active duty.
16 MR. LANNING: Medically retired, sir.
17 MR. RIOS: Medically retired. Does that
18 mean that you got a kind of a rating?
19 MR. LANNING: Yes, 50 percent permanent
20 disability retirement list.
21 MR. RIOS: And did they at that time say
22 that you were suffering from some Gulf War illness?
1 MR. LANNING: They don't want to admit to
2 anything, even though I am on -- both on the VA
3 registry and the DOD registry and I am on the Legion
4 registry as well.
5 MR. RIOS: And you are awaiting a rating
6 from the VA?
7 MR. LANNING: Yes. In fact, the VA has --
8 Cheyenne sent my file in August of last year to
9 Phoenix for the Persian Gulf because they said it was
10 Persian Gulf. And Phoenix has manipulated with the
11 dates they received it. They -- even though they got
12 it August of last year, they have changed the dates to
13 keep their case load delinquency file down to May of
14 this year.
15 They altered dates and they won't give the
16 VA in Cheyenne any answers on why they have
17 manipulated dates in my case file and everything. And
18 every time an inquiry is made about why my case has
19 taken so long, they have delayed me.
20 DR. TAYLOR: Any other questions?
21 MAJOR KNOX: I have one. Mr. Lanning, you
22 mentioned that your son had seizures. Is your wife
2 MR. LANNING: She has had menstrual
3 problems, cramping and such. And she has had problems
4 with -- not severely but she loses a lot of hair since
5 I have got sick. And another thing, I -- when my
6 liver enzymes were elevated, I had rashes on my
7 abdomen. She had them on her hands.
8 MAJOR KNOX: And how old is your son?
9 MR. LANNING: He is three and a half.
10 MAJOR KNOX: So he was born after the Gulf
12 MR. LANNING: Yes. And I got married
13 after the Gulf as well.
14 DR. TAYLOR: Any other questions? Thank
15 you, Mr. Lanning.
16 MR. LANNING: Thank you.
17 DR. TAYLOR: Jim Van Houten?
18 MR. VAN HOUTEN: Ma'am, you are the first
19 one to pronounce that correctly.
20 DR. TAYLOR: Great.
21 MR. VAN HOUTEN: My name is Jim Van
22 Houton. I served with the Colorado National Guard in
1 the Persian Gulf. And what I would like to do is to
2 paint a picture of before service in the Gulf and then
3 after, if that will be of any benefit.
4 My occupation at the time I was mobilized,
5 I was a full-time employee of the National Guard
6 which -- I was a federal technician, which meant that
7 I wore the uniform but had a GS or a civil service
8 status. I was a major in the Guard. I was an
9 infantry officer.
10 My work attendance -- and it is ironic
11 that Major Walker is in the back because he worked
12 with me in the Guard. I think he can attest to this.
13 My work attendance was such that I had very little
14 sick leave. I used to pride myself on the fact that
15 I carried the maximum number of sick hours on the
16 books -- 250 hours was the maximum carry-over.
17 And I just -- my health was in excellent
18 condition. I belonged to the special forces unit in
19 the state. I think Major Walker can attest to the
20 fact that I was in excellent health. On the military
21 side, I am a former sergeant in the Marine Corps. I
22 had service in Vietnam. Saw active combat over there
1 as a section sergeant for an ordnance motor crew.
2 At the time of our mobilization, I was
3 serving as the executive officer for the headquarters
4 detachment of the 193rd Military Police Battalion.
5 When we mobilized for the Gulf War, we mobilized and
6 deployed to Saudi in January of 1991.
7 Our mission was to establish and secure an
8 enemy prisoner-of-war camp which -- just below the
9 Kuwait border outside of a village called Al Surar .
10 This camp in the -- The Colorado National Guard did
11 something unique in this state which they should be
12 credited for.
13 They took an immediate interest in the
14 National Guard members who went to the Gulf. They
15 produced some wind fans that showed the debris coming
16 out Iraq from secondary explosions and they also
17 showed wind fans from the oil fires in Kuwait.
18 And our EPW camp was in those wind fans.
19 Our prisoner-of-war camp, we dealt cumulatively with
20 over 25,000 Iraqi prisoners. Initially, we had a lot
21 of prisoners that were captured prior to the invasion.
22 And then during the invasion and then during the civil
1 war in northern Iraq, while at the camp, I
2 participated in a three-week tribunal in which we
3 interviewed over 600 prisoners inside the camp to
4 determine their detainee status.
5 I was also involved in a number of prison
6 riots in which we physically grappled with prisoners.
7 I was injected with anthrax on 21 February 1991, if my
8 memory serves me correctly. We received the booster
9 ten days later. Initially -- and you have heard this
10 before -- initially, the security classification for
11 that inoculation was classified as secret.
12 They told us at that time that we were not
13 going to be allowed to put that in our shot records
14 because to do so would make it a secret document. Our
15 commander, Lt. Col. Bruck Beckman fought that issue
16 and they eventually put it in our shot record and I
17 have a copy of that I can provide this commission.
18 Not reflected in the shot record, however, is the ten-
19 day booster -- the booster that we received ten days
21 My current situation, I returned to
22 federal technician employment until I retired from the
1 military in October 1994 and I transferred my federal
2 civil service status over to Fitzsimmons Army Medical
3 Center where I am now employed as a logistics
5 My work attendance -- the earliest leave
6 and earnings statement that I can find, going back in
7 my records, is dated January of '93. It shows that I
8 had 249 hours on the books but it also shows that
9 year-to-date, meaning from January of '92 to January
10 of '93 -- January '92 being only six months after my
11 return from the Gulf -- I had used 147 hours of sick
12 leave. That is highly unusual for me.
13 Over the last several years, I have been
14 forced to deplete both my sick leave and my annual
15 leave. At this point, I have four hours accumulated
16 on the books for my sick leave. Within six to 12
17 months of my return, I began to experience aches in my
18 joints, in particular my knees, elbows, and shoulder.
19 My wife noticed this as well as, to her,
20 irritating memory lapses. She accused me of not
21 paying attention to her. I began to have a recurring
22 cough. I had trouble resisting flu, bronchial
1 inflammations, gastrointestinal problems and it would
2 hit me harder than I was used to.
3 Even to this day, they lay me up anywhere
4 from a week to ten days if I catch the flu or if I
5 have a gastric problem. I have a general -- I had a
6 general sense of fatigue -- just plain being tired.
7 The joint aches eventually spread to the wrists,
8 ankles, and hips and at that point, I began to receive
9 cortisone injections.
10 I was diagnosed with fibromyalgia in April
11 '96 and asked for a second opinion. I received that
12 in July of '96. I am getting -- I am scheduled to
13 begin cortisone treatments -- ultrasound cortisone
14 treatments as part of a physical therapy program later
15 this month.
16 DR. TAYLOR: We would like to leave time
17 for questions as well, so --
18 MR. VAN HOUTEN: Say again?
19 DR. TAYLOR: Time for questions from the
20 panel. Okay.
21 MR. BROWN: Mr. Van Houton --
22 MR. VAN HOUTEN: That is correct. Thank
2 MR. BROWN: Thank you. When did you first
3 start to come down with the symptoms that you were
4 describing after your return -- after your separation
5 from the National Guard?
6 MR. VAN HOUTEN: No. I was not separated
7 from the National Guard until October of '94. I began
8 to experience those problems within six to eight
9 months of my return from Saudi. I can attest to what
10 the lieutenant colonel was saying earlier. You don't
11 like to admit that you have a problem, particularly
12 when you are going before the promotion boards.
13 In my case, I had 20 years military
14 already. I retired with 23 years but in the National
15 Guard, you go before a selective retention board every
16 20 years so you don't like to have those red flags
18 MR. BROWN: And after you started having
19 these symptoms, did you seek a physician's assistance
20 or did you get any diagnoses for what might be --
21 MR. VAN HOUTEN: I did. I was -- I
22 belonged to the HMO Kaiser-Permanente and I was
1 fortunate to see one doctor in particular. And he
2 diagnosed it initially as tennis elbow or sprain to
3 the wrist. Then they began to inject me with
5 Then when I still complained about -- when
6 they were injecting me with cortisone, my elbow was --
7 but when I was complaining that it was in my wrists,
8 my elbows, my knees, they finally sent me to another
9 doctor who diagnosed it as fibromyalgia and then they
10 sent me to a specialist who confirmed it.
11 You asked the question, ma'am, about my
12 wife -- or about a spouse. My wife, within six months
13 of my return from Saudi, developed a dry, hacking
14 cough that she has to this day. And no one at Kaiser
15 can tell her why. I have a ten-year-old son and he
16 has just been diagnosed with asthma but I think that
17 is just part of being a kid.
18 MR. RIOS: You mentioned that, you know,
19 that you go up for promotions after 20 years or re-
20 evaluation and that you don't want to have any black
21 marks, especially in the health area. Is that
1 MR. VAN HOUTEN: That is correct, sir.
2 MR. RIOS: Does it make -- would it make
3 sense when you are being evaluated to ignore or to not
4 have anything on your medical history at the time that
5 you are being evaluated? Would that make sense?
6 MR. VAN HOUTEN: Sir, could you rephrase
7 that just a little bit? I am not sure --
8 MR. RIOS: I am saying, you know,
9 following up on the questions that were asked earlier
10 about how do we combat, you know, this mentality about
11 active military not wanting to state anything that
12 they have -- any, you know, health care problems that
13 they may have and so -- because they are afraid they
14 may get black-balled. Okay.
15 What I am saying, though, is when you go
16 into the evaluation process, would it make sense to
17 not look at that part of a person's profile?
18 MR. VAN HOUTEN: No, sir. I mean, as much
19 as I understand the trepidation to put a physical
20 illness down or a problem down, I also understand the
21 system's need to have healthy people in the field.
22 You can't fight a war and you can't conduct a combat
1 operation with people who are disabled.
2 I mean, that may be an unpopular statement
3 but you just can't do it. The reverse side of that,
4 however, is that the system -- the system being the
5 military -- has a responsibility to take care of those
6 people who -- for instance, I have a broken back that
7 I incurred while I was in the Marine Corps part of my
8 deployment to Vietnam. And the VA gave me a 20
9 percent disability on that. That was a positive step
10 to try and take care of it.
11 When I joined the National Guard, they
12 asked me to reduce that disability down to 10 percent
13 so it wouldn't look so bad on their -- on the entrance
14 exam. But again, it is from the perspective that when
15 you go to the field and you conduct continuous combat
16 operations in a real live war environment, you need
17 healthy people out there who can carry that load. And
18 I don't think there is a veteran in this group who
19 will disagree with that.
20 DR. TAYLOR: Any other questions? Thank
21 you. Michelle Juarez?
22 MS. JUAREZ: My name is Michelle Juarez,
1 widow and mother of two fatherless children, thanks to
2 the Gulf War. My reason for being here today is to
3 talk about what happened to my husband, Staff Sergeant
4 Augustin Juarez and how he met his unexpected death.
5 He went to the Gulf War for six months,
6 November 1990 to April 1991. Within one year of
7 returning from the Gulf War, we went to Germany for
8 two years. During that time, he came home from work
9 with an unexplained ailment, headaches to feet
10 tiredness and aching joints.
11 We came back to the States to Fort
12 Huachuca, Arizona in March of 1994. In May of 1994,
13 he got sick, throwing up, diarrhea, high fever, and he
14 went to the hospital for tests. The doctors diagnosed
15 him of leukemia. He was flown to El Paso, Texas and
16 Army doctors confirmed the diagnosis.
17 We asked the doctors how he could have
18 caught leukemia or how it was caused and the Army
19 doctors said this form of leukemia was caused from
20 radiation and chemicals. They had to test his
21 brothers and sisters for a bone marrow match.
22 His brother was a perfect match so we went
1 to Lackland Air Force Base in San Antonio, Texas to
2 perform the bone marrow transplant. The doctor said
3 he would have an 80 to 90 percent chance of recovery.
4 While in that hospital, I met other people that had
5 leukemia and other types of cancers by the Gulf War.
6 Some made it, some did not.
7 On the seventh floor of the hospital, it
8 was full of people from the Gulf War, sick. There was
9 this one guy that I saw, his skull was caving in and
10 they didn't know why. They put a plate on his head
11 and said, Go home. You have three months to live.
12 The bone marrow transplant was taken.
13 However, he had a reaction to the chemo and was
14 intensive care for six days. Died on March 12, 1995.
15 After his death, I received a letter from the Army
16 saying that his death was work-related -- and like it
17 changed to work-related because he did serve his
18 country and now he is with the Lord because of it.
19 I am not fighting for money. All I want
20 the government to do is to stop denying that they were
21 at fault for using chemical warfare and doing so,
22 hurting our soldiers and killing them. I would like
1 some day to see a wall with the names of all the women
2 and men and babies that have died because of the
3 chemicals used during the Gulf War.
4 It isn't just women and men that are
5 dying. It is also babies of these women and men that
6 are dying and that have birth defects caused by the
7 chemicals that the soldiers were exposed to. My
8 children and I continue living with this pain caused
9 by my husband's and their father's death.
10 He was only 28 years old and he had never
11 been sick before going to the Gulf War. There is no
12 cancer in his family. How can our government deny
13 that they are not responsible for these deaths when so
14 many people that went to the same war have died as a
15 result or have been sick with so many different ugly
16 kinds -- types of cancer as a result?
17 How can the men and women in our
18 government who deny our soldiers the dignity of saying
19 that all their deaths were related, look at themselves
20 in the mirror every day without feeling guilty? These
21 people died serving their country. They deserve at
22 least this honor. Their families deserve the honor,
1 not overlooked.
2 Because of my husband, Staff Sgt.
3 Augustin's, death, I now have to raise my children
4 alone. It has been extremely hard. However, it is
5 only through the Lord's help that we have survived
6 this tragedy. In closing, I would like to thank the
7 few people in the Army and Senator Ben Nighthorse
8 Campbell, who helped me and my children get the
9 benefits we did.
10 My heart goes out to all the families who
11 had to endure this heartache. When my baby was born,
12 she only weighed four pounds, 12 ounces. The doctors
13 didn't understand that because she was full term, I
14 had her a day late. And to this day -- she is 22
15 months -- she only weighs 19 pounds.
16 DR. TAYLOR: Thank you, Ms. Juarez. My
17 heart goes out to you as well. Are there any
18 questions from the panel?
19 MR. RIOS: You said that you received a
20 letter from the military saying that your husband's
21 death was work-related.
22 MS. JUAREZ: Yes.
1 MR. RIOS: And?
2 MS. JUAREZ: That is it. They just told
3 me he died of work-related --
4 MR. RIOS: They didn't say it was the Gulf
5 War or --
6 MS. JUAREZ: Just work-related.
7 DR. TAYLOR: You also mentioned that
8 doctors, when diagnosing his condition of leukemia,
9 stated that it was as a result of exposure to
11 MS. JUAREZ: And chemicals.
12 DR. TAYLOR: And chemicals. Did they give
13 any specifics of how that could have happened or did
14 your husband ever talk about his service?
15 MS. JUAREZ: The type of leukemia he
16 has -- I am not sure if I am going to say it right but
17 the only kind you get it, is from radiation and
18 chemicals. I can't think of the name.
19 DR. TAYLOR: Any other questions? Thank
20 you. Susan Meyer?
21 MS. MEYER: My name is Susan Meyer. I
22 returned from the Middle East in February, 1991. I
1 didn't realize it at the time but I was already
2 suffering from what is called Desert Storm Syndrome.
3 I first believe the sore muscles I had were due to
4 tension. I was told two years later that it was a
5 symptom of fibromyalgia.
6 The joint pain of fibromyalgia started at
7 the end of 1991. It started out with minor pain but
8 has since increased to constant, mid-level pain with
9 occasional episodes of severe pain that is not
10 relieved by any of the usual narcotics or sleep.
11 When my legs began to hurt, I thought I
12 was out of shape. Three years later, I was told I had
13 the legs of a 75-year-old man with 80 percent blood
14 flow in one leg and 85 percent blood flow in the
15 other. I had one kind visual disturbance, which are
16 called visual migraines, before I left the Gulf. Now
17 I have three.
18 I had a heart attack last year at the age
19 of 31. Medical personnel I came into contact with in
20 the hospital said, You are too young to have a heart
22 I am nauseous almost all the time. In bed
1 at night, my calf muscles spasm as I try to sleep,
2 making it difficult to do so. I lost a pay raise and
3 Christmas bonus two years ago because I was not seeing
4 a lot of mistakes I was making.
5 I didn't know at the time that what I was
6 seeing and what was actually written were two
7 different things. I have learned to compensate for
8 these difficulties. I have either learned to live
9 with the response, I don't know what caused this
10 problem but you have it and I can't do anything to
11 help it, that I get from doctor after doctor.
12 When I first heard about others having the
13 same or similar problems, I wondered if we were
14 suffering from the same thing. I didn't worry too
15 much about it because it wasn't that bad. As time
16 went on and I got physically worse, I contacted the
17 Denver VAMC to schedule a physical for the Desert
18 Storm vets.
19 I went to the physical in February of 1994
20 and was looked over superficially and asked a few
21 questions. I felt I was just being humored and the
22 doctor didn't really believe I was ill. I was not
1 referred to any specialists nor did I have any blood
2 taken or urine sample requested.
3 Four months later, I had heard nothing
4 regarding my condition but I had heard of the group
5 called Desert Storm Veterans that worked Denise
6 McNichols as contact. Through this group, I met
7 others like myself. In August of 1994, I learned the
8 VA was going to do more extensive testing.
9 I called the VAMC to make an appointment
10 and was told that since I had already had a physical,
11 I didn't need another one. I told her that I
12 understood that more extensive testing was going to be
13 done and thought that I should have it. She went to
14 check her records and when she called me back, she
15 scheduled a physical for me in October of 1994.
16 In this physical, I finally felt that I
17 was beginning to be taken seriously. I believe part
18 of the problem is that I look very healthy on the
19 outside. I was scheduled to see different specialists
20 through a period of approximately four months.
21 In December of 1994, I decided to start
22 the claim compensation process and contacted Mr. Floyd
1 Colgard of the Marine Corps League to help me. I
2 anticipated getting through the process fairly quickly
3 because I had already started the physical.
4 From November of 1994 through April 1995,
5 I saw several different doctors that kept telling me
6 I was sick but they didn't know from what or how to
7 fix it. In April 1995, I had my heart attack. After
8 that, I felt as if the doctors were beginning to
9 realize that I hadn't been lying or exaggerating about
10 what was going on and to take more seriously my
12 In November of 1995, I was told I would be
13 receiving a letter to schedule me for my compensation
14 physical. At the end of December, I called and was
15 told that due to the government shut-down, everything
16 was being delayed.
17 In February of 1996, I called again and
18 was told that they still hadn't caught up from the two
19 government shut-downs. I waited patiently until mid-
20 May. When I contacted them at that time, I was told
21 the paperwork had been lost.
22 I went to the Marine Corps League and
1 filled out the paperwork again. On July 10, I called
2 and was told to expect a letter within the next five
3 months telling me of my compensation physical. On
4 July 26, I received a letter scheduling my physical
5 for August 2.
6 I went to the physical, expecting to be
7 seen and questioned regarding the physical problems I
8 have developed since Desert Storm. Instead, I was re-
9 evaluated for the problems I have already compensated
10 for. When Floyd Colgard contacted the VA to discover
11 the reason for the re-evaluation, he was told that it
12 was a routine re-evaluation that occurred every couple
13 of years and that I would be scheduled for another
14 physical in two months.
15 This was the first re-evaluation physical
16 I have had in five years and I was not notified in the
17 letter that it would be a re-evaluation physical. I
18 was disappointed and angry after waiting for 19 months
19 to get to the point where I thought I was to find out
20 I was actually back where I had begun five years ago.
21 DR. TAYLOR: Thank you. Any questions?
22 MAJOR CROSS: Are you currently getting
1 compensation now?
2 MS. MEYER: Yes, sir. I am.
3 MAJOR CROSS: What percentage is that?
4 MS. MEYER: 10 percent.
5 DR. TAYLOR: What was your job assignment
6 in the Gulf?
7 MS. MEYER: I was in a communications
8 maintenance -- microwave long-distance communications
10 MR. BROWN: Ms. Meyer, do you recollect
11 any exposures that occurred to you while you -- during
12 your service in the Gulf?
13 MS. MEYER: Yes. In the chow hall, the
14 bug spray that they used to kill the bugs -- I had a
15 tent mate that had additional duty in the chow hall
16 for one week. She reported to work one morning
17 shortly after they had sprayed the chow hall for bugs
18 and she became extremely ill.
19 She kept throwing up. She couldn't keep
20 anything down. She had aches, pains. She was a real
22 DR. TAYLOR: What was the spray? What was
1 the bug spray used?
2 MS. MEYER: I have absolutely no idea what
3 they used.
4 MR. BROWN: But were you exposed as well?
5 MS. MEYER: Yes. I believe everybody was
6 exposed at that time.
7 MR. BROWN: Everyone in this group?
8 MS. MEYER: Yes.
9 MR. BROWN: Have you received any
10 diagnoses for the -- it sounds like in spite of the
11 fact that you have had a number of physicals, you have
12 never received any diagnosis or have you had some?
13 MS. MEYER: Well, I was given
14 fibromyalgia -- that was one of my diagnoses, and
15 arteriosclerosis for my legs and the visual migraines.
16 But that, I believe, is it.
17 DR. TAYLOR: Was the arteriosclerosis the
18 reason given for your heart attack by the physicians?
19 MS. MEYER: No, it was not. For the heart
20 attack, they said that they knew what caused the blood
21 clot but they had absolutely no idea what caused the
22 blockage in the first place. They said it should not
1 have happened.
2 MAJOR KNOX: Do you have a family history
3 of cardiovascular disease?
4 MS. MEYER: Heart attacks, yes. Legs, no.
5 MAJOR KNOX: Are your parents still
7 MS. MEYER: My father is. My mother died
8 in surgery.
9 MAJOR KNOX: From a heart attack?
10 MS. MEYER: From a brain tumor.
11 MR. BROWN: What is your hope that this
12 commission can do?
13 MS. MEYER: I would like you to see that
14 the VA starts taking people seriously. As I said,
15 when I first went for my first physical, I felt that
16 he was just thinking, Oh, here is a -- it is all in
17 her head. She is not really sick and she is just
18 imagining things.
19 Shortly after my heart attack when I
20 started seeing the physicians again on my regular
21 schedule, I could tell that their attitude had
22 changed. Like, Oh my god, she was telling the truth.
1 Because when I complained of the chest
2 pains, it was like, Okay. Well, if it happens again,
3 go to the emergency room -- and that was it. Five
4 days later, I had the heart attack and they were all
6 DR. TAYLOR: Any other questions? Thank
8 MS. MEYER: Thank you.
9 DR. TAYLOR: Edmee Hills?
10 MS. HILLS: If I may have your permission,
11 I would like to hand you out a letter written by a
12 Persian Gulf war veteran that recalls everything that
13 you have heard so far from every testimony.
14 Good morning, members of the commission,
15 ladies and gentlemen. As the national chairman of the
16 Veterans' Widows International Network, Incorporated,
17 I wish to bring to your attention the plight of widows
18 and dependents of Persian Gulf war veterans who have
19 died since their return to the United States.
20 Of an unconfirmed number of more than
21 3,000 such deaths mentioned to me, as of June of this
22 year, only 161 widows have been approved for
1 dependency and indemnity compensation. Something here
2 doesn't equate. Several such young widows have called
3 on our organization to help them with their need to be
5 One of them has come forward and has
6 provided me with a written testimony. It is heart-
7 wrenching to read and it goes almost word for word
8 what I have heard from others. It took 20 years for
9 the government to recognize eight different forms of
10 cancer as being related to the defoliant spraying in
11 Vietnam and there are thousands of veterans' widows
12 who are not aware they now qualify for DIC benefits.
13 Are we going to allow for the same tragedy
14 to repeat itself in conjunction with the much-maligned
15 Gulf War veterans' illnesses? These widows and their
16 dependents need help now and ways to come to their
17 assistance rest with President Clinton, the United
18 States Congress, the Secretary of Veterans' Affairs,
19 and you, members of the commission.
20 I shall close by reading an excerpt from
21 Maria Abrou's letter to me, which you have presently
22 in your hand. I am sorry. I have to turn the page.
1 So I ask myself -- it is on page 6. "I ask myself, My
2 husband was there when they needed him. How come they
3 are not here when we need them?"
4 I thank you very much for your attention
5 you have given me.
6 DR. TAYLOR: Thank you, Ms. Hills. Are
7 there any questions? Any questions? Thank you.
8 Kevin Jenson?
9 MR. JENSON: Good morning.
10 [unintelligible] the other gentlemen also. When we
11 first were deployed in Desert Storm, we were given a
12 numerous amount of shots and from the day you have
13 basic training, you are given a medical shot record
14 that lists all your shots that you have received.
15 We were only given two days to deploy to
16 get ready to leave and they did not put down any of
17 the shots that we were given. And the pills that we
18 were supposed to take, that bromide, the nerve agent,
19 we were told either we take it and it is not approved
20 by the FDA, it is experimental -- and we were to take
21 it or be court-martialed. So we had no choice whether
22 to take it or not.
1 Since I can't state, like some people have
2 said, you can't really say when it exactly started
3 because when we first -- I was there from January of
4 '91 to April of '91 and then, like everyone said, you
5 didn't know what it was. And right now, I have had
6 diarrhea for about five years.
7 I go from, on a good day, three to four
8 times. The week of the 4th of July and the week
9 after, it was almost ten to 12 times a day. I can't
10 keep food down. I have lost 40 pounds. It is --
11 within a half an hour, an hour after I eat, I have to
12 go to the bathroom. I can't enjoy -- I can't do
13 anything any more. Can't sit in a movie theater
14 without having stomach cramps.
15 The stomach cramps are constant all day.
16 It is just one -- I have no choice when I go to the
17 bathroom. It could be the middle of the night. It
18 could be during the day. I have been late to work
19 because I only have a half-hour drive from work and
20 all of a sudden, I got to pull over a find a bathroom
21 really quick or, you know, there has been times when
22 I have been at work at 6:00 in morning, there has been
1 times by ten o'clock, I have gone to the bathroom
2 three or four times.
3 And I have been seen at the VA hospital
4 now for a year and a half and they can tell me is, I
5 don't know. We don't know what it is.
6 They have done a numerous amount of blood
7 tests. They have taken stool samples. I have been in
8 for upper and lower GIs. And they come up and they
9 tell me one thing and then a week later they change
10 their minds and say, Well, it might be this, It might
11 be that. And they cannot give you a definite answer.
12 And I just -- I can't say that the medical
13 care there is exactly all that great. I don't think
14 they really take you serious. I go to the VA down
15 here on Clermont Boulevard. At first, like I have
16 heard other people say, they don't really take you
17 serious until it actually goes too far. And I think
18 they need to start catching it before it goes too far.
19 I also have scars all over my arms, my
20 back, and my chest anywhere from a half-inch long to
21 an inch and a half long. It started off as a rash in
22 Desert Storm on my foot and it started covering my
1 body and they don't know -- they have already ruled
2 out that it is genetic. They have ruled out -- being
3 genetic and they said the only other way it could be
4 is from chemicals.
5 So now I have scars all over my body and
6 it wasn't too good. That is all I have got to say, is
7 that they just need to start catching this sooner and
8 take it a little bit more serious.
9 DR. TAYLOR: Where did you serve and what
10 were some of the exposures that you remember?
11 MR. JENSON: That is a tough one, too.
12 People always ask you that but I didn't go over with
13 my active duty unit. I was in an active duty unit it
14 Germany and only 29 of us were sent over as casualty
15 replacement crews and I was assigned to the Oklahoma
16 National Guard.
17 And the whole time, we were not given any
18 maps. We were not allowed to know where we were at
19 the whole time. They said because they did not
20 wanting us writing a letter back home, our position
21 and having the enemy get those letters and maybe find
22 out where our position was at.
1 All I do know is, we were by the oil-well
2 fires for two weeks and we camped out right next to
3 them. And we started off and went clear up north. At
4 the end, we went clear up north and we leapfrogged
5 back, protecting the other units. And I do know we
6 went through Lane Hotel on the south part of Baghdad.
7 That was our whole mission there.
8 Basically, we were all over the place. In
9 the four months we were there, we were on 12-hour
10 convoys, 16-hour convoys. We travelled the whole
11 country over there but they would not give us a
12 definite answer where we were at. They told us we
13 don't need to know where.
14 DR. TAYLOR: Okay. Any other questions?
15 MR. BROWN: Mr. Jenson, you mentioned that
16 you went -- had a number of physicals from VA
17 hospitals. Did you have any sense that they -- the
18 doctors that looked at you had a -- were knowledgeable
19 about problems that Gulf War veterans had experienced?
20 And my second part of the question is, it
21 sounds like they never provided you any diagnosis at
22 all? You weren't able to --
1 MR. JENSON: They started to. They will
2 give me one diagnosis and they will come back and say,
3 Well, like for -- a good example is, I went in for a
4 test of -- the sodium test where they stick -- you
5 drink the fluid and it shows them your body. Well,
6 that caused a reaction and I was in the hospital for
7 three days.
8 Then they told me, Well, it might be your
9 appendix and it might be Crohn's Disease. But we are
10 not going to let you eat for three days in case your
11 appendix ruptures but we don't want to go in and see
12 if it is Crohn's.
13 So then they come back and started telling
14 me it is some kind of deficiency. And I have never
15 gotten exactly an answer. Every time I go in, they
16 say, Well, we have ruled this out but we think it
17 might be this. Then I will see -- the VA, you don't
18 ever see the same doctor twice. I would see different
19 doctors every time and every doctor has given me their
20 own opinion, so.
21 MR. BROWN: Did the doctors that you see
22 seem knowledgeable about Gulf War health issues?
1 MR. JENSON: I don't -- I can't really
2 say. I don't -- me, personally, I don't think so. I
3 think their whole thing is, Well, I am only at this
4 hospital for a couple of weeks and I am going to get
5 sent to a real hospital, because they are all from a
6 university there so I don't think they really care.
7 They are just there for their intern for a couple of
8 weeks or whatever.
9 As long as -- I have only seen -- I have
10 never seen -- I have only seen a couple doctors twice.
11 The only ones I have seen are the ones in the
12 dermatology, the ones that keep taking lumps of skin
13 out. But for the diarrhea, no one has given me a
14 definite answer. I have been seeing them for a year
15 and a half.
16 They will come up with one -- I think they
17 pump me full of medication and either it makes it
18 worse or it doesn't do anything. And that is all they
19 keep telling me, is, Well, we will try this next week,
20 We will try this next week. We will need more blood.
21 That is about it.
22 DR. TAYLOR: Any other questions?
1 MAJOR KNOX: Do you receive any VA
3 MR. JENSON: No.
4 MAJOR KNOX: Do you have a claim that is
5 pending at this time?
6 MR. JENSON: I had a claim. I put it in
7 a year and a half ago and I went back to check on it
8 about a year ago and they couldn't find it so I have
9 to start it all over again.
10 MAJOR KNOX: But it is active?
11 MR. JENSON: And -- well, yes. Floyd
12 Colgard at the VA is helping with that.
13 DR. TAYLOR: Did any doctors ever suggest
14 the possibility of virus and put you on antibiotics?
15 MR. JENSON: They have not tried any
16 antibiotics yet. Right now, they are waiting -- I go
17 in later on this month. They are thinking about
18 putting me on steroids, maybe gain some of the weight
19 back and to see if that corrects anything in my
21 But they haven't come up with any -- they
22 just don't want to try anything just like -- instead,
1 they give you all -- I have a big box at home with
2 medications, about this big, that doesn't even work.
3 I mean, I have it all. I don't throw it away. They
4 aren't definitely giving me anything yet for sure
5 until they find out what it is and they still can't
6 find out what it is.
7 And I would go to the civilian side of the
8 doctors. They might do a better job but I can't
9 afford it.
10 DR. TAYLOR: Any other questions? Thank
11 you, Mr. Jensen. Cathleen McGarry? Cathleen McGarry?
13 DR. TAYLOR: David Oliver?
14 MR. OLIVER: Thank you for calling on me.
15 I served on board the USS Missouri, BB63, in the
16 Persian Gulf. We got there through the Straits of
17 Hormuz and in order to get an 880-foot long battleship
18 through the Straits of Hormuz, there were risks
20 I did take some of the bromide tablets on
21 order. And I didn't know the effect of them but I
22 don't think that is the problem. I feel pretty good
1 right now, thanks to Major Denise Nichols. She found
2 me and she brought me -- or, encouraged me to go to
3 the Veterans' Hospital at 9th and Clermont.
4 I called University of Colorado Medical
5 Health -- or, Health Sciences Center. I went there.
6 I stayed there for approximately 30 days and was
7 transferred to Fort Lyons Veterans' Hospital. It is
8 an old Navy base in southeast -- I think it is
9 southeast Colorado -- and I stayed there for -- I
10 believe it was another 30 days there.
11 And I definitely suffer from memory loss.
12 It takes certain events and certain people to, you
13 know, remind me where I have been and what I did. I
14 was Med-Evac'd from Fairfield, California on a CY-
15 Nightingale and we flew to a base in Texas -- Fort
16 Hood, I believe -- and we went from there to
17 Mississippi and from Mississippi to Scott Air Force
18 Base in Illinois.
19 And from Illinois -- I think I stayed the
20 night there one night. From Illinois, they flew me to
21 what was then Stapleton International Airport. From
22 Stapleton, they transferred me to -- I met someone
1 like a Petty Officer Kennedy and he took me to
2 Fitzsimmons Army Medical Center and I don't know if
3 that is working right now. I don't know whether the
4 Fitzsimmons Army Medical Center is still treating
6 From there, I went to Lowry Air Force Base
7 and I believe a chief there said, Well, you are a
8 battleship sailor. You don't want to just swab decks
9 around here. Why don't you just subsist out?
10 So I went home to my mother and got a call
11 and they said they wanted to re-evaluate me. So they
12 flew me on a plane from Buckley Air National Guard
13 Base down to Millington, Tennessee where I was
14 evaluated by a Lt. Coates, United States Navy.
15 Stayed there for about 30 days and
16 received an honorable discharge from -- I am not
17 exactly sure of the commander's name. I believe it
18 was Capt. Means, United States Navy. So as a result
19 of all this flying around and being flown around and
20 everything, I suppose I should be eternally indebted,
21 not only to the United States Marine Corps, the United
22 States Navy, the United States Army but also the
1 United States Air Force and all those men and women
2 that were involved in bringing me back to the United
3 States because we did see oil fires but we didn't get
4 close enough to them nor breathe them.
5 We were out in the Gulf on a ship. I
6 remember Naval gunfire support exercises and if you
7 have seen the movie "Under Siege," my first
8 lieutenant, 1st Lt. Carrey, is in that movie as a
9 naval aide. You know, it is that kind of thing that
10 makes a veteran a little worried, like, am I seeing
11 things? I am watching television here and I see my
12 1st lieutenant, the USS Missouri, on a movie called
13 "Under Siege" with Steven Segal, blah, blah, blah, and
14 on and on --
15 DR. TAYLOR: We would like to leave some
16 time for questions before you --
17 MR. OLIVER: I would like to respond.
18 DR. TAYLOR: Okay. Are there any
19 questions of Mr. David Oliver?
20 MAJOR DENISE NICHOLS: I want to mention
21 to the commission -- and sorry to interrupt -- but
22 David was in severe trouble. He was homeless. He was
1 getting into legal problems. David -- what you are
2 seeing today -- is not the David that his mother and
3 dad knew and sent to the Gulf War.
4 I also got a call from his mother, that
5 she had seen my picture in the paper. This man, you
6 wouldn't know it to see it today but he is college-
7 educated. He is college-educated and what I saw early
8 on with these veterans were veterans that were almost
9 like Alzheimer's patients. And they are severe and
10 they need help now.
11 And the reason I stepped up is to get that
12 message through a little clearer. The vets here in
13 Colorado are speaking from their heart. They are not
14 speaking from prepared testimony like we have seen at
15 other commission hearings but they are telling you how
16 they normally get along and function.
17 This isn't the troops that we sent to war.
18 And I want the committee and I want the press and I
19 want the people here today to know how severely
20 impaired these veterans are.
21 MR. OLIVER: One thing might help.
22 DR. TAYLOR: Thank you.
1 MR. OLIVER: One thing might help. And I
2 spoke with a psychologist at the Veterans' Hospital --
3 VAMC. And I said, One thing would help me. One
4 thing. If you could just introduce me or show me at
5 least one other person that was on that ship. And if
6 they are dead, then I would appreciate somebody to
7 tell me but I pray that they aren't.
8 DR. TAYLOR: Are there any questions?
9 MR. OLIVER: I can handle the pain.
10 DR. TAYLOR: Are you receiving currently
11 any kind of disability or assistance?
12 MR. OLIVER: Yes. I am 100 percent
14 DR. TAYLOR: What was your diagnosis?
15 MR. OLIVER: Bipolar disorder. You know,
16 like Major Denise Nichols said, I have a college
17 education. I studied five years at the University of
18 Colorado, Boulder, and I suppose I could go down to
19 the Health Sciences Center here in Colorado and look
20 up what bipolar disorder is but I don't know. I know
21 some people know. It has something to do with your
1 DR. TAYLOR: Any other questions? Thank
3 MR. OLIVER: Is that all?
4 DR. TAYLOR: That is all.
5 MR. OLIVER: Thank you for letting me
7 DR. TAYLOR: Sure.
8 MR. OLIVER: I didn't prepare a statement
9 but I am glad you called on me.
10 DR. TAYLOR: That is fine. It is on the
11 record. Frederick Hosterman?
12 MR. HOSTERMAN: Good morning,
13 distinguished panel members and honored guests. My
14 name is Frederick Hosterman III. I am a master
15 sergeant in the active duty Air Force currently on
16 leave pending my normal retirement after 20 years of
17 proud service to this country.
18 My full military background regarding what
19 I believe to be my Gulf-related illness is provided in
20 the attachment I just gave you. But briefly, I was
21 the first military historian to arrive in the Gulf
22 region, arriving on August 14, 1990 and serving there
1 for eight months.
2 I worked directly under Gen. Charles
3 Horner in the city of Riyadh, Saudi Arabia. Gen.
4 Horner, as you may know, commanded all allied air
5 forces during Operations Desert Shield and Desert
6 Storm. Then a year after the cease-fire, I traveled
7 to southern Turkey and northern Iraq to cover the
8 ongoing allied effort to protect the Kurdish refugees
9 in that region.
10 Of course, like any good sergeant, any
11 time I was told to report for immunization, I rolled
12 up my sleeve and got inoculated. And I believe it was
13 the pharmaceutical cocktail that is now in my blood
14 that brought me to this podium.
15 It was during my six-month deployment to
16 Turkey in late 1993 that I first displayed symptoms of
17 an illness that I cannot help but attribute to my
18 Gulf-related service. I have been diagnosed with
19 chronic fatigue, among other things, which include
20 dizziness, disorientation, and numbness of the
22 Others have pointed out that I am
1 displaying changes in my usually pleasant personality,
2 such as severe mood swings. I first displayed these
3 symptoms while in southern Turkey. The severity of my
4 physical fatigue alone greatly jeopardizes my
5 potential for a second career in the private sector
6 and I have no doubt my personality changes would do
7 far worse to me if I were willing to admit to them.
8 But the most troubling thing is this. If
9 current medical reports are accurate, my Gulf service
10 raises the potential of even greater jeopardy to my
11 health looming in the future. And as current rules
12 stand, if my medical records don't document a problem
13 while I am still on active duty, I am on my own to get
14 treatment when that problem finally appears.
15 It is this jeopardy that caused me to
16 request the use of your valuable time today. I
17 believe I speak for many of us for whom the Gulf War
18 is more than a lasting memory. We were proud to serve
19 and fight for an honorable cause. The hero's welcome
20 we were given when we returned home has since been
21 replaced by scorn, suspicion, and a shameful
22 dishonesty on the part of our government we proudly
2 Most important, we and our families aren't
3 getting the information we need and we are not getting
4 the help we need. The illnesses we experience are
5 real and the relation of these illnesses to our duty
6 in the Gulf is medically provable.
7 But our country also has a proven track
8 record of conveniently muffling the bearer of bad
9 news, so we appreciate your presence here today. From
10 the victims of atomic testing in the 50s to the
11 victims of Agent Orange, we are aware there is a
12 tendency for bureaucracy not to want to admit
14 I myself have experienced a negative shift
15 in the attitudes of the active duty doctors I visited
16 since the government officially repudiated the title
17 of Gulf War Syndrome. And at some point after my
18 initial processing in the Gulf Veteran Medical Profile
19 Program, my medical records were completely sanitized
20 to remove every last one of my laboratory results --
21 20 years.
22 I am not a conspiracy-minded person by
1 nature but I would be a fool not to be intensely
2 concerned by what I have seen happen to me and around
3 me. Now, if an American serviceman gets wounded while
4 supporting our country's strategic needs, the
5 Veterans' Administration promises a lifetime of
6 support for the physical and even psychological wounds
7 that result. And I have seen this support in action
8 all over the world.
9 It is something we have learned to trust
10 over the years. And concerning the erosion of
11 military benefits over the last few years, trust is a
12 precious commodity. The bureaucratic foot-shuffling
13 that the Gulf vets have mentioned to you today
14 threatens to further erode our faith in our government
15 and that faith is essential to our way of life.
16 After all, if you are not doing right by
17 those who have offered their lives in defense of our
18 nation, what can the other voting citizenry expect?
19 We ask the Clinton administration to act quickly and
20 decisively. Restore the trust the Gulf vets have lost
21 so far and assuage the fears we have for our futures.
22 Please, heal all the Gulf wounds now and
1 in the future. It is critically important to those of
2 us on active duty today to know that we will be
3 welcomed by the VA or other support agencies when we
4 develop Gulf-related illnesses, regardless of whether
5 those symptoms appeared when we were on active duty.
6 The members of this committee, not being
7 essentially military, might not be aware of it but
8 those of us on active duty in the U.S. military aren't
9 supposed to speak out when others recite the pledge of
10 allegiance. The reason is quite simple. We don't
11 need to pledge our allegiance because when we joined
12 the service, we held up our right hands and pledged
13 our lives.
14 All we ask in return is not to be
15 forgotten. Ladies and gentlemen of the committee, we
16 appreciate the work you are doing today on our behalf
17 and we applaud the attitude that was the impetus for
18 these briefings. Thank you for your valuable time.
19 And I would also like to publicly thank
20 Denise McNichols for all the selfless effort that she
21 has given to us. Thank you very much.
22 DR. TAYLOR: Thank you. Are there any
2 MS. GWIN: I have a question. You said
3 your medical records were sanitized for the last 20
4 years. How do you know that and why do you think that
5 that --
6 MR. HOSTERMAN: My -- I have one doctor I
7 am working with who is trying to help me through what
8 I have got and she was interested in looking at my
9 past lab results and there aren't any. They are all
11 DR. TAYLOR: There is no record of any of
12 your lab results?
13 MR. HOSTERMAN: They have all been
14 removed, 20 years' worth.
15 MR. BROWN: Mr. Hosterman, we have though
16 about this issue of the relationship, the trusting --
17 the nature of trust in terms of the relationship
18 between soldiers and our government and our society.
19 Do you -- what do you think, in your opinion -- you
20 sound like you have given this some thought yourself.
21 What kind of ideas do you have as the most
22 important things that we could do -- recommendations,
1 for instance, this committee could make?
2 MR. HOSTERMAN: Well, I noticed in your --
3 MR. BROWN: Along those lines.
4 MR. HOSTERMAN: I have noticed in your
5 agenda you have listed -- or, your -- the presidential
6 proclamation that formed your committee mentions
7 outreach. Unfortunately, it was listed as one of the
8 last items but I think it is really important.
9 This meeting itself is a good example. It
10 was very poorly publicized. The efforts that the
11 government is making -- and I know that they are
12 making some -- are not being publicized. It would
13 really help if the VA were more aware because they are
14 a center of communication for us.
15 It would also help if they were given a
16 little boot up the bum, if you will, to put out
17 brochures that publicize who you can call, what you
18 can talk about. Admit that there are a lot of
19 questions being raised but these are the possible
20 illnesses or symptoms that have been shown and if you
21 have these, these are the people you should meet or
22 talk to -- that kind of thing. Outreach is really
1 important to us.
2 MR. BROWN: The fact that -- I just should
3 add that the fact that outreach was listed last by no
4 means implied that it was the least important.
5 MR. HOSTERMAN: I understand.
6 MR. BROWN: Thank you.
7 DR. TAYLOR: Any other questions? Thank
8 you. Gilbert Roman?
9 MR. ROMAN: Thank you. If I seem to be
10 reading with difficulty sometimes, it is because I am.
11 Madam Chairman, members of the Presidential Advisory
12 Committee, thank you for allowing this opportunity to
13 be here with you today on this extremely important
15 I am a veteran of the Persian Gulf war
16 during both Desert Shield and Desert Storm. I served
17 in the theatre of operations between 6 January through
18 17 March although I was called up much earlier than
19 that. My job was as an executive officer for a combat
20 evacuation hospital [unintelligible] as liaison to the
21 ministry of health.
22 I reported to the medical command 5th U.S.
1 Army, theatre of operations, Riyadh, Saudi Arabia.
2 And my mission was to work with hospitals in the
3 theatre of operations. As a colonel [unintelligible],
4 I flew Star Routes C-141 or C-130 flights in and out
5 of Dhahran and Riyadh regularly.
6 I was exposed, I believe, to anything
7 anyone in or out of Kuwait burning oil fields may have
8 been exposed to and had my shots both prior to leaving
9 the USA and after arriving in the country. While I
10 was in Riyadh, they gave me shots and pills and
11 whatever they thought I hadn't taken. And as a good
12 soldier, I took them.
13 Upon returning home, I began to notice
14 severe rashes. They were like hives which would come
15 and go were not responsive to normal treatment. These
16 would last several days to weeks and would appear on
17 my chest, arms, neck, legs, other parts of my body you
18 don't even want to hear about.
19 Also, I began experiencing stomach cramps
20 with attendant diarrhea, vomiting, nausea, constant
21 headaches. These symptoms also did not respond well
22 to normal medications or treatment. In addition, my
1 wife noticed, as did other people who have known me
2 most of my life, that I have what they thought was a
3 severe, acute depression.
4 I was irritable. I had mood swings. I
5 became somewhat self-isolated. In addition, I would
6 get teary, usually for no apparent reason, and would
7 begin to cry while just driving down the street. I
8 noticed a noise sensitivity where I could hear every
9 noise, every creak, every dog barking at night,
10 listening for I don't know what. Since I was in
11 charge of security, I guess that was something that I
12 should have been -- I should have expected.
13 This was in addition to my recurring
14 nightmares, startle reaction to loud noises, and
15 overall I had become a non-participating member of
16 society which I had left in good standing. In
17 essence, I went into a shell and withdrew from
19 Only the Veterans' Administration
20 consulate in Washington, D.C. where I was living
21 coaxed me back out of that shell again. I reported
22 myself to the Washington, D.C. Veterans'
1 Administration Hospital, I believe it was in January
2 or February of '93, and went through the Persian Gulf
3 Illness evaluation program that they had sent me some
4 materials on.
5 After a thorough physical examination,
6 they duly noted all the findings, which were
7 considerable. I transferred back to Denver, Colorado,
8 which was home, and reported to the Denver VA Hospital
9 here where they also gave me a complete physical
10 examination -- started from scratch, including MRIs,
11 EKGs, barium tests, x-rays, and so forth although I
12 asked them to transfer my records from D.C. I don't
13 know if they ever did.
14 They also found a number of illnesses in
15 my body and they also duly noted these in a report.
16 Everything has been duly noted but I haven't seen very
17 much of it. Next, the time in 1994 I was -- while I
18 was Denver, I received a letter telling me that I
19 should report to the U.S. Army Fitzsimmons Center for
20 a Persian Gulf evaluation examination.
21 I reported in and for a number of months,
22 I would spend time being evaluated by Fitzsimmons
1 health care personnel. Some of my conditions they
2 found are as follows: precancerous nasal polyps,
3 precancerous colon polyps, short-term memory loss,
4 degenerative arthritis of my knuckles, knees, and
5 ankles; sleep apnea -- that is a sleep disorder in
6 which a person actually stops breathing for up to a
7 minute sometimes, numerous times during the night; a
8 30 percent hearing loss, confirmation of my hive-like
9 condition, confirmation of my flu-like condition
10 wherein I suffered from diarrhea and vomiting. They
11 did take a stool test several times -- sample -- to
12 find no parasites or other causal factors. Weight,
13 lost 20 pounds or more in any given period; and
14 chronic fatigue.
15 These are findings that Fitzsimmons made
16 confirming the VA reports, which I have not seen. I
17 did see the findings from Fitzsimmons center. I have
18 not included the many other conditions which they
19 indicated were not attributable to my military service
20 but these were things they themselves found and noted.
21 Fitzsimmons did not treat me as my
22 condition was not yet attributable to any service-
1 related time. I have not been treated for any of
2 these conditions except for hives and that was on my
3 own. I went to the Colorado Asthma and Allergy clinic
4 when I couldn't stand any more and was able -- and
5 they were not able to attribute the hives and rash to
6 any of their regularly tested flora or fauna in
7 Colorado and were at a loss as to what caused it.
8 Recently, I developed a breathing problem
9 which is like congenital heart failure but as it -- or
10 is it only one more notch in the Persian Gulf score of
11 unrecognized and unattainable and unrecognizable
12 illnesses. In essence, my health prior to going to
13 the Persian Gulf was excellent or I wouldn't have
14 gone, except for a little high blood pressure I had
15 under control.
16 At my return, I deteriorated to the point
17 where I have been unable to get or hold a job of any
18 consequence given my education and experience. I have
19 had a doctorate, a masters, and a bachelors and I
20 worked on an MBA just in case that might help.
21 Would I do it again? Yes. I would not
22 hesitate. Do I have any regrets? Hell, no. My
1 country called and I answered. Now please, let's
2 start treating these men and women to find the
3 symptoms, the causes of the Persian Gulf Syndrome --
4 Persian Gulf Syndrome or not, according to what the
5 Center for Disease Control has stated, contrary to the
6 Pentagon's statements. And let's quit pointing
7 fingers at each other.
8 Our soldiers and their families gave when
9 they were asked to give. Now we expect something back
10 in return, very simply, our health. Thank you very
11 much. I appreciate it.
12 DR. TAYLOR: Thank you. Are there any
13 questions? How long, again, was your service in the
15 MR. ROMAN: I was there from 6 January
16 until March 17 but I have a short-term memory loss
17 after [unintelligible].
18 DR. TAYLOR: Were there any particular
19 exposures that you remember?
20 MR. ROMAN: There at the -- some hospital
21 sites that we were looking at there with the
22 radiation, we found some signs that where the
1 battalions had been before, they had left signs of
2 radiation in the area so that could have been left in
3 the hospital itself.
4 But I also spent a lot of time in Riyadh,
5 Dhahran, and in the Kuwait area when I was flying on
6 a star shuttle. I was there during the time that the
7 oil field were burning as well.
8 DR. TAYLOR: Any other questions?
9 MS. GWIN: What type of VA compensation do
10 you receive?
11 MR. ROMAN: None.
12 MS. GWIN: None?
13 MR. ROMAN: No. My paperwork has been in
14 for about two years -- two and a half. It is in
15 Phoenix somewhere, floating around.
16 MS. GWIN: Have you been satisfied with
17 the care that you have received at the VA?
18 MR. ROMAN: I received no care at the VA.
19 I received no care at Fitzsimmons since I am not
21 MS. GWIN: So you were active duty?
22 MR. ROMAN: I was active in reserve. I
1 retired as a reserve colonel.
2 MS. GWIN: But did you have your Persian
3 Gulf physical at a VA facility?
4 MR. ROMAN: Yes.
5 MS. GWIN: Okay.
6 MR. ROMAN: At Washington, D.C. and Denver
7 VA facilities and Fitzsimmons. I have had three.
8 MS. GWIN: Okay.
9 DR. TAYLOR: And I am -- you said you
10 don't receive any assistance from the VA. Where is
11 your medical assistance? Private medical -- you have
12 private medical coverage or --
13 MR. ROMAN: I have -- well, I have private
14 medical coverage at this point in time. It is just --
15 not really. I am not -- I really can't afford private
17 DR. TAYLOR: Is Cara Whitford here? Cara
18 Whitford? What about Cathleen McGarry? Michael
19 Martin? Michael Martin? John Adams? Jim Adams?
21 MR. ADAMS: I was a Navy corpsman on USS
22 Tara during the Gulf War. I was augmented with 28
1 other people from the Naval Hospital, Camp Lejeune.
2 Excuse me, I am a little nervous. I was one of the
3 few -- of the many administering anthrax shots, giving
4 pyridostigmine, and I was also receiving the shots and
5 taking the pyridostigmine because we were told at the
6 time that we had a ten-minute life expectancy as
7 corpsmen in the field because of Vietnam, so they
8 expected the same thing and they expected to put us
9 into the field so we had anticipated this.
10 We had followed the regimen of everybody
11 else. We were directly ordered not to give -- or, not
12 to put anything into the service records because
13 everything was secret and at the time I was only an E-
14 2, so I followed my orders. You know, I didn't raise
15 too much of a stink about it.
16 We hit Al Jabal -- we pulled into port Al
17 Jabal on February 15 and we were offloading all of our
18 medical equipment, the oxygen that we had used at
19 Fleet Hospital 5. I was reloading. Well, at 0200, we
20 had a SCUD come in. The air defense system didn't
21 notice it until it was directly above us.
22 And within a few minutes, the Patriots
1 locked onto it and knocked it away from us, out of the
2 sky. But we had chemical detectors going off. We
3 were outside of the shed, standing in line, waiting to
4 go to the telephones that they had there. You know
5 they -- with the chemical detectors going off -- we
6 did not have MOC gear because we were squids, you
7 know, stuck on the ship so we didn't have to worry
8 about that.
9 But shortly after the fact, we had -- I
10 had buddies in line that were having memory loss. I
11 started having skin problems shortly after the
12 incident. I have had skin problems since. I have it
13 on my face. I have it on my arms. I have it on my
14 body. It hurts.
15 I tell people -- or, my wife says I have
16 memory loss but I attribute that to being a man. So
17 I don't know if the memory loss is because of the Gulf
18 or if it is just being me but I worry about it and I
19 have been to Fitzsimmons Army Medical Center.
20 I had a colonel there tell me that he was
21 over there. He didn't -- he was there. He had people
22 there. He didn't see anybody getting sick so it must
1 be psychosomatic. I have been given 40 percent
2 disability, which is great. You know, I am happy for
3 that. It is for chronic labyrinthitis, which I had
4 prior to the Gulf War. I was given 30 percent for
5 that, and also for my skin condition, which they call
6 keratosis pilaris, which was 10 percent.
7 But however, the keratosis pilaris which
8 they have been trying to treat, every treatment that
9 they use for keratosis pilaris does not work. It
10 makes it worse. I have been treated for scabies. I
11 have been given Kwell cream, thinking that I have got
12 crabs or anything like that. I have been through the
13 whole regimen and it doesn't work.
14 So I deal with the 40 percent disability
15 but what I am trying to get across is, it is not
16 money. It is not the compensation that we want. We
17 want the answers. We won't to sit here and get sick.
18 You know, I could care less about the money. You
19 know, everybody can take that back as long as I get
21 I talked to my senator, Al Simpson, who is
22 chairman of the veterans' committee and he is my
1 senator in Wyoming. We had a town meeting in Laramie.
2 I talked to him about Gulf War Syndrome. He told me
3 that Vietnam, that Agent Orange wasn't a factor in the
4 veterans' health since the Vietnam war.
5 So there is no scientific proof of my
6 illness and until we get scientific proof, nothing is
7 going to be done about it. So what do we get? We
8 get, you know, vague diagnoses that do not -- that
9 cannot be treated with the regular regimen and we are
10 told that is it and we are given some money and hope
11 that we shut up.
12 But you know, I am just -- I am confused.
13 And that is why I called Tom yesterday and wanted to
14 come down here and speak because I just want you to
15 know that it is not the money. We just want some
16 answers and I don't want to get any sicker.
17 I don't want to have a heart problem. Or
18 I don't want to have the memory loss but -- once
20 DR. TAYLOR: Okay. Thank you, Mr. Adams.
21 Are there any questions?
22 MR. MCDANIELS: I have a question. Did
1 you say you had no MOC gear? No mask, nothing on your
3 MR. ADAMS: No. We did have masks,
5 DR. TAYLOR: On the ship?
6 MR. ADAMS: Yes. We had masks that we had
7 to carry with us at all times but we had no MOC gear,
8 okay, so we did not have the suits that you have to
9 put on, the gloves, the boots and all that but we did
10 have a regular MR2 mask -- gas mask -- that we could
11 put on, which many did.
12 But once again, my problem is skin, you
13 know, which I had no protection on. We were in a hot
14 climate, short-sleeved shirts.
15 DR. TAYLOR: You mentioned that soon after
16 that exposure with a SCUD missile that several of your
17 cohorts also experienced types of --
18 MR. ADAMS: Yes. They had memory loss.
19 I had a buddy of mine, right after we got back to
20 camp, losing -- he was given a psych discharge because
21 he would actually come in, you would say hi to him,
22 and he would say, Who are you?
1 You know, he did not know who you were.
2 He would just completely forget what his purpose was
3 there. So they gave him a psych discharge. And this
4 was before anybody came up with Gulf War Syndrome.
5 And you know, there were a lot of people getting sick.
6 A lot of us don't want to -- didn't want
7 to bring anything into the open because, you know,
8 they didn't want to have problems with their careers.
9 DR. TAYLOR: What about skin rashes? Did
10 many have skin rashes of --
11 MR. ADAMS: Yes. Other friends of mine
12 have had skin problems that -- do have skin problems.
13 Me personally, I thought mine would go away. I
14 thought I just had a little case of acne, you know.
15 DR. TAYLOR: But this is soon after -- how
16 soon after this?
17 MR. ADAMS: This was probably ten days
18 after the fact that we started -- that I noticed
19 myself that I had skin problems. But I didn't go
20 around and advertise that to people because it was
21 embarrassing, you know. I don't want to tell people,
22 Hey, man, I have got zits, you know, or whatever it
1 is, because it comes up in a hive. It is not actually
2 coming up as a pimple but I scratch because it hurts
3 so bad. And I scratch the worse at night.
4 And I didn't -- I wasn't initially seen
5 until 1992 because I thought it would just go away.
6 DR. TAYLOR: Any other questions?
7 MS. GWIN: I have one. Where were you
8 docked when --
9 MR. ADAMS: Al Jabal.
10 MS. GWIN: Al Jabal?
11 MR. ADAMS: Right.
12 MAJOR CROSS: Have you contacted any of
13 the other members of that unit to see how they are
15 MR. ADAMS: Yes. I have talked to quite
16 a few. Many of them still had skin problems. Some of
17 them have a lot of chest pains and things like that.
18 But you know, I have wondered -- and like I was saying
19 to another person -- me, if I start saying I am having
20 a problem and if I keep attributing it to the Gulf, I
21 feel like I am whining, you know, because nobody
22 really wants to listen to it, you know. So I keep it
1 to myself.
2 When other people say that they are having
3 these problems, I say, Jesus, I hope that doesn't
4 happen to me, you know. But I worry. But me, really,
5 I hate complaining. You know, that is one of my
6 biggest pet peeves, I hate complaining.
7 But it is obvious the more and more I get
8 around these people, the more and more -- I am lucky
9 I just have a skin problem. And you know, I worry
10 about the future, if I come up with anything else.
11 You know, will I just be whining or complaining that
12 it is the Gulf.
13 DR. TAYLOR: Any other questions? Thank
14 you, Mr. Adams.
15 MR. ADAMS: Thanks for letting me ramble.
16 DR. TAYLOR: James Jones.
17 MR. JONES: I served in the Army from
18 1982 -- January of 1982 to September of 1992. I was
19 in the Gulf War during December of 1990 -- or, during
20 the -- was over there in the Gulf from December of
21 1990 to May of 1991. I worked as a mechanic for the
22 73rd Maintenance Company in Germany, attached to 843
1 Artillery, which was a Patriot battalion.
2 When we deployed over there in Saudi
3 Arabia at Al Jabal, we stayed there for approximately
4 two months -- or, approximately a month in Saudi
5 Arabia. When the Gulf War started, we moved into Iraq
6 following the Patriot battalion. The Patriot
7 battalion set up off -- 60 miles approximately from
8 the Kuwaiti border, at which time we had passed
9 several areas that were bombed out and ruins that were
10 totally wiped out where the Iraqis had stayed.
11 I have a condition that was diagnosed in
12 1984 called ulcerative colitis which was not
13 attributed to the Gulf in any way. However, back in
14 1993 after I got out of the service, I started having
15 problems with skin rashes, muscle joint pains, minor
16 muscle joint pains -- not major, stomach cramps which
17 were very severe but however I attributed it to my
18 other condition, the ulcerative colitis, because you
19 do have diarrhea and problems with stomach pain.
20 In 1994, I started having severe skin
21 rashes and what seemed to be allergies -- very bad
22 allergies. The stomach pains were constant. I had to
1 take baths -- hot baths, cold baths -- because I was
2 having hot and cold flashes.
3 I would run severe temperatures of
4 approximately 103 and then they would go away for no
5 apparent reason. I went to the VA Medical Center. I
6 did receive a 30 percent disability for my ulcerative
7 colitis when I was discharged. I went to the VA
8 Medical Center approximately a year ago and had my
9 bone marrow checked and they examined me several
10 different ways with biopsies and surgical biopsies.
11 I was diagnosed with what is a
12 generalization of sarcoid. My white blood cell count
13 was up and my body was actually fighting itself for no
14 apparent reason. The doctors had told me that what
15 the problem was is your body had something in there it
16 is attacking but it doesn't know what it is attacking
17 and it is leaving scar tissue.
18 My liver has been affected and so has my
19 spleen. The doctors have also told me that it is very
20 unusual for a sarcoid to affect the liver and spleen
21 but it is not totally uncommon. It usually affects
22 the lungs. I am currently taking prednisone for it.
1 It keeps it slightly under control but it doesn't
2 totally cure it. There is no known cure and there is
3 no known cause.
4 I have a young child that was born -- he
5 is approximately almost four years old. He was born
6 right after the Gulf War when I returned. He has skin
7 rashes that are starting to occur and we can't explain
8 them because allergy medicines don't seem to work with
9 him. He has stomach pains that I can't explain and my
10 wife can't explain.
11 DR. TAYLOR: Okay. Are there any
12 questions? Can we ask you questions now?
13 MR. JONES: Go ahead.
14 DR. TAYLOR: Questions of the panel? No
16 MR. MCDANIELS: I would like to ask the
17 other public commenters, stand by. Could you see me
18 during the break before you go?
19 MAJOR CROSS: Sir, could I just ask you,
20 what would you like this commission to do for you and
22 MR. JONES: When I went to Saudi, I didn't
1 know anything about the Gulf War Syndrome and Gulf War
2 Syndrome wasn't even in my mind when I got out of the
3 military. The conditions started happening after
5 What I would like the commission to do is
6 set up committees or investigations on what kind of
7 chemicals the Iraqis may have had in the bunkers. If,
8 in conjunction with some of the shots we got --
9 because we had many shots before we went over there as
10 many of the other veterans and active service can
11 attest to.
12 All of us seem to have taken a nerve agent
13 pill. At one time, I did have -- we were ordered to
14 take the pill during -- when the Gulf War started. If
15 we can find out what this is, if it is specific, maybe
16 we can make a difference with Gulf War veterans, all
17 of us. And their families can rest or be a little
18 more comfortable and not have to worry about their
19 spouses passing away on them before they reach a
20 certain age.
21 DR. TAYLOR: Any other questions? Thank
22 you very much.
1 MR. JONES: Thank you.
2 DR. TAYLOR: It is approximately 10:32.
3 We need to take a 15-minute break at this point. And
4 I guess we will back around 12:45, 12:47 -- I am
5 sorry -- I am looking at my watch -- 10:47. Still on
6 Eastern time.
7 (Whereupon, a short recess was taken.)
8 DR. TAYLOR: We are ready to get started.
9 For public comment, I just wanted to announce for
10 those of you who asked to speak today, at the end of
11 this morning's session, if there is still time, we
12 will go in the order of the requests until 12:30. So
13 if there is time at the end, we will have testimony
14 right before lunch.
15 We have with us Colonel Edward Koenigsberg
16 and Lieutenant Moldenhauer. Good morning.
17 COL. KOENIGSBERG: Yes. I am the director
18 of the Persian Gulf War Veterans' Illness
19 Investigation Team which is under the direction of the
20 Assistant Secretary of Defense for Health Affairs.
21 And your commission requested that the team present
22 testimony discussing the personnel assigned to the
1 team and the procedures and processes we use in our
3 We have also provided you with material on
4 54 cases we have initiated to date. A few files are
5 single-incident investigations while others are a
6 series of incidents that are all related to the same
7 possible cause of illness.
8 We also have case files containing
9 information relating to a particular theory provided
10 by veterans or scientists. Material in one case file
11 may be cross-referenced with other files since many
12 theories and incidents are not mutually exclusive.
13 Your staff has requested we discuss
14 certain of the case files to illustrate our procedures
15 and that we give you updates on case files of other
16 specific interest items. We are, however, prepared to
17 respond to questions relating to any of the cases in
18 the files provided to you. I will be assisted, as you
19 mentioned, by Lt. Edward Moldenhauer, a Navy
20 pharmacist with prior experience as an Army military
21 intelligence analyst.
22 We would like to point out that although
1 there are teams within the Department of Defense
2 involved in the clinical and research aspects of
3 Persian Gulf illnesses, we are the only team dedicated
4 to the actual overall investigation, coordination, and
5 analysis of information on this issue.
6 Therefore, in addition to our primary
7 mission, we have many additional responsibilities,
8 which we listed in the packet we provided for you. As
9 requested, we have also provided written testimony
10 outlining the resources allocated to our investigation
11 effort. These resources not only include the monetary
12 aspects of our operation but also our staffing.
13 A biographical sketch for each staff
14 member has been provided. As you can see on this
15 slide, the team's composition is a mix of diverse
16 individuals. Before discussing the case files of the
17 team's investigations, I would like to discuss general
18 procedures we use for conducting the investigations.
19 The team initiates a case file based upon
20 information we receive which may have a relationship
21 to Persian Gulf veterans' illnesses. This information
22 may come from eye witnesses to an event, a health care
1 provider theory, testimony to various committees or
2 from other cases being investigated.
3 In most instances, we do not take the
4 recollection or theory of one individual and regard it
5 as factual until we are able to substantiate it by
6 several sources. These sources, such as additional
7 interviews, literature research, expert consultations,
8 or physical evidence allow the team to reconstruct an
9 incident or clarify a theory.
10 Once we have compiled enough preliminary
11 information to feel comfortable in addressing the
12 issue, the team as a group discusses the item and runs
13 it through a logic test. The test, simply stated,
14 allows the team to determine if the item truly has
15 relevance to the Persian Gulf veterans' illnesses --
16 a filter, if you will.
17 We also determine if the item falls within
18 our area of expertise and whether we can expect
19 results from further efforts of investigation. This
20 process is similar to that of an institutional review
21 board or IRB. If the item brought to our attention
22 falls outside the team's scope or expertise, we relay
1 the information to other more suitable experts for
2 review or analysis.
3 Within the Department of Defense there
4 exists a wide spectrum of medical, scientific, and
5 operational experts to consider such proposals. An
6 example of this would be a proposal such as for a
7 long-term epidemiologic study, which we wouldn't be
8 able to do but which other people within the system
10 As you can see, the team dedicates a
11 significant amount of time to preliminary
12 investigation prior to it actually becoming a formal
13 case file. During the investigation itself, we use
14 telephonic interviews, personal visits, literature
15 research, consultation with experts and government
16 agencies and civilian institutions and other DOD
17 assets required to resolve an issue.
18 When a case file has reached the point
19 where the team feels it is unlikely to obtain
20 additional information, we still maintain the file as
21 open but no longer considered active. At that point,
22 we prepare an interim report for GulfLink.
1 We do review all cases on a regular basis
2 to determine if new information has become available.
3 There is always the possibility of new information
4 surfacing prior to our scheduled termination date of
5 June '97. We continually monitor testimonies and
6 theories presented at congressional hearings,
7 scientific meetings, and the PAC panel meetings for
8 new information.
9 Also, we continue to monitor the
10 operational and medical records undergoing
11 declassification. The scheduled completion date for
12 record processing is not until December 1996. It is
13 intuitive that as June '97 approaches, we must compile
14 a final summary report on our investigated efforts.
15 In the interim, we will continue to
16 generate reports and testimonies concerning our
17 efforts which, when applicable, are released for
18 public examination and review. We also meet regularly
19 with the Assistant Secretary of Defense for Health
20 Affairs and additional members of his staff who are
21 working in other areas relating to the Persian Gulf
22 illnesses. We provide these individuals with
1 information assisting them in their particular
3 In addition to a final report, our team
4 has an electronic archive system which is being
5 constructed. This archive will house the collection
6 of our computerized investigation case management
7 system, other supportive data bases, and the document
8 repository of the Persian Gulf war veterans' illnesses
9 health-related documents. This amassing of data will
10 be concluded by the summer of '97.
11 Obstacles to our investigative efforts
12 revolve around three primary issues. First is the
13 inability to locate individuals for interview
14 purposes. The Defense Manpower Data Center, Monterey,
15 California, maintains a data base of several members'
16 last-known addresses.
17 These -- this address is current at the
18 time the member discharges from active duty or
19 separation from the reserves or National Guard. If
20 the service member has remained on active duty or is
21 a drilling reservist or guardsman, they are
22 considerably easier to locate and contact.
1 Nevertheless, you can imagine the time spent to locate
2 a veteran who separated immediately after returning
3 from the Persian Gulf war.
4 The second difficulty is determination of
5 unit locations during the war. During our
6 investigation of a particular incident, the
7 identification of all units, their location during a
8 specific time period and subsequently all personnel
9 assigned to those units is very time-consuming. Once
10 the environmental support group data base becomes
11 available, this part of our investigation should be
12 accomplished more rapidly.
13 Our last obstacle deals with the lag time
14 associated with declassification and digitization of
15 the Persian Gulf war illnesses-related documents.
16 Until all record processing is accomplished in
17 December '96, our investigations remain incomplete.
18 It would be a disservice if we closed the case file
19 and the last piece of paper digitized contained key
20 information relating to Persian Gulf war illnesses.
21 Therefore, our investigative efforts will continue
22 until proper analysis of all digitized documents is
2 At this time, I would like to turn the
3 testimony over to Lt. Moldenhauer.
4 LT. MOLDENHAUER: As stated in previous
5 testimonies, the team does not focus its efforts
6 strictly on chemical warfare issues. Our case files
7 do, however, appear to be skewed in the direction of
8 chemical warfare issues. This is due to the
9 sensitivity of this topic.
10 Our charter is to investigate any
11 plausible theory relating to Persian Gulf veterans'
12 illnesses and to guarantee we do not overlook any
13 possible cause. Many of our files interrelate and
14 some also provide supportive information to overall
15 subject area reviews.
16 In order to efficiently discuss our case
17 files, they are arbitrarily separated into general
18 file categories. The team bases its investigations on
19 information identified to date, realizing that new
20 data may be added. For your assistance, a list of
21 acronyms used throughout our case file summary sheets
22 has been provided.
1 I will now address several of our
2 representative files. This first slide illustrates
3 the diverse subject matter investigated by the team.
4 These categories are for administrative and
5 presentation purposes only.
6 Your staff has requested we discuss the
7 thallium toxicology case file. We identified the
8 thallium exposure theory during a review of
9 declassified intelligence information released on
11 A civilian physician employed by the
12 Kuwaiti government from 1978 to 1983 recalls the use
13 of thallium rat poison some time during the time
14 period of 1980 to 1981. He recalls the
15 hospitalization of many Kuwaiti civilians having the
16 same symptoms as Persian Gulf war veterans.
17 He proposed that thallium residue in the
18 soil was dispersed into the atmosphere during the
19 extensive military operations in Kuwait. In a review
20 of the medical and toxicological literature, thallium
21 exposure does produce some symptoms similar to those
22 seen in Persian Gulf veterans.
1 These symptoms, such as fatigue, mood
2 changes, pain in the leg and arms, hair loss, and
3 peripheral neuropathy may occur some time after
4 exposure and last for months or years. The team
5 consulted members of the Armed Forces Pest Management
6 Board to determine if U.S. forces used thallium rat
7 poisons during Operations Desert Shield/Desert Storm.
8 The Pest Management Board stated that U.S.
9 forces used only anticoagulant-based, not thallium-
10 based, rodenticides. Thallium was an item of interest
11 during Operation Vigilant Warrior in '94. CENTCOM's
12 problem definition and assessment -- PDA -- team,
13 comprised of infectious disease, epidemiology,
14 laboratory, and environmental and occupational health
15 experts conducted soil and air sampling and discussed
16 this issue with the Kuwaiti Ministry of Health.
17 The U.S. Army Center for Health Promotion
18 and Preventive Medicine performed the soil sample
19 analyses and found no thallium present. The Kuwaiti
20 Ministry of Health stated that thallium rodenticides
21 were not used. We are investigating the possible
22 Saudi Arabian use of thallium rodenticides even though
1 the soil samples tested were negative.
2 Although the symptoms of Persian Gulf
3 illnesses mimic that of thallium exposure, we are
4 unable to substantiate the claims of thallium use or
5 presence in Kuwait prior to or during Operations
6 Desert Shield/Desert Storm. Therefore, current
7 evidence does not support the theory that thallium is
8 an underlying cause of veterans' illnesses.
9 I will now discuss depleted uranium as a
10 representative environmental health-related case file.
11 Depleted uranium, or DU, is a recognized hazard in
12 today's modern battlefield. I am sure the committee
13 realizes the importance of this matter as evidenced by
14 the numerous veterans' testimonies and reports in the
16 The issue of DU relates to the possible
17 contamination by heavy metal uranium dust and the
18 associated radiation. DU is present in armor-
19 penetrating munitions used by coalition forces. In
20 order to understand the dynamics of DU munitions, we
21 consulted weapons experts and research specialists at
22 the Armed Forces Radiobiological Research Institute.
1 The team reviewed medical literature to
2 educate ourselves on the heavy medical -- excuse me,
3 heavy metal and radiological effects of DU. There
4 exists several detailed technical reports by AFRE, the
5 U.S. Army Environmental Policy Institute, the
6 Government Accounting Office, and CHPPM, each
7 discussing the hazards associated with DU.
8 We reviewed congressional testimony
9 specific to DU as well as the Institute of Medicine's
10 health consequences of service during the Persian Gulf
11 war report. We have reviewed CENTCOM's PDA report on
12 residual DU findings and their discussion of the issue
13 with the Kuwaiti Ministry of Health.
14 Eyewitnesses identified through various
15 testimonies and our 1-800 incident reporting hotline
16 have also been interviewed. The net result of our
17 investigative effort is that current literature and
18 research do not indicate that DU is a likely cause of
19 Persian Gulf illnesses.
20 It is evident that many soldiers were
21 around vehicles destroyed by DU munitions without
22 taking proper protective measures. Additional
1 research is definitely required. The Baltimore VA is
2 currently following approximately 30 veterans with
3 embedded DU fragments and the Boston VA is following
4 approximately 25 veterans of the U.S. Army 144th
5 Maintenance Company.
6 The latter unit was responsible for the
7 recovery of DU-contaminated vehicles and may have been
8 exposed to breathable DU dust. To date, no evidence
9 has been found to connect DU exposure to physiological
10 conditions in these patients. The team will continue
11 our monitoring of the research efforts of these two
12 study groups.
13 The team's file category labeled, Medical
14 Policy and Clinical Issues, deals with health care
15 provider theories. The committee staff requested that
16 we discuss two of these case files, mycoplasma and
17 delayed neurotoxicity. The mycoplasma case file being
18 investigated by the team is multi-faceted.
19 Mycoplasma and myco-organism has been
20 proposed as an infectious disease in Persian Gulf
21 veterans. Also presented was the theory that
22 mycoplasma were intentionally genetically manipulated,
1 thus implying an offensive weapon technology.
2 Finally, it has been proposed that
3 mycoplasma was a contaminant in the vaccinations given
4 to U.S. forces. In order to effectively investigate
5 each of these theories, this case file was divided
6 into several facets.
7 Mycoplasma species cause human disease,
8 usually seen in patients with severely compromised
9 immune systems. Many of the symptoms exhibited by a
10 mycoplasma infection are similar to those associated
11 with Persian Gulf illnesses. Mycoplasma are difficult
12 organisms to identify and the illnesses are equally
13 difficult to treat.
14 Mycoplasma are an endemic organism in
15 southwest Asia. The team consulted with medical
16 experts at the National Naval Medical Center, the
17 Armed Forces Institute of Pathology, the National
18 Institutes of Health, the Center for Disease Control,
19 the Veterans' Administration, medical personnel at the
20 U.S. Embassy in Kuwait, and the academic research
22 We presented the issue of genetic
1 manipulation to these same experts. There is no
2 evidence supporting the possibility of genetic
3 manipulation of mycoplasma. Experts at the U.S. Army
4 Medical Research and Materiel Command, the Armed
5 Forces Medical Intelligence Center, and one prior
6 technical director of the U.S. Army Biological Weapons
7 Laboratories, which was dis-established in 1969, all
8 located at Fort Detrick, Maryland, addressed the issue
9 of possible mycoplasma weaponization.
10 These experts and the intelligence
11 information review to date identify no known
12 biological warfare research on mycoplasma being done
13 worldwide nor had the U.S. ever done any biological
14 warfare research on mycoplasma. Additionally, the
15 experts state that the technical capability to
16 genetically engineer this organism does not exist
18 Presidential Advisory Committee staffers
19 testified at the June 1996 meeting on the issue of
20 mycoplasma vaccine contamination. Their testimony
21 stated that this contamination is not possible due to
22 the techniques used in vaccine preparation. The
1 available evidence agrees with this assessment.
2 We also consulted the U.S. Army Medical
3 Research Institute for Infectious Disease to answer
4 the question, "Did Fort Detrick supply vaccine
5 precursors to manufacturers?" USAMRIID states that no
6 anthrax or botulinum toxoid precursors were ever
7 provided to vaccine manufacturers.
8 After all literature reviews and expert
9 consultations, there does not exist enough substantial
10 evidence to support any theory linking mycoplasma to
11 Persian Gulf illnesses. We also find no evidence to
12 suggest that mycoplasma described is a result of
13 biological warfare research. Since mycoplasma is
14 endemic in the area, medical research should continue.
15 The issue of delayed neurotoxicity is
16 being investigated as a result of the work being done
17 at the University of Texas. The theory behind delayed
18 neurotoxicity, more precisely identified as
19 organophosphate-induced delayed neurotoxicity relates
20 to "low-level" exposures to organophosphate
21 insecticides and/or consistent with nerve agents.
22 This low-level exposures theorizes being
1 able to produce chronic neurological symptoms similar
2 to those exhibited in Persian Gulf veterans. The
3 University of Texas study also attempts to link this
4 low-level exposure and at the same time the use of
5 pyridostigmine bromide.
6 We have done extensive review of the
7 medical literature and available operational data.
8 The team has also studied the Armed Forces
9 Epidemiological Board literature review and report of
10 information on this same subject.
11 We have reviewed the CCEP data and
12 consulted with experts within the Department of
13 Defense, federal government, and academic research
14 communities. Based on our investigation in the review
15 performed by the Armed Forces Epidemiological Board,
16 current research on this topic concurs with the
17 findings reported by the Presidential Advisory
18 Committee staffers at the June 1996 meeting, that
19 there is no current evidence supporting the existence
20 of chronic illnesses derived from exposure to low-
21 level organophosphate agents and that further research
22 is required. The team will continue to monitor the
1 progress of ongoing research efforts in this area.
2 To shift gears slightly, the following
3 slides will address several case file updates
4 requested by members of your staff. As mentioned
5 earlier in our testimony, there are times when case
6 files are grouped together, all relating to one issue.
7 In this case, low-level chemical exposure. The case
8 files shown build upon or are supportive of one
10 For today's testimony, I will update the
11 chemical and biological warfare facilities and target
12 destruction, the Czech and French detections and the
13 37th Engineering Battalion, Khamisiyah ammo depo case
14 files. As the team has testified to in the past, we
15 are examining the possibility of low-level chemical
16 agent exposure from several perspectives.
17 We are examining the possibility that
18 chemical agents were released as fallout from
19 coalition bombing of Iraqi chemical production and
20 storage facilities, or by ground force destruction of
21 chemical munitions sites. We are continuing to work
22 closely with the CIA in this effort.
1 Air targeting and battle damage
2 assessments of suspected chemical facilities have been
3 compared to post-war UNSCOM inspections of these
4 suspected sites. As CIA previously reported to you,
5 munitions or bulk chemical agents at only three sites
6 were destroyed by coalition forces. These sites are
7 Mahmudiyah and Al Muthana during the air war and
8 Khamisiyah, which I will discuss shortly.
9 Satellite imagery has been analyzed and
10 since these sites were bombed repeatedly, our efforts
11 are now being placed on identify the exact day that
12 designated chemical bunkers were destroyed. The Air
13 Force is assisting us in analyzing over 4,000 hours'
14 worth of archived aircraft cockpit or gun camera
15 videos and attempting to tie this to the UNSCOM data
16 which describes the specific chemical-containing
17 bunkers. This is an extensive effort and we plan to
18 keep the committee updated as to the status of the
19 video analysis. Determining the exact time and day
20 will allow the CIA to further refine their modeling of
21 downwind hazards.
22 Just need to look over this slide before
1 I continue my testimony. As stated in prior
2 testimony, based upon the information available at
3 this time, the available evidence indicates that the
4 Czech detections of 19 to 14 January 1991 are
5 credible. The other Czech and French reports are
6 unsubstantiated although they cannot be discounted.
7 The reported mustard agent detection of 24
8 January 1991 still remains unresolved in the absence
9 of any evidence of an attack. Our report of the
10 Czech/French detection is complete and has been
11 released on GulfLink as of the other day, so it is
12 currently on GulfLink.
13 Efforts to solidify information on all the
14 units located at Khamisiyah ammunition depot are still
15 ongoing. Through our interview of eyewitnesses and
16 operational unit logs, we have been able to ascertain
17 many of the additional units in the immediate area.
18 CIA has modeled exposure limits for this
19 site. A worst-case analysis indicates that a
20 potential agent release from bunker 73 would result in
21 an area of approximately 25 kilometers in a general
22 east by northeasterly direction, not meeting the safe
1 level of continuous human exposure for 72 hours.
2 After identifying the units who were
3 directly involved in the demolition operation at
4 Khamisiyah, we have contacted over 60 members of the
5 37th Engineering Battalion and travelled to Fort
6 Bragg, North Carolina to interview key personnel still
7 on active duty.
8 We have enlisted the efforts of an Army
9 explosive ordnance disposal -- EOD -- specialist who
10 is currently assisting in the analysis of operational
11 records and unit logs of the various EOD teams
12 deployed during the Persian Gulf war.
13 This addition of an EOD specialist may
14 also aid in the possible identification of other
15 ammunition storage sites which may have also contained
16 chemical munitions. This case file investigation on
17 EOD activities will be fruitful in clarifying the
18 question of whether or not there are other Khamisiyahs
19 existing in the theatre of operations.
20 We will continue to investigate
21 circumstances surrounding the pit area destruction to
22 determine a more detailed description of the pit and
1 the number of missiles destroyed there on 10 March
2 1991. This information is important for modeling any
3 agent release during the demolition operations at that
4 site. We will then attempt to identify units which
5 may have been exposed on 10 March. We hope to have
6 this item resolved by the end of August.
7 COL. KOENIGSBERG: As you can see, the
8 actual procedures required for each case file are
9 unique to that case. Medical hypotheses,
10 toxicological and conditional investigations require
11 significant reviews of the medical literature.
12 Incident or event investigations, such as
13 Khamisiyah, require substantial resources dedicated to
14 reviewing intelligence and operational records as well
15 identifying, locating, and interviewing eyewitnesses.
16 Team members have travelled to obtain information on
17 a first-hand basis to Kuwait, to individual units, and
18 to technical experts in the field being investigated.
19 We consult subject matter authorities both
20 within the Department of Defense and the civilian
21 sector to assist us with their expertise or to analyze
22 information and samples. The Persian Gulf War
1 Veterans' Illnesses Investigation Team is striving to
2 fulfill its mission of identifying the underlying
3 causes associated with veteran' illnesses.
4 We have tried not to become too focused on
5 one specific issue. If we did, me might miss an
6 opportunity to discover a new and valuable piece of
7 information. This piece of information might be the
8 key to solving the puzzle of the Persian Gulf war
9 veterans' illnesses. Thank you for this opportunity
10 to present our findings.
11 DR. TAYLOR: Thank you. Col. Koenigsberg,
12 I am going to start out with questions on, how does
13 PGIT decide which matters to investigate?
14 COL. KOENIGSBERG: We -- as we said in our
15 testimony here, we look at anything that has been
16 proposed to us. And it will be assigned to an
17 individual who then will go out and do the preliminary
18 investigation to see what is out there and bring it
19 back to the committee and then we sit and decide, on
20 a priority basis, which things we can hit first and
21 which things we put back further in the que. Nothing
22 is ever taken off the list.
1 DR. TAYLOR: So how do you determine which
2 is priority versus something else?
3 COL. KOENIGSBERG: Based on the fact of,
4 do we feel that we can expect to find something on
5 this particular issue. I think, you know, if an issue
6 is such that there is not a lot of material out there
7 that you can find or there would be no way to prove
8 it, then it would go further down the list.
9 If it is something where you can go out
10 and get your hands around it to find something that
11 will either prove or disprove the issue, then that
12 would go more to the front of the list. And I think
13 some of, also, what has been done in prioritizing is
14 based on what -- on the pressures from the outside as
15 well. Obviously, the business of chemical exposure
16 has a lot of supporters. This business of mycoplasma
17 has a lot of supporters. There has been a lot of
18 these issues that have been brought up where people
19 have come forward quite strongly that they feel these
20 are issues that need to be resolved and so they are
21 going more to the front of the list.
22 DR. TAYLOR: You mentioned long-term
1 epidemiological studies as being one example of an
2 item that could be filtered out from and I was just
3 wondering, how do you decide what not to pursue and
4 what else has PGIT decided not to pursue?
5 COL. KOENIGSBERG: If it is a long-term
6 epidemiological study would not be within our
7 capability of doing so we would refer this out. If it
8 is something that would necessarily have to go to a
9 research group to look at, then we would turn it over
10 to the research people very early on. We may turn it
11 over with a recommendation that we think this thing is
12 of interest and we think you ought to take a look at
13 it and make a decision as to whether further research
14 needs to be done. They have the expertise to consider
15 the possibility of what could be done from a research
17 DR. TAYLOR: I wanted to refer -- are
18 there any questions, Marguerite?
19 MAJOR KNOX: I have just a couple for Col.
20 Koenigsberg. I know that one of your biggest tasks
21 has been to declassify all the classified material.
22 Is that correct?
1 COL. KOENIGSBERG: We don't declassify.
2 We are the customers. We get it. So we get the
3 material before it is declassified. We also see what
4 goes on to GulfLink in terms of what has been
5 declassified. So we are the customer.
6 DR. TAYLOR: Do you review all documents
7 that appear on GulfLink? You do?
8 COL. KOENIGSBERG: We do. And one of the
9 problems we are having right now with the classified
10 documents is the fact that -- and we are trying to
11 work through this -- is we have over 800,000 pages of
12 material that has been given to us. A lot of this is
13 duplicates, triplicates, and quadruplicates because
14 the same message would go out to -- if it came, say,
15 from Defense Intelligence Agency, it might go to Army,
16 Navy, Air Force intelligence circles, everything, so
17 we may get the message four times.
18 So what we are trying to do is to weed
19 this out to get it down to a workable level. We also
20 use search engines primarily to go looking for
21 something. If we are looking for an item, then we
22 would use a search engine to go in and find anything
1 related to that particular item for us. And we have
2 something called Pathfinder now that has been
3 developed by the intel community that shows
4 relationships between data.
5 MR. RIOS: Let me ask a few questions
6 here. I am sorry, were you --
7 MAJOR KNOX: Go ahead.
8 MR. RIOS: Is there -- has there ever been
9 a model or have we ever -- has the government ever
10 undertaken the task of trying to confirm low-level
11 detections of chemical exposures in any other military
12 engagements or is this something that we are doing for
13 the first time?
14 COL. KOENIGSBERG: I don't know of any
15 previous attempt to do this and even try and do it on
16 this one. In this particular instance, I don't know
17 that you could qualify it as an attempt to confirm
18 low-level. I think there is a lot of research going
19 on and there is new research that will look at, what
20 are the effects of low-level.
21 But the question that has been asked, Is
22 there low-level, the problem is, how do you answer
1 this and how do you research it? If the level is so
2 low that it doesn't cause symptoms and it doesn't
3 cause the alarms go off, then how can we prove that
4 there has been low-level -- you know, that there has
5 been a low level of chemicals there?
6 That has been the problem all along. It
7 is very easy to say, yes, there is definitely or there
8 should have been low level there but to prove it --
9 MR. RIOS: Well, what is the process that
10 you are using in this particular instance to see if
11 you can reach a determination as whether or not you
12 can confirm a low-level detection?
13 COL. KOENIGSBERG: I don't think that the
14 answer comes from the investigation. I think the
15 answer to this is going to come from the idea of
16 looking at the people that are being evaluated within
17 the CCEP program and within the veterans' registry.
18 And I think the answer will come from
19 research that is being done because all previous
20 research on this has never shown that low-level causes
21 any problems in people. So if you go back to the
22 literature, there is nothing there. Does that mean
1 that it can't happen? No. Nobody is saying that.
2 What we are saying is that at least research that has
3 been done to date has never shown a connection between
4 low-level exposure and somebody developing a chronic
5 problem unless that low-level was on a long-term basis
6 and even those studies that were done -- and this goes
7 back to the German studies -- that was done on people
8 who were working in manufacturing places for years
9 making the material and they developed some problems
10 but the studies were never -- they were never done
11 with the idea in mind of what we are looking for
13 MR. RIOS: Well, let me try and
14 understand. You are saying is that you are not
15 engaged right now in the process of trying to confirm
16 any detections of low-levels of chemical exposure. Is
17 that correct?
18 COL. KOENIGSBERG: We started out, as we
19 told you in one of our previous testimonies, looking
20 for exposures. And what we found is --
21 MR. RIOS: What do you mean by exposures?
22 Any exposures?
1 COL. KOENIGSBERG: That is why I am
2 leaving it as a general -- yes, as a general
3 statement. We started looking at --
4 MR. RIOS: Low levels, high levels?
5 COL. KOENIGSBERG: Any level, right. And
6 we determined that the only thing that we could
7 contribute to this is if we could prove that there had
8 been an exposure. And how would you prove that there
9 would be an exposure, would be that someone had gotten
10 sick with an acute exposure and you saw some effects
11 in the field.
12 What we found when we went out and as was
13 testified to this committee, there is no evidence of
14 that. As far --
15 MR. RIOS: But that is a pretty high
16 standard, isn't it? I mean, if you -- we know that
17 nobody got sick. I mean, so that -- the answer to
18 that is no.
19 COL. KOENIGSBERG: That is correct.
20 MR. RIOS: But we knew that before you
21 went out on it.
22 COL. KOENIGSBERG: Right.
1 MR. RIOS: The question is, what are you
2 doing now to try and confirm lower levels of --
3 COL. KOENIGSBERG: As I said before, there
4 is nothing we can do other than look for positive
5 evidence that either there was the use of chemicals,
6 which we have found none. People got sick, which we
7 have found none. We are looking at the possibility of
8 collateral from bombing and from the effects of the --
9 MR. RIOS: Well, what about --
10 COL. KOENIGSBERG: -- demolition of sites
11 and those are things we can look it.
12 MR. RIOS: What about these kits that have
13 been off?
14 COL. KOENIGSBERG: Kids that what?
15 DR. TAYLOR: Test kits? Detection --
16 MR. RIOS: Test kits that went off. A
17 lot --
18 COL. KOENIGSBERG: As we have testified
19 previously to you all, the -- what you have to look
20 for is positive evidence. These tests have many false
21 positives. These tests have a lot of things that will
22 trigger them off. Therefore, you have to look for
1 something -- and we did look for evidence.
2 We looked at sampling that has been
3 done -- samples that have been sent back to the United
4 States. We looked through the 256 kits that were
5 done. We looked at all of these things and what it
6 boils down to, you have a bunch of alarms that went
7 off. Does that absolutely prove that there was a
8 chemical there? No. It is suspicious.
9 What we are doing is, we are trying to
10 gather as much data as we can on when alarms occurred.
11 We want to put this into a data base to see if there
12 is some pattern to this that would look suspicious.
13 If there is a wave of these things that comes down
14 that shows some kind of a pattern for it, then that
15 would be helpful.
16 We do know that there were more alarms at
17 the beginning. And we have done this and we did show
18 this to you once before. There were more alarms at
19 the beginning of the air war and at the very beginning
20 of the ground war. Now, does this mean that something
21 was used? That is a decision you can make.
22 MR. RIOS: What I am saying, though, is
1 besides all these alarms going off, you also have the
2 reality that there were chemical weapons all over the
3 area. There was a lot of bombing going on. There was
4 a lot of personnel or witnesses from troops that were
5 there. It seems to me that the most logical
6 conclusion would be that there was probably something
7 there rather than, Well, we don't know. You know, I
8 mean, it is not like it is just a guess. There is a
9 lot of things to suggest that there may have been
10 something there rather than --
11 COL. KOENIGSBERG: We are dealing in
12 facts. We will leave the idea of making conclusions
13 like that to others. But we are looking for facts.
14 We have not found facts.
15 MR. BROWN: Can I just follow that point
16 up? I guess I share some of Rolando's uneasiness with
17 that criteria for exposure to the low-level chemical
18 weapons. And I guess -- I think if you -- by the
19 analogy to our occupational or work setting, factory
20 setting, if we had the criteria that we would only be
21 worried about a factory exposure to a solvent or to
22 some process, we would only get worried if we had
1 examples of, you know, people who are dead or dying or
2 seriously injured, we would have a seriously different
3 Occupational Safety and Health program than what we
4 have today.
5 And I guess, you know, I guess I am uneasy
6 that with such a high standard, that you sort of pre-
7 judge. You will never be able to show an example of
8 exposure to chemical weapons despite all the
9 eyewitness accounts and other testimonies that we have
10 heard. With that -- with the high level of -- the
11 high standard that you have set precludes the
12 possibility of ever coming up with a positive.
13 COL. KOENIGSBERG: I think your analogy is
14 a good one, Mark, but I take it a different way than
15 what you are saying. If you go back to private
16 industry and how we work with, say, asbestos
17 poisonings and things of this nature, I don't think we
18 wait exactly until people die in order to say that
19 this is a standard that we set. There are standards
20 set by OSHA and others that are based on the fact,
21 okay, if there is laboratory data that can show some
22 safe level -- and OSHA and other places have come out
1 with safe levels to say, This is what a safe level is,
2 then they set up laws to control this.
3 We are not saying that we are in the
4 business of setting the laws. I think whatever
5 exposure precautions that need to be taken are not
6 based on the fact of what we are doing. What we are
7 still dealing with is the factual information, whether
8 there is something there.
9 And I think that you all keep asking us to
10 prove something that is impossible to prove. I mean,
11 what is the level? What will prove it?
12 MR. BROWN: Let me clarify my analogy. I
13 was thinking if you have an occupational situation
14 where you know that that factory is using some solvent
15 that has certain toxic properties, you might not
16 necessarily wait until you had actually sick people.
17 You might want to do some investigations
18 to consider what kinds of health effects you are going
19 to see --
20 COL. KOENIGSBERG: Exactly.
21 MR. BROWN: -- what should we expect to
22 see in this population? You wouldn't wait to find
1 somebody who is actually poisoned. That --
2 MR. JONES: Exactly. And that is where
3 the research comes in. That is what I am saying, that
4 research is being done and can be done and we suggest
5 it be done on low-level exposure, what is the
6 realities of low-level exposure?
7 There has been a lot of low-level exposure
8 studies done at this point and you all reviewed a lot
9 of them.
10 MR. BROWN: Can I just follow that up,
11 too, with the general issue of exposure is obviously
12 very important, not just for chemical weapons but for
13 any of the risk factors that we are concerned about
14 and the Gulf War veterans are concerned about: the
15 pyridostigmine bromide, the rates that vaccines were
16 used with Gulf War veterans, the depleted uranium --
17 the exposure to depleted uranium of troops in the
18 Gulf; how are you going about assessing those types of
19 exposures where again, you might not expect, say, in
20 the case of depleted uranium other than those
21 unfortunate individuals who actually received so-
22 called friendly fire incidents and have depleted
1 uranium in their bodies.
2 What criteria do you set for, say,
3 assessing the exposure of, say, depleted uranium or
4 anthrax where we know from the start that we have very
5 poor records of anthrax -- of the use of anthrax
6 vaccines on our veterans. And if you go in and just
7 assume, Well, we are only going to use, you know,
8 somebody who, say, showed a negative effect from
9 anthrax vaccine, you know, you have already said that
10 you are going to find nobody.
11 COL. KOENIGSBERG: Yes. The problems, if
12 you take anthrax as part of it, is there is, right
13 now, no good list of who exactly got the anthrax
14 vaccine. So here is a good example of saying, it
15 would be great from a research standpoint if we knew
16 everybody exactly who had gotten the anthrax vaccine.
17 We don't know. We have made extensive
18 efforts to try and find immunization records and
19 unfortunately we have not had any more success than
20 anybody else has had to determine everybody who got
21 anthrax. So what can be done about looking at anthrax
22 is certainly limited because we can't go back and
1 compare the physical health of these people compared
2 to the people who didn't get anthrax vaccine.
3 MR. BROWN: Because the records aren't
5 COL. KOENIGSBERG: Because the records
6 aren't there. And I think this is part -- goes back
7 to the question you were asking, Dr. Taylor, you know,
8 how do we select some of these?
9 Well, in an initial evaluation, if we
10 can't find the records on some of this material, we
11 didn't close it, we still have people out there
12 searching for this but if somebody comes up with a
13 list, then it will open the whole ballgame up again on
14 these vaccines.
15 So if we can't find it, then the only
16 thing we can go back to is the same kinds of things
17 that you all have done in looking at the research
18 community, looking at the fact that the anthrax
19 vaccine has been given to thousands of people prior to
20 going to Desert -- before it was ever used in Desert
21 Storm and none of these symptoms ever showed up in
22 those people
1 Now, you know, that is facts of it right
2 now. As far as where do we go from here with it, in
3 so many of these items, I think it is going to be left
4 not to the actual research that we can do or the
5 investigation that we can do but what kind of research
6 can be done on it. And there -- in many of these
7 areas, there is continuing research.
8 MR. RIOS: Let me make sure I have got
9 this straight just so -- and then I will pass it on.
10 Right now, you are not actively engaged in trying to
11 determine whether or not you can confirm an actual
12 low-level exposure incident. Is that correct? I
13 mean, you are not --
14 COL. KOENIGSBERG: No. That is not true.
15 We are -- we showed a list of incidents, many of which
16 are still open, that we are looking at for exposure.
17 We do look at the incident and you know, like was
18 mentioned here with Al Jabal, when a SCUD missile
19 comes over, we look at the incident.
20 We have looked at it. We know that there
21 were two days in particular that were -- where SCUD
22 missiles came over that site. We know that they went
1 out and did testing. We talked to the chemical
2 officer in that area that was responsible for checking
3 this out and we know that they didn't find anything.
4 We know that there is manufacturing plants
5 in that area and that these people were constantly
6 being exposed to ammonia and other things that were
7 coming off of some of the plants. We know that there
8 was a Navy team that went in and checked these plants
9 and came back and said that their OSHA standards were
10 pretty good. We have done a lot of work in --
11 MR. RIOS: But right now, you cannot say
12 there have been any confirmations. Is that correct?
13 COL. KOENIGSBERG: That is correct.
14 MR. RIOS: In 1996, there is still no
16 COL. KOENIGSBERG: No, sir. But they
17 haven't stopped looking. That is the other thing.
18 MR. RIOS: Well, we are going to be
19 looking forever. We are never going to find it.
20 COL. KOENIGSBERG: No.
21 MS. GWIN: What are you saying there has
22 been no confirmations of?
1 DR. TAYLOR: Low level.
2 COL. KOENIGSBERG: Of low -- at the low-
3 level --
4 MS. GWIN: Low-level exposure, low-level
5 releases or what? Because you have confirmed the
6 Czech detections.
7 COL. KOENIGSBERG: Yes.
8 MS. GWIN: Two of them, although not
10 COL. KOENIGSBERG: Yes.
11 MS. GWIN: So what are you saying? It
12 does appear, from your previous testimony, that you
13 are attempting to confirm instances of reported --
14 COL. KOENIGSBERG: Yes. That is correct.
15 MS. GWIN: -- CW releases and that you
16 have confirmed one exposure. That is Fisher.
17 COL. KOENIGSBERG: Right. And we do know
18 that there is a very highly suspicious at Khamisiyah
19 which appears to be a release of something at that
20 particular site. Yes.
21 MS. GWIN: And then the other two sites
22 where CIA has confirmed that they were bombed --
1 COL. KOENIGSBERG: Well, yes. There
2 were --
3 MS. GWIN: -- Mahmudiyah.
4 COL. KOENIGSBERG: -- releases but the
5 question would be did U.S. troops have any exposure
6 from that.
7 MS. GWIN: And then you have confirmed two
8 of the Czech detections but then as your slide
9 indicated today, you have left others unresolved. And
10 from your previous testimony, I can't understand your
11 basis for differentiating between those types of
12 detections because you have told us you have evaluated
13 the Czech equipment and found it adequate and that
14 they used more than one type of detection device in
15 the field.
16 Your problem with it is that you are
17 unable to identify the source. And so I wonder what
18 the difference is between the Czech detections that
19 you have confirmed and the Czech detections that you
20 have left unresolved.
21 COL. KOENIGSBERG: The two that were
22 confirmed were based on the fact that they did the
1 full analysis. We do not have enough information on
2 the other detections to know whether they used their
3 full-scale analysis as they did in the first two.
4 The same thing with the French detections.
5 There was no follow-up and there is no data that we
6 have been able to get from either the French or the
7 Czechs to show us that they did the full evaluation as
8 they did in those two particular instances.
9 MR. TURNER: Have you tried to get data
10 from the Czechs?
11 COL. KOENIGSBERG: Yes.
12 MR. TURNER: You have contacted the Czechs
13 and the French?
14 COL. KOENIGSBERG: Yes.
15 DR. TAYLOR: I have one question -- other
16 question I wanted to ask. Just how does PGIT -- how
17 do you supervise and manage an investigation and with
18 your staff, do you give them a time frame from when
19 the investigation must be completed?
20 COL. KOENIGSBERG: Not generally. We have
21 tried to, in some of these, to come up with -- we meet
22 three times a week and discuss our cases. We sit down
1 and review our cases that are not active on about a
2 90-day basis so that we go back and take a look and
3 see whether there is something we want to reopen or
4 there has been new information to it.
5 As far as the time lines are concerned, we
6 had some time lines for things. At the beginning of
7 the summer, we sat down and said, Okay, here are some
8 things we would like to get wrapped up as best we can
9 and have it out on GulfLink and we set the time lines.
10 At that point, Khamisiyah became a big
11 issue and the whole team got exercised into getting
12 information on Khamisiyah and it destroyed any kind of
13 time lines that we had set for doing this. In most
14 instances, there is not a specific time line on a
15 particular subject. It is left open and we discuss it
16 each week. If it looks like we are getting close,
17 then we can say, How about let's getting this finished
18 up and put out on the GulfLink.
19 If there is other things that need to be
20 done, we discuss what needs to be done and try and
21 prioritize how that will get done.
22 DR. TAYLOR: So do you have an idea -- do
1 you decide what your final product should be with each
2 investigation or not? It doesn't sound as if you do.
3 COL. KOENIGSBERG: No. It is not a final
4 product as such. We know that the goal in every one
5 of our investigations is to put this information out
6 once we feel that we have completed the investigation,
7 that we would put it out on the GulfLink.
8 MAJOR KNOX: Well, let me just stop you
9 there then. If that is your job, to take declassified
10 information and put it on the GulfLink, initially when
11 you did that, initially you had several reports on the
12 GulfLink that you since removed -- 300 such reports
13 that you have taken off of the GulfLink.
14 COL. KOENIGSBERG: We don't put things on
15 GulfLink --
16 MAJOR KNOX: Well, who does?
17 COL. KOENIGSBERG: -- in the
18 declassification. That is a whole different effort.
19 The only thing we put on the GulfLink are our
20 assessments. We do not control the declassification
21 part of it. That is all done differently. The Army
22 is executive agent for the declassification process
1 and they control what goes on and goes off of it.
2 They do the -- I am sorry. The Army does
3 the operational side of it. The intelligence
4 community does their own separately and we do not
5 control either one of those.
6 MR. BROWN: Can I ask a question relative
7 to the declassification issue. Mr. Moldenhauer, in
8 your testimony, you mentioned that one of the biggest
9 impediments to your work is the declassification and
10 digitization of data. And of course, it is not
11 secret, everyone we have heard -- the committee has
12 heard repeatedly from veterans that one of the things
13 that many veterans are most concerned about is getting
14 information about what may be causing their health
15 problems, what kind of exposures occurred to them,
16 what really happened.
17 And I guess -- it is not clear to me, I
18 wonder if you can explain why the declassification
19 issue is an important one for you. I am sure you and
20 your staff all have the appropriate security
21 clearances. What prevents you from just bypassing
22 that whole step, reviewing the data, finding out what
1 it tells you about Gulf War-related illnesses, Gulf
2 War exposures and so forth, and getting it out in a
3 more timely fashion on the -- on to, say, GulfLink?
4 LT. MOLDENHAUER: An interesting analogy
5 would be if you ever saw "Indiana Jones" and there is
6 a giant warehouse and they pulling that box at the end
7 of the movie. We have warehouses throughout the
8 nation of Gulf War documents that have been pulled
9 together from field units that are in the que to be
11 MR. BROWN: Wouldn't it speed it up if you
12 could get access to those documents? I mean, you
13 don't need a declassification as part of --
14 LT. MOLDENHAUER: Oh, we have access to
15 the documents and when an issue comes up that is of
16 vital importance, i.e. Khamisiyah, when that came
17 about, we went over and reviewed -- physically
18 reviewed over 60 cases of records, going through page
19 by page by page.
20 So there is four man-days, two individuals
21 for two days looking through boxes of information,
22 trying to find the needle in the haystack. And that
1 is hoping that the information was forwarded from the
2 field units to their higher headquarters and then up
3 through the proper archival chain of command, if you
4 will, to get to the declassification and digitization
6 We see them classified if we need them but
7 it is trying to find them, if they exist. And that
8 is --
9 MR. BROWN: But you were making the point
10 in your testimony that the declassification was really
11 a stumbling block, that this was really holding you
12 back somehow. I still don't -- I don't get that.
13 LT. MOLDENHAUER: Well, it is moreso the
14 digitization. We have a classified version and an
15 unclassified version and we can go in with our
16 Pathfinder system and tweak both, either the class or
17 the unclass system.
18 MR. BROWN: Digitization is turning it
19 into --
20 LT. MOLDENHAUER: It is taking a document
21 of text, running it through a computer than then takes
22 all the text and converts it into computer language --
1 or, not computer language but into a file that can go
2 onto the computer vs. a hard piece of paper.
3 And then once it is in the computer, then
4 we can use these search engines to go through and scan
5 these at, you know, light speed vs. --
6 MR. BROWN: For key words and so forth
7 that --
8 LT. MOLDENHAUER: For key words, phrases,
10 MR. BROWN: Now, is that really going to
11 be appropriate? I mean, some of this document must be
12 in handwritten form. Some of them must be in rather
13 poor -- it seems to me, you know, this -- it sounds
14 like a high-tech solution to what you are talking
15 about, using technology, but it sounds like a classic
16 example where doing it by computer actually makes it
17 slower, I am wondering.
18 LT. MOLDENHAUER: Well, I won't --
19 MR. BROWN: Wouldn't it be --
20 LT. MOLDENHAUER: I won't say slower
21 because if you -- if I took one box of data, half of
22 it may be computer-generated messages. And if you are
1 familiar with most message traffic at higher levels of
2 the military, it is all done with microwave
3 communications and it is digitized already.
4 MR. BROWN: Sure.
5 COL. MOLDENHAUER: So that exists and --
6 MR. BROWN: I am thinking of the paper
8 COL. MOLDENHAUER: -- that stuff goes
9 through the scanner very easily. You get down to the
10 unit log level and it is PFC Smith that is entering in
11 the unit log and it is stubby pencil. So those are
12 then scanned as an image which then have to be looked
13 through manually.
14 What they do when they look at them is
15 pick the unit and the date of the record and put it as
16 a little header which the computer can identify for
17 us. So if, say, we are looking for unit XYZ, unit
18 logs from this date, we type in XYZ and the date and
19 it will search for that. And then we have to visually
20 review each piece of paper.
21 MR. BROWN: But I guess the unit logs are
22 likely to have some of the most important information.
1 COL. MOLDENHAUER: Right.
2 MR. BROWN: And I guess I am concerned
3 that some months from now you are going to end up
4 having to say, Well, I guess really we are going to
5 have to go back and look at the actual logs manually.
6 And you are going to actually have lost time by going
7 through this process.
8 COL. KOENIGSBERG: We are reading logs
9 currently in this. And I think one of the things you
10 have to keep in mind is the massive amount of
11 information that is out there which --
12 MR. BROWN: Sure.
13 COL. KOENIGSBERG: -- the Lieutenant has
14 alluded to. The other thing is that it is in a train
15 somewhere. It is basically set up that it is being
16 sent to the Army at Fort Leavenworth. They have boxes
17 of this material there that are in warehouses all over
18 the place. They are then sent up to Washington for
19 the declassification people to start to digitize.
20 Now, if we go looking for a particular
21 record, then it is somewhere in this train which
22 becomes very difficult to find, number one, and so in
1 many cases, there is a delay here in getting it. We
2 have gone back and pulled material out of the train in
3 order to get it up so that we can take a look at a
4 specific case.
5 But in many instances, there are things
6 that we are going to be able to do much more with once
7 we do get it into a digitized format because then you
8 can manipulate it, you can compare it to things more.
9 So is it high-tech, yes, but it is still stubby
11 A lot of the material we are doing is
12 going to a box and looking in a box to find
13 information that is there. And in many cases, the
14 information has not even been turned in yet which is,
15 you know, part of the problem. It is not in a box
16 that we can find anywhere.
17 And when we have gone out to the field and
18 talked to units that are out there, invariably
19 somebody says, Oh, you are looking for this? And they
20 pull it out of drawer somewhere and they hand you a
21 document that is something you have been looking for
22 all along and you have never seen it. And it is still
1 sitting in a drawer back at their home unit somewhere.
2 MR. TURNER: But isn't that the effective
3 way to investigate anything? To go out into the field
4 and interview somebody and say, I am looking at this
5 incident. Do you have paper on it?
6 And the guy, as you say, reaches down in
7 his desk drawer and pulls out a document.
8 COL. KOENIGSBERG: Exactly.
9 MR. TURNER: Not to wait until everything
10 has been digitized so you can say, Oh, now I need to
11 go find this guy and ask him about this document.
12 COL. KOENIGSBERG: We have done exactly
13 what you are saying.
14 MS. GWIN: Could you give me an estimate
15 of how much of your resources in terms of people time
16 you devote to that kind of investigation vs. the type
17 of literature review you described in some of your
18 toxicology and environmental health --
19 COL. KOENIGSBERG: I have never really
20 thought about it.
21 MS. GWIN: Because that seems where PGIT
22 is uniquely qualified with the investigation --
1 COL. KOENIGSBERG: Yes.
2 MS. GWIN: -- in your name that you would
3 devote a lot of resources to that.
4 LT. MOLDENHAUER: One, as the Colonel
5 mentioned earlier, it is case-specific, depending on
6 the case. If it is a toxicology issue, maybe 95
7 percent of the time will be spent looking at
8 literature review. If it is an incident like
9 Khamisiyah, I personally spent three days in Fort
10 Bragg interviewing people and trying to find records.
11 And I have been to numerous other locations at
12 different units that become a priority and are
14 And I think the key is, is that yes, there
15 may be boxes of information scattered throughout the
16 country in unit archives and in people's desks and
17 using the information that we have and the data
18 sources we have, if we can identify units in an area
19 or specific to an event, then we can mobilize and
20 focus our efforts on that area and those units.
21 I think it would be, you know, kind of
22 blindsided if you sit back and said, I want to go out
1 to every single unit that deployed to the Gulf and go
2 through everybody's desk and look for bits of
3 information and review the unit logs. That is an
4 ineffective, in my mind, waste of man-hours. We have
5 to focus on --
6 MR. BROWN: Well, maybe not every one but
7 there are some that must stand out as being --
8 LT. MOLDENHAUER: Well, that is what
9 happens. When a --
10 MR. BROWN: -- particularly important and
11 I think --
12 LT. MOLDENHAUER: When a unit is
13 identified -- excuse me -- like Khamisiyah and we
14 identify the units that were assigned in that general
15 vicinity, then we have some place to go and we can
16 focus in on specific units at specific times and talk
17 to people and that is how we have to conduct our
19 I think if we were looking at -- you know,
20 we focus too much on the forest and not the trees,
21 sometimes. And what we have to do is focus down on
22 the tree and then we can actually find out what is
1 going on there.
2 MR. BROWN: Well, just to follow up
3 Holly's idea, though, it seems that PGIT is uniquely
4 set up in this investigation in Gulf War veterans'
5 health issues to actually go out and do the field
6 work. You have the list of names. You know who was
7 in what units and who was located where.
8 Other groups -- our own committee, for
9 instance -- have less -- considerably less access to
10 that type of information. Isn't the best thing you
11 could do with your time is to go out there and do
12 these types of field investigations and, you know, de-
13 emphasize the literature searches, going through
14 literature on effects and health effects or
15 whatever -- I am not exactly clear what you are doing
16 but shouldn't you be focusing on the field work, the
17 field investigation?
18 COL. KOENIGSBERG: I think the field work
19 is important but as has been mentioned several times,
20 in certain issues, the field work doesn't help us any.
21 So yes, when the issues were -- field work is the
22 major thing, yes, we have a unique capability because
1 we have people with operational background, can go in
2 the field and talk to the folks and that is what we
3 have done.
4 DR. TAYLOR: I guess I am unclear on how
5 much of your time is actually done conducting field
6 work versus reviewing literature.
7 COL. KOENIGSBERG: Depends on what you
8 call field work. If you mean going out in the field,
9 it is a very small part. As far as being on the
10 telephone talking to people out in the field --
11 because these people are so scattered that it is
12 impossible to go to these specific sites --
13 DR. TAYLOR: Right.
14 COL. KOENIGSBERG: -- then it is a
15 tremendous amount of our time is spent on the
16 telephone, talking to veterans and talking to people
17 that were at a specific site, whether it is Al Jabal,
18 whether it is at Khamisiyah, whether it is at one of
19 the other sites that we are particularly interested
20 in. We spend a tremendous amount of time on the
22 LT. MOLDENHAUER: Some cases are very
1 interesting. If you take a, say, a National Guard or
2 reserve unit, the people in that unit tend to be
3 localized around the area where they drill on the
4 weekends so it is usually -- and the people tend to
5 stay there.
6 They may be in the same reserve unit for
7 20, 25 years. On an active duty side of the house --
8 and some people on the panel that were active duty,
9 you know that once you leave the unit, people scatter
10 every three years. So for me to travel to Fort Bragg,
11 which was a good instance because in that community,
12 those people tend to stay in that community. Airborne
13 people tend to stay so there was quite a few people
14 who were still in other elements down at Fort Bragg,
15 so that was a fruitful investigation.
16 However, if I flew to Fort Stewart to
17 interview an infantry battalion, then there might not
18 be one person in that entire division that was part of
19 that battalion at the time during the Gulf War. So
20 then we spend time on the telephone.
21 MAJOR CROSS: Have you gone out and
22 interviewed reserve units?
1 LT. MOLDENHAUER: Yes, we have.
2 MAJOR CROSS: Have you come out here to
3 Colorado and talked to reserve units here in Colorado?
4 LT. MOLDENHAUER: Not yet.
5 MR. TURNER: If we could just go back to,
6 I think, one of the points Mr. Rios was raising on the
7 standards. We have all looked pretty carefully at the
8 testimonies that you have provided before. And if I
9 understand it correctly, your assessment of whether
10 there is a chemical exposure, the standards you are
11 using are essentially the same standards that our
12 government uses to decide whether retaliation is
13 appropriate or that would be a basis for a referral to
14 the Geneva War Crimes Tribunal.
15 I don't understand. I would like you to
16 explain to us how that standard is the appropriate one
17 when you are not talking about retaliation or possible
18 war crimes but about the health of American service
19 men and potential effects from low-level exposures.
20 COL. KOENIGSBERG: I think as we have
21 tried to explain on multiple occasions in here, what
22 we are looking for is factual evidence. It happens
1 that the factual evidence goes in the same line as the
2 idea by the United Nations and others that are out
4 We are looking for any factual evidence.
5 There are no criteria for low-level exposure.
6 There -- I have asked your committee on multiple
7 occasions, Can you tell me what you think we should
8 look at in this?
9 We have talked to experts in the field and
10 said, What can we look at that will show low-level
11 exposure? And no one has ever given us anything that
12 we could go out and plug in and say, This is specific
13 to low-level as opposed to anything else.
14 The only thing that you can look for is
15 out and out evidence. And the evidence you are
16 looking for, as I have mentioned before, goes back to
17 the fact of whether we can find some evidence of
18 chemicals anywhere, whether we can find people that
19 got sick immediately and had symptoms that were
20 referable to this. These are the kind of things you
21 can look at.
22 MR. TURNER: If you don't find people who
1 are sick, is there any set of evidence that will lead
2 you to conclude that there was a low-level exposure?
3 COL. KOENIGSBERG: I don't think there is.
4 MR. BROWN: Can I suggest one here? Just
5 to --
6 COL. KOENIGSBERG: Sure.
7 MR. BROWN: Well, you said that the
8 committee and staff had never you given you one. I
9 will suggest one now. What if you can show with the
10 Khamisiyah incident where apparently chemical weapons
11 were destroyed and there was a release that some U.S.
12 units were located within a plume -- a modeled plume
13 of where that material would have gone? Would you
14 count that as an exposure? It is quite plausible that
15 you wouldn't expect any health effects in that but --
16 COL. KOENIGSBERG: It would show that they
17 conceivably were exposed. Now, the next step would be
18 to look at the CCP data and the veterans' data and see
19 if you could tie anything together.
20 MR. BROWN: Sure. I -- fine.
21 COL. KOENIGSBERG: And that is what we are
22 doing. In Khamisiyah --
1 MR. TURNER: But that is confusing --
2 COL. KOENIGSBERG: Let me bring --
3 MR. TURNER: No, let me just finish. That
4 is confusing exposure with a fact. I understand your
5 position that the human body is itself a detector but
6 we know the human body does not detect low levels of
7 chemical agent in the ways that we are used to seeing
8 the human body detect chemical agent.
9 We don't see myosis. We don't see
10 twitching. We don't see potential death.
11 COL. KOENIGSBERG: Right.
12 MR. TURNER: Now, if you are willing to
13 put that aside -- put aside effects as Mark described
14 to you a system, a test, a standard that you are
15 comfortable with for the exposure side -- not the
16 effects side, the exposure side.
17 COL. KOENIGSBERG: Yes. Well, do we say
18 that somebody was exposed if the plume goes out? Yes,
19 there is such exposure there. Does this mean that
20 this is related to Persian Gulf illnesses --
21 MR. TURNER: Separate question.
22 MR. BROWN: Two questions there.
1 COL. KOENIGSBERG: And indeed, what we are
2 doing with Khamisiyah as, I think, we have briefed you
3 all on before, there is a process that has already
4 been started to contact everybody that we know that
5 was in that demolition process and to figure out which
6 one of those people were exactly at the site because
7 not the whole unit was there. It was a small portion
8 of the units that were there.
9 So we are trying to determine who was
10 there. The CCP people and the VA will then work on
11 taking a look at these people who were at the site and
12 who show up in their program and see whether there is
13 anything different in terms of the symptoms that they
14 are currently having as compared to, say, others.
15 It then becomes more of an epidemiologic
16 type of survey where you have the exact amount of
17 people. And that is where, I think, the answer comes
18 from in what you are asking. Is there a low-level
19 effect? Has it anything to do with Persian Gulf
20 illnesses? That is how it has got to be answered. It
21 can't be answered by something that I can pull out of
22 the air and say that a sample was done and it was --
1 there was chemical there.
2 MR. RIOS: Have any patterns emerged in
4 COL. KOENIGSBERG: Well, they are in the
5 process of contacting the -- all the people. There is
6 1,100 -- approximately 1,100 people that have been
7 identified that had something -- that could have had
8 anything to do with the demolition process. And they
9 are in the process of making phone calls now to these
10 people, also telling people that as an outreach
11 program that if they are ill and they have not
12 registered to go into the programs, they are giving
13 them the opportunity to go ahead and get into the
14 programs so they can be involved.
15 MR. RIOS: Are you looking at -- to see if
16 there is any patterns between the Khamisiyah incident
17 and the kits going off -- the detection kits going
18 off, that were reported by our troops?
19 COL. KOENIGSBERG: The only -- this was
20 after the war and the only ones that we know of that
21 went off during that period of time were right there
22 at Khamisiyah and it was only one alarm that went off.
2 MAJOR CROSS: So you are saying there was
3 1,100 people in that vicinity?
4 COL. KOENIGSBERG: In the immediate
5 vicinity, there is 1,100 people that were a part of
6 that process. Those were the people -- oh, no. There
7 weren't 1,100 out there. There are 1,100 that could
8 have been out there. In other words, we are looking
9 at people like the 307th -- 37th and then the 307th.
10 In the 37th, there were probably somewhere
11 about 150 out of 4- to 500 people in that unit but
12 there were only about 150 or less that were up there
13 at the site at the time when they did the explosion.
14 So what we are trying to determine is which were those
15 150 people and then have a look at what it is that
16 their health status looks like.
17 MAJOR CROSS: All right. Now, looking at
18 the unit location data, has that been helping you out
19 at all or are you finding tremendous gaps in that
21 COL. KOENIGSBERG: They are -- it is not
22 as complete as one would like it to be. It helps us
1 because it gets us started. And if we get started
2 with finding where a unit is, then by talking to the
3 people in that unit, we then find out who else was
4 there and we go from there.
5 You call the next person and who else do
6 you know that was there, what other units were with
7 you, who were you working with, and we are able to
8 determine others. So we have been able to fill in
9 gaps by the interviews and such that we have with
11 MAJOR CROSS: Now, I sent -- you are going
12 to initially begin with the smaller group of people
13 that were there.
14 COL. KOENIGSBERG: That is correct.
15 MAJOR CROSS: In the vicinity, there could
16 be upwards of maybe 3,000 troops of all services going
17 back, if you take a circular --
18 COL. KOENIGSBERG: Yes.
19 MAJOR CROSS: -- pattern and just go out.
20 Is it your intent to try to interview those people or
21 at some point are you going to say, Stop. It is just
22 not -- you can't do that?
1 COL. KOENIGSBERG: I don't know that the
2 interviewing part of it, to go out, as to what will be
3 determined from that. I think what the decision is
4 going to be made not by us but by the people that are
5 looking from the epidemiologic standpoint to whether
6 you do the same thing with the remainder of the folks
7 out there in terms of taking a look at their health
8 data as compared to going out and actually calling,
9 you know, interviewing someone.
10 What is going on now, I wouldn't, you
11 know, call it an interview, basically. It is a matter
12 of finding who was really in that area and then being
13 able to go, number one, and tell them that if they are
14 having problems, there is a -- we want you to be aware
15 that there is -- that this incident occurred and we
16 want you to be aware of it. And if you have not been
17 in to be checked, then you should be.
18 And we are hoping that by looking at all
19 the check-ups on these individuals, that we might be
20 able to see some pattern emerge that would, you know,
21 that would show you that this was related -- that
22 there is any relationship between being there, being
1 exposed, and now having some kinds of symptoms
2 thereafter. It is a step by step process.
3 MR. TURNER: Given the gaps and
4 limitations in the unit locator information that you
5 have observed at Khamisiyah, if I understand your
6 methodology correctly for the time and space analysis,
7 that is also largely dependent on the unit locator
8 information as one of the components that you feed
9 into your analysis.
10 Is that really something that is feasible
11 at this point, given the problems we already know of
12 in the quality of the data that is in the unit locator
14 COL. KOENIGSBERG: I think it is going to
15 be easier because I think that the units where we are
16 getting logs from to find that a alarm went off, if
17 they have a log of that nature, then it is very likely
18 that somewhere in that log, it tells you where they
19 were located at the time when this occurred.
20 So I think that this will be easier than
21 trying to use the logs -- or, the unit identifiers for
22 some other questions.
1 MR. TURNER: But it is going to involve
2 the same kind of legwork.
3 COL. KOENIGSBERG: It is going to take a
4 lot of legwork.
5 MR. TURNER: Going out and tracking down
6 the logs to establish the exact --
7 COL. KOENIGSBERG: Exactly. And that is
8 what you asked, where a lot of our time is spent. A
9 lot of our time is legwork -- investigative legwork
10 because, as was mentioned earlier, we can't find an
11 individual so we spend time on the phone trying to
12 call various places, locate an individual, and then
13 when we finally get ahold of the individual, leaving
14 messages or several different conversations with that
15 individual and this, to me, that is field work.
16 That is the stuff we are doing. And if
17 you ask, you know, do we do much? That is more field
18 work than going out. The easy part has been to go out
19 to the unit as Lt. Moldenhauer says, and have a bunch
20 of people all together in one place. That has not
21 been a luxury we have had that often.
22 DR. TAYLOR: I wanted to refocus a little
1 bit on depleted uranium.
2 COL. KOENIGSBERG: Yes, ma'am.
3 DR. TAYLOR: And ask a question about
4 whether you have made any effort to determine which
5 units had DU ammunitions -- munitions and where they
6 were used and what units were later in those areas
7 where depleted uranium was used?
8 COL. KOENIGSBERG: That is part of the
9 work that we are doing currently to try and identify
10 who may have been. What we are finding is that in
11 most cases in the veterans that we have talked to,
12 there is not going to be any record of it because what
13 a lot of these people did is they went out and crawled
14 all over tanks.
15 They were never told not to. They went up
16 there. They went for souvenirs. In some case -- in
17 one case, they brought a whole tank back to the United
18 States with them. They took parts out of tanks and
19 brought them back but there is no record of any of
21 So we have been looking at the number of
22 rounds that are used of depleted uranium. We are
1 trying to get a handle on areas and units that we know
2 might have been. And as in some of these others, I
3 think it is one of the valuable things that we can add
4 here is by trying to put together possible areas of
5 exposure, who might have been exposed because right
6 now, there may not be a lot of evidence that this
7 exposure was meaningful but if we can put together a
8 list of the people and then leave it as part of our
9 investigation effort, that if someone then wants to go
10 back and do a study five years from now, say, on
11 cancer or something else in that particular unit, that
12 is what we see one of the functions we are doing.
13 Lindane has been brought up as an example
14 here and that is one of the theories here. We can't
15 find anything that would say that lindane really
16 caused some of the things that people are saying it
17 did. However, lindane is a carcinogen --
18 DR. TAYLOR: Yes, suspect.
19 COL. KOENIGSBERG: -- or, not is, it is
20 suspected of a possibility.
21 DR. TAYLOR: Yes.
22 COL. KOENIGSBERG: So is there a
1 possibility that five, ten, 20 years from now, it may
2 be useful. So what we are doing is compiling a list
3 of the MP units and others who were using lindane in
4 an enclosed area, to just set this list aside.
5 So it is there and we can say we have a
6 list as best we can of who might have been exposed and
7 then if someone wants to go back in five, ten, 20
8 years from now and take a look, they will be able to
9 use that list that we compiled.
10 DR. TAYLOR: So you are identifying or
11 trying to at least identify those who might have been
12 exposed to depleted uranium?
13 COL. KOENIGSBERG: Yes.
14 MR. BROWN: What about the incident at
15 Doha, the ammunition fire, the accident where, as I --
16 as the committee has heard, that some uranium --
17 depleted uranium weapons were destroyed in that fire?
18 Now there, you have an incident where you should have
19 very good records.
20 You are not just asking for personal
21 anecdotes. There should be records of the amounts of
22 ammunition that was there. There should be records of
1 the clean-up -- some efforts to assay the nature of
2 that accident, how extensive it was, and even the
3 extent of exposure to U.S. service members. Are you
4 pursuing that?
5 LT. MOLDENHAUER: One thing I would like
6 to note with that, just so people understand in
7 clarity, this occurred after the war. The war was
8 over. We were at Camp Doha. Set up garrison
9 operation. An accident happens. It is a lot easier
10 to investigate some place where we are friendly and we
11 have a camp set up. An accident occurs. All the
12 assets are there in place to do a thorough
14 To take a team of people and drive back
15 into Iraq and look at some place we think may have had
16 something is not a viable option for our team. So in
17 that instance there, it is kind of out of the realm of
18 Persian Gulf war illnesses that we are focusing on.
19 If you take that as an isolated case, you
20 know, this occurred after the war.
21 MR. BROWN: But U.S. troops were still in
22 the vicinity. I mean, it was after the ground and air
2 MR. TURNER: Khamisiyah occurred after the
3 war. You still look at that.
4 LT. MOLDENHAUER: Well, we have to look
5 at, you know, you could define the dates and you could
6 argue on what date is the end of the war and what date
7 is not the end of the war. And if you try to look --
8 and this is a personal observation -- we are looking
9 at global exposure of everyone.
10 We don't have people saying that they are
11 sick from all infantry units that were on the Iraqi
12 border or all Marines that were in Kuwait. We have
13 people who were airmen at rare deployed bases. We
14 have sailors that are on ships throughout the Gulf.
15 So yes, DU is one of the issues we look at
16 as one of the pieces in global exposure. And from the
17 information we have given you, we don't feel that it
18 is a global exposure issue right now.
19 MR. BROWN: But are you investigating Doha
20 possible exposure?
21 COL. KOENIGSBERG: Yes. There has been a
22 lot of work done on Doha by the Army themselves on
1 this, before we ever got into this. There was a lot
2 of work that was done on it. We are privy to the work
3 that has been done.
4 DR. TAYLOR: That is still an open
5 investigation, then?
6 COL. KOENIGSBERG: Oh, yes. And I think
7 as we have mentioned in our thing here, I suspect the
8 biggest plus that is out there in looking at this are
9 those people that are being followed by the VA right
10 now that have known exposures to depleted uranium and
11 to see whether anything occurs.
12 Our understanding currently is, and as was
13 mentioned in the report, that so far they have not
14 seen physiologic changes in any of these people who
15 have either the embedded depleted uranium or the
16 people that were exposed to it from inhalation.
17 I think this is a question that has to be
18 definitely answered. And as we have said, further
19 research needs to be done on this.
20 MR. TURNER: Just so the record is clear,
21 you do not have a separate investigative item on Doha,
22 do you?
1 COL. KOENIGSBERG: No.
2 MR. TURNER: And that is not a separate
4 COL. KOENIGSBERG: No. It is under
5 depleted uranium.
6 MR. TURNER: It is under depleted uranium.
7 COL. KOENIGSBERG: That is correct.
8 MR. TURNER: And are you going to issue a
9 report on what happened at Doha or are you just going
10 to subsume it into the DU analysis and then whenever
11 that comes out, it will treat Doha or it won't treat
13 COL. KOENIGSBERG: That depleted uranium
14 analysis has not been completed. I don't know -- that
15 is a good point, Mr. Turner. The question --
16 MR. TURNER: Yes. My concern is, Doha
17 is --
18 COL. KOENIGSBERG: Yes. You want
19 something specifically to Doha. That is not --
20 MR. TURNER: It is an issue that has been
21 of considerable concern to the veterans' community.
22 It has been highly publicized. People have come
1 forward with it and said, This is a, you know,
2 clinical test case, if you will, where you have a
3 vicinity where there was a dispersion. And are you
4 guys going to evaluate that in its own context, I
5 think is the question.
6 COL. KOENIGSBERG: We can put out a
7 separate report on it.
8 MR. BROWN: Well, I guess just to follow
9 up that point, I think it would be -- most -- many
10 veterans would not be satisfied if you decide to
11 exclude Doha simply because of the somewhat late date
12 in the overall time frame --
13 COL. KOENIGSBERG: It wouldn't be
15 MR. BROWN: -- of the war, that that
16 would not -- and that is not your intention.
17 COL. KOENIGSBERG: No. It is not going to
18 be excluded. It is just that it has been put as part
19 of the whole depleted uranium issue, not as a separate
21 MAJOR KNOX: Yes. And I think the
22 committee understands what a big task you have to
1 address all these problems but I guess we are
2 concerned about the process in which you are doing it
3 and how it is being done and then how the public will
4 be made aware of each one of those incidents.
5 And help me understand again, tell me what
6 the purpose of the GulfLink for Internet service, what
7 was that developed for?
8 COL. KOENIGSBERG: It was developed
9 basically for several different purposes. The first
10 purpose was to take all the documents that are being
11 declassified and put them on GulfLink so that anyone
12 can take a look at it and see what is out there, make
13 their own conclusions, do whatever they want with it
14 but it is out there as part of the system.
15 The second thing was to put information
16 out for veterans that they could see on various things
17 such as congressional reports, reports from our
18 committee, any other reports that were helpful in
19 educating people to know what is being done with it.
20 It also have a referral system in there
21 to, where do you go to get your physical examinations
22 and things of this nature so it is an information
1 distribution system. And then they are currently
2 looking at whether it will be on GulfLink itself or it
3 will be somewhere else similar to GulfLink where the
4 data from the CCEP system will go onto that as well,
5 so the people will have access to look and see what
6 information comes out of that.
7 MAJOR KNOX: So essentially, it is a data
8 base for veterans to go to and look and read about --
9 COL. KOENIGSBERG: That is correct.
10 MAJOR KNOX: -- information that concerns
11 Gulf War illness. Well, tell me about -- there have
12 been, like, 300 documents that were initially placed
13 on GulfLink that have since been removed. Can you
14 tell us why that occurred?
16 MR. TURNER: Mr. Walner, if you would
17 identify yourself.
18 MR. WALNER: I am Paul Walner. I am the
19 staff director of DEFSECDES oversight panel on
20 Persian Gulf illnesses. The documents you are
21 referring to, Marguerite, were in the intelligence
22 component of GulfLink. And the issue was raised by
1 the Central Intelligence Agency that some of these
2 might have been inadvertently classified and released
3 in a classified form.
4 And what happened in the process after we
5 closed down that particular file and took those off-
6 line was to review all of them. And there were more
7 than several hundred, there was about 1,000.
8 MAJOR KNOX: Okay.
9 MR. WALNER: 1,200 total. And this review
10 was done in an inter-agency form and it was determined
11 that some 350, I think is the -- 350 to 400 should not
12 be put back on GulfLink. We did not -- and they
13 weren't. They are, however, still available and
14 anyone who wants to see them, they can do that through
15 the Freedom of Information process and they would have
16 to go to DIA for that purpose. Indeed, some people
17 have done just that already.
18 So the bottom line is, they have been
19 removed and they are not individually -- they have not
20 be reclassified, however, I must say and they are now
21 available on an individual basis with further
22 redaction by the Department, specifically through the
1 Defense Intelligence Agency.
2 MAJOR KNOX: What is the difference? I
3 mean, if an individual can obtain them, why can't all
4 veterans see them on the GulfLink?
5 MR. WALNER: No. I mean, on an individual
6 document basis.
7 MAJOR KNOX: A request. Is that correct?
8 MR. WALNER: A request. That is right.
9 MAJOR KNOX: Well, what is the difference?
10 I mean, why would it be necessary for an individual to
11 have to go through the painstaking paper chase when
12 they -- when you say they are available to the
13 individual, why can't you put them out on GulfLink so
14 everybody can still see them?
15 MR. WALNER: Because in the aggregate,
16 there is some sensitive information that is in there,
17 at least in the opinion of part of the intelligence
18 community and it was a compromise to go this way. Not
19 to deny them from the public; they can still get
20 specific documents if they ask for them but in the
21 aggregate, we cannot.
22 MR. WALNER: And we would point out, too,
1 that a member of your staff came over and reviewed all
2 those documents.
3 MAJOR KNOX: But --
4 MR. WALNER: Oh, we have had veterans tell
5 us that they have all those documents, too.
6 MAJOR KNOX: Sure. But from a veteran's
7 point of view, aren't you concerned that that
8 decreases your credibility with the veterans, that you
9 might be trying to cover something up?
10 MR. WALNER: A little bit but not to any
11 extent. Because if they are really interested in a
12 specific document which they might know about already,
13 they can still get their hands on it. It isn't --
14 DR. TAYLOR: So is that information made
15 available, though, that it is available through the
16 Freedom of Information Act, those documents are --
17 MR. WALNER: Yes. That information has
18 been available.
19 DR. TAYLOR: That is on the GulfLink.
20 MR. TURNER: How has that been made
22 MR. WALNER: I think it is on GulfLink, as
1 I recall.
2 MR. TURNER: It is on GulfLink?
3 MR. WALNER: Yes.
4 MR. TURNER: Do you list the documents so
5 somebody knows what to ask for?
6 MR. WALNER: No. We do not list the
8 MR. TURNER: So you say, If you ask for
9 the document, we will give it to you but you have got
10 to know which document to ask for? Is that the
11 Department of Defense's current position on
12 declassified information that has already been made
14 MR. WALNER: What is your question again,
16 MR. TURNER: Your current position is, We
17 will give it to you if you know it already exists and
18 can identify it to us.
19 MR. WALNER: No. If they --
20 MR. TURNER: But if you can't request the
21 individual document specifically, you are not going to
22 get it.
1 MR. WALNER: That can come with a request
2 for a specific document if they happen to know what
3 that is. If they don't happen to know what it is and
4 have some sort of information that they want queried
5 against that material that was pulled off, we will
6 respond to that, too.
7 MR. TURNER: What are you going to do when
8 you get a Freedom of Information Act request that
9 says, Provide me copies of all the documents that you
10 took off GulfLink?
11 MR. WALNER: We are going to go back and
12 redact them and provide them in accordance with the
13 standard law that covers that.
14 MR. BROWN: On what basis do you redact
15 them? None of these documents are secret. Isn't that
17 MR. WALNER: None of them are currently
18 classified. That is correct.
19 MR. BROWN: None of them are currently
20 classified. I guess the concern --
21 MR. WALNER: So what is your question?
22 MR. BROWN: Well, the concern is it
1 creates a -- just to follow up Marguerite's point, it
2 creates an impression of a cover-up, I guess, because
3 it looks like you are holding on to documents which
4 aren't classified. Why?
5 MAJOR KNOX: Yes. I mean, it really
6 does --
7 MR. WALNER: Because as I said before, in
8 the aggregate, there is some sensitive information in
9 there. Not enough to make them classified in our
10 judgment, but in the aggregate, all 350 or 400 of
11 them, and there are some parts of the intelligence
12 community believe that is sensitive.
13 So what we will do in response to
14 individual requests for documents or individual
15 requests for information from the whole body of things
16 that were pulled off, is we will search that body,
17 find the reports that are relevant, do additional
18 redacting. I don't know what that is going to
19 contain -- what it is going to entail but there may be
20 some other things that are taken out of it, and then
21 release them in accordance with the law.
22 DR. TAYLOR: So there may be some
1 information taken out of the documents.
2 MR. WALNER: That is possible. Yes,
4 MR. TURNER: That isn't current
5 classified? You are going to take other stuff out of
6 the documents that --
7 MR. WALNER: That is currently -- that is
8 possible. Yes.
9 MAJOR KNOX: Well, what created that? Was
10 there some type of incident that occurred from
11 veterans reading the GulfLink?
12 MR. WALNER: No. It occurred from people
13 at the Central Intelligence Agency looking into the
14 information that the Department of Defense
15 intelligence components released early on. But they
16 didn't start that until very late -- early part of
17 this year, in fact.
18 And it was their view that some of these
19 things contained information that should not have been
20 released to the public and then that snowballed and
21 went through a very serious level of high policy
22 consideration and convinced Dr. White, indeed, to
1 close down GulfLink for a short time and then to start
2 putting things back on, not only all of GulfLink, the
3 non-intelligence part, but the intelligence part as
4 well as soon as we possibly could thereafter.
5 MR. RIOS: It had already been available
6 in the aggregate.
7 MR. WALNER: That is correct. It had
9 MR. RIOS: So somebody could already have
11 MR. WALNER: That is correct. So what do
12 you -- lots of people already do have it.
13 MAJOR KNOX: Well, but I think the issue
14 again is -- and I don't know that I have made you
15 understand is, the deception is what concerns people
16 and I think that is what most of the veterans have
17 difficulty with is that they feel like there has been
18 some deception.
19 And for a veteran to present a public
20 testimony, your memo that your wrote regarding such
21 incidents -- you know, if you were on the other end,
22 I think you would be very aware of that.
1 MR. WALNER: That is possible, yes. I
2 won't deny that that could be the case. That is not
3 our intent, to deceive anyone. Our intent, as Col.
4 Koenigsberg has mentioned, in everything that is
5 available on GulfLink is to share as much as possible,
6 to be as open and as candid and as forthcoming as we
7 can be.
8 DR. TAYLOR: I have question regarding
9 mycoplasma. In October of last year, you said that
10 PGIT was trying to determine whether mycoplasma could
11 we weaponized.
12 COL. KOENIGSBERG: Right.
13 DR. TAYLOR: Have you found any other
14 information to that?
15 COL. KOENIGSBERG: Yes. As we mentioned
16 in our briefing today, we have consulted with
17 everybody that has anything that we can find to do
18 with mycoplasma and we have not found anybody that has
19 ever said that there -- that this could be weaponized
20 the way that it has been proposed.
21 You can't genetically engineer to the way
22 that has been stated by some scientists. The people
1 both inside and out government that are experts along
2 the area who we have to rely on for their expertise
3 have said that right now, the technology does not
4 exist to that.
5 We have gone back to the community, both
6 in the intel community to find out what foreign
7 governments are working on mycoplasma. And we have
8 gotten the answer that there are none that we know of
9 that are working with mycoplasma as a weapon.
10 And we have talked with people in the U.S.
11 side of the house as to whether they ever did work
12 with mycoplasma and the answer has been, No, we didn't
13 because it wasn't -- it is not an organism that one
14 would consider for weaponization. When we did have
15 system for biologic warfare years ago, that was not on
16 of the things that -- they looked at it. They said,
17 this is not an organism that could be effective,
18 therefore, they went on to other ones.
19 MR. TURNER: That was in 1969 is when
20 those studies were done, thereabouts? It wasn't the
21 biological shutdown, then?
22 COL. KOENIGSBERG: The program shut down
1 in '69 --
2 MR. TURNER: Shut down then?
3 COL. KOENIGSBERG: -- so this was before
5 MR. TURNER: Yes. So my point is that it
6 is fairly dated information that you are relying on.
7 COL. KOENIGSBERG: As far as -- no. As
8 far as the U.S., we never looked at it again.
9 MR. TURNER: Yes.
10 COL. KOENIGSBERG: If you want to -- the
11 intel information is not back to '69. The intel
12 information is as of today.
13 MR. TURNER: Thank you.
14 COL. KOENIGSBERG: And that is on foreign
16 DR. TAYLOR: Any other questions?
17 MAJOR KNOX: Yes. I have one more. Can
18 you tell us what reports that you have issued thus far
19 to the public concerning certain incidents? I know
20 you have done some on ASA and --
21 LT. MOLDENHAUER: Well, as of right now,
22 we have released the vaccine adjuvant theory, the
1 final report; the death rate mortality comparison
2 report. And as of -- it should have been yesterday,
3 the Czech and French detection report was put out and
4 there is a few more that are in the que that are
5 either finalized and moving through review chain that
6 should be -- I know of two right now that are in the
7 final stages of review for release.
8 COL. KOENIGSBERG: Plus we have put on
9 GulfLink every time we have testified to you all so
10 that covers quite a bit of ground.
11 MR. BROWN: That is probably the best
12 stuff, right?
13 MAJOR KNOX: Thank you very much.
14 MR. WALNER: But there are three out right
15 now, Marguerite. Three, today, on there.
16 COL. KOENIGSBERG: And I would like to go
17 back to one thing that you asked a question on just
18 once again to make sure that it is clear. And that
19 is, you talk about the process that we are using,
20 etc., and then you are putting in the declassification
21 effort. And I would just go back again to say that
22 the declass is a whole separate operation than what we
1 are doing. We have nothing to do with that aspect of
2 it. We are customers and we use that material just as
3 anyone else uses it.
4 MR. TURNER: And Mr. Walner overseas the
5 declassification effort? Oversee -- pick your verb.
6 MR. WALNER: In a general sense, that is
7 true. The executive agent for the intelligence
8 declassification is Defense Intelligence Agency. The
9 executive agent for the operational declassification
10 is the Army but I work very closely with them.
11 MAJOR KNOX: Yes, you do.
12 MR. TURNER: I have just a couple of
13 specific areas. The Army's computerized hospital
14 admissions records indicated that there was one case
15 of anthrax diagnosed in theatre which we found out
16 working with our medical staff and passed on.
17 Could you tell us what you have done or
18 plan to do with that information? Obviously, anthrax,
19 as we know, is a principal biological weapon that the
20 Iraqis had, is a matter of great concern.
21 LT. MOLDENHAUER: Okay. And also in
22 addition to that, it is also endemic in the area.
1 MR. TURNER: Correct.
2 LT. MOLDENHAUER: So there is the two
3 sides. It exists there normally and it can be
4 weaponized and used as a biological warfare agent.
5 That -- the individual who was identified in that
6 report, we were able to locate through our -- the DMDC
7 data base out in California as being a National
8 Guardsman from somewhere in Alabama.
9 When we called the National Guard site, he
10 has no telephone listed and the last known address of
11 this individual is the Reserve site. So we tried to
12 contact the Reserve site and they don't know what
13 happened to this individual.
14 We don't have access to resources such as
15 the Social Security data base where we can say, Here
16 is someone's Social Security number, tell me where
17 they -- the address they put on their last IRS form is
18 so we can go and look at it. So we have attempted to
19 identify him and we have hit a stone wall.
20 MR. TURNER: You have identified the
22 LT. MOLDENHAUER: Correct.
1 MR. TURNER: And you have been unable to
2 contact them. Have you made any contacts with the
3 physicians who were at the hospital that treated him
4 to try to find out whether it was connected in some
5 way to possible exposure to a biological agent?
6 LT. MOLDENHAUER: Well, that question I
7 could answer very bluntly. That is not my case that
8 I am working on and the person who is --
9 MR. TURNER: You, generically. PGIT.
10 LT. MOLDENHAUER: Generically speaking,
11 the individual who is investigating that is looking
12 into that issue as well as scanning the remainder of
13 that data that came that you all reviewed.
14 MR. TURNER: And that relates to a nuclear
15 biological casualty under the NATO code. Has there
16 been any progress on that? Has that person been
17 located or a physician been interviewed to find out
18 what the basis --
19 LT. MOLDENHAUER: Negative.
20 MR. TURNER: No?
21 LT. MOLDENHAUER: No.
22 DR. TAYLOR: Any more questions? Thank
1 you very much. We have time for only a few more
2 public comments. Two -- only two.
3 MR. ADAMS: Can we make --
4 DR. TAYLOR: I am sorry. We don't have
5 the time. There are others who have not had an
6 opportunity --
7 MR. ADAMS: I understand but these people
8 are the ones that have -- that are pretty much --
9 MS. GWIN: We are going to take them in
10 the order that they signed up.
11 MR. ADAMS: I know. But they are
12 stonewalling us, you know, and they are sitting there
13 giving us a lot of crap.
14 MS. GWIN: Sir, if you -- we want to get
15 to the speakers who signed up so --
16 MR. ADAMS: Well, I want to be able to
17 address --
18 DR. TAYLOR: You could talk to them
19 individually. They will be here during --
20 MAJOR CROSS: You have had an opportunity
21 to --
22 MR. ADAMS: I understand but this is --
1 MAJOR CROSS: -- speak to this panel
3 MR. ADAMS: -- what is giving me the
4 chance to -- what I have to say here and listen to
5 these people say that they don't have any -- there was
6 no traces of chemicals, you know. And the Czechs
7 found it. Our own --
8 DR. TAYLOR: Sir, I am sorry --
9 MS. GWIN: We need to move on.
10 MR. ADAMS: Our own -- wait a minute --
11 our own -- we paid a billion dollars for these
12 vehicles --
13 MAJOR CROSS: You cannot disrupt this
15 MS. GWIN: Sir, you have had your
16 opportunity to testify.
17 MR. BROWN: You are disrupting our
18 meeting. We have to move on.
19 MR. ADAMS: Well, I understand that but --
20 MS. GWIN: We have additional --
21 MR. ADAMS: Well, you don't know how
22 aggravated I am, okay?
1 MS. GWIN: We have additional veterans who
2 have asked to --
3 DR. TAYLOR: We understand that and we
4 sympathize with you.
5 LT. MOLDENHAUER: We will be available at
6 the break.
7 DR. TAYLOR: They will be available for
8 you to talk to them.
9 MR. BROWN: We have to move on. Others
10 are --
11 MR. ADAMS: What would it matter, talking
12 to you? You -- I get the same line of crap that
13 everybody else --
14 DR. TAYLOR: Rick Walker, if you are still
15 in the audience? Is Rick Walker?
16 MR. ADAMS: Jesus. Excuse me for
18 DR. TAYLOR: Rick Walker is the next on
19 our list for making public --
20 MR. BROWN: He is coming.
21 UNKNOWN: I would like to ask the panel
22 why -- or, if it inquired into whether or why the --
1 Dr. Foster made a statement discounting the Vietnam
2 Syndrome at the same time as the distinguished
3 Presidential Committee was working on the subject.
4 DR. TAYLOR: Sir, we cannot answer that at
5 this point. I think we should move on to public
7 MR. TURNER: And I will be glad to talk to
8 you afterwards.
9 DR. TAYLOR: Afterwards, yes. Thank you.
10 MR. WALKER: Thank you. My name is Dick
11 Walker. And first off, I would like to thank Holly
12 and a few of the others for coming to Washington and
13 talking earlier on readjustment issues.
14 My job in the civilian community is a
15 veterans' service officer. I was also in the Persian
16 Gulf. There were eight times that our alarms went off
17 and that has been addressed in and amongst other
18 information. But the one thing that I need to comment
19 is, number one, the Denver VA Medical Center and the
20 medical centers in Colorado face a couple of things.
21 First off, distance. Veterans have a hard
22 time getting to and from a point when it is to and
1 from medical care and so forth. If you live in
2 Pueblo, you live 90 miles from the nearest VA Medical
4 The other issue is -- that I deal with on
5 a daily basis with veterans is that the information
6 like we saw today is very confusing. When it gets
7 down to the veteran level, they don't know what to
8 believe. They don't know what to hear and so forth.
9 When they come and see us, when they are
10 trying to find out such as this medical information
11 here or help with their medical problem, what ends up
12 happening is the VA can only go so far in the legal
13 aspects granting compensation and pension evaluations
14 or whatever and they end up only granting 5 percent of
15 the Persian Gulf-related illnesses.
16 Now, the confusion that goes on at that
17 level, not only VA but with the veteran, is the
18 biggest issue that is there. If some of the issues
19 can be resolved -- number one, there is only a two-
20 year time limit that a veteran had to report an
21 illness. If that time limit can be extended to two to
22 four years or even five years, not necessarily based
1 on medical issues but based on the fact that some of
2 these symptoms are just now coming up, it would allow
3 the veteran to get medical attention from a VA
4 facility rather than in the Medicaid or Medicare.
5 In my county, I have 17,000 veterans. I
6 have approximately 16 to 17 of them that are seriously
7 affected by Persian Gulf Syndrome in some form or
8 fashion. At the present time, I have three of them
9 that are permanently and totally disabled by the VA.
10 Now, this is a whole array of symptoms.
11 It is the problems that they face. The civilian
12 community has even tried to pitch in and tried to find
13 answers and it is not there. I think our -- some of
14 the answer that at the end that the committee can come
15 up with, one, is the networking problem that the VA is
16 having, not only with the civilian community,
17 Medicaid, but also with itself and the different types
18 of protocols that were sent down for the evaluations
19 to make sure that the individuals that were evaluated
20 on the first protocol are followed up and that a
21 follow-up after that is taken into consideration.
22 The other thing is, is a balance where
1 there is a committee on-line to oversee all of the
2 aspects that are going on federally to enable that
3 information that you report back to the VA to be
4 utilized at the local level. Because if it does not
5 get back to the local level to be utilized by
6 veterans' service officers and veterans, then like the
7 information you were speaking about earlier, it is not
8 accessible to the veterans.
9 Some of the veterans that are out there
10 right now are homeless. Some out there are on the
11 verge of being homeless. A lot of them are living on
12 A&D because their children need help, because they
13 can't go out and work. There are some that are still
14 trying to work and they are being laid off because of
16 My hands are tied as a veterans' service
17 officer because I cannot provide them with an income
18 of any type that they would qualify through the VA
19 because the medical documentation is not there. It is
20 nebulous at best. And so you go in and say, Well, I
21 have all of these symptoms. They say, Well, it sounds
22 like Persian Gulf.
1 The civilian community is going to send
2 you to the VA. The VA is going to say, Well, we don't
3 know what it is, or worse yet, some of the
4 professionals don't believe that there is a Persian
5 Gulf problem.
6 What are your questions?
7 DR. TAYLOR: Any questions?
8 MAJOR KNOX: I don't really have a
9 question but I would just like to make a comment. The
10 two-year limitation I addressed at the very first
11 meeting and talked with Jesse Brown about it and he
12 informed me that that was something that was
13 established by our Congress.
14 MR. WALKER: That is correct.
15 MAJOR KNOX: So that is nothing really
16 that we can do or address except that we know that
17 some of the cancers that can be caused by exposures
18 can have a later onset than a two-year period so we
19 can certainly --
20 MR. WALKER: Absolutely. Well --
21 MAJOR KNOX: -- identify that.
22 MR. WALKER: -- one thing you can do is
1 that -- and excuse me for interrupting -- is in your
2 report, you can suggest that Congress and the
3 President re-look at that issue because that is a very
4 easy step that they can take to extend that period.
5 They have done, in the past, where
6 radiation from clean-up efforts in Nagasaki, they
7 extended it from 30 to 40 years and they included a
8 lot of veteran widows in benefits because the cancers
9 that they had have onset, like you said, after that
10 period of time.
11 And those types of things we can do to
12 really make a positive impact on this because there is
13 a ton of negative out there but we can bring it to a
14 positive conclusion.
15 DR. TAYLOR: Mark?
16 MR. BROWN: You mentioned networking and
17 outreach that VA could do. What kinds of information
18 did you have in mind? What kinds of information, in
19 your experience, would be useful for veterans to have
20 access to that would help them find benefits,
21 understand their illnesses, and so forth.
22 MR. WALKER: Any medical information that
1 comes out of the studies needs to be put out as best
2 it can be. Education with the professionals within
3 the VA Medical Centers --
4 MR. BROWN: Physicians, for example?
5 MR. WALKER: Physicians, correct -- needs
6 to be an ongoing process. VA sends information down
7 but what needs to go on is other information in the
8 community research needs to be provided to them and
9 they, in turn, then need to be able to apply it to the
10 veterans. If that is not being done, it needs to be
12 Any civilian activities that are going on
13 needs to be, of course, screened by the VA itself and
14 then put out into the field. More civilian networking
15 that I am talking about is, if any veteran shows up on
16 A&D in a local social service level, the federal
17 social services program should be able to network with
18 the VA themselves and say, Look, we have got a veteran
19 that is on Medicaid right now. Is he or she entitled
20 to any VA benefits?
21 You end up with a fair amount of people on
22 social service benefits because they cannot get to a
1 VA medical center or they can't obtain medical care
2 from the VA because they don't qualify.
3 MR. BROWN: And you are speaking from
4 personal experience with these issues, aren't you?
5 MR. WALKER: Absolutely.
6 MR. BROWN: This is something you deal
7 with every day.
8 MR. WALKER: Yes, sir. Now, I have had
9 four of them that cannot, because they earned enough
10 money -- they are category C, which the VA can explain
11 to you -- and they have to pay a certain portion of it
12 or whatever and it is real tough to get them in. So
13 either their wife is earning too much money or
14 whatever but they have to have chronic medical ongoing
15 care and don't get it.
16 DR. TAYLOR: Any other questions? Thank
17 you very much for that information.
18 MR. WALKER: No problem. Thank you.
19 DR. TAYLOR: Jack Merlin Modig?
20 MR. MODIG: If I could, I would like to
21 make this very brief and to the point. I did not go
22 to the Persian Gulf. I am a disabled veteran and I am
1 treated at the VA hospital. I go out there monthly
2 and every time I go, I get sick.
3 Realizing that there is a wide variety of
4 complications involved of the possibilities of what
5 might have occurred in the Persian Gulf and that I
6 wasn't actively on duty at the time, that my treatment
7 in its precedence would have to be done independently
8 by myself.
9 I had to decide what I felt might have
10 occurred with all the factors that have been brought
11 to your attention and being accumulated through time
12 and the presence of the information available. I
13 strongly believe that a nuclear facility was used to
14 pump chemicals into the facility which would radiate
15 the chemical itself and all the metals that are within
16 would become radioactive.
17 And if it was dispersed into the
18 atmosphere, you would have a vapor that would not be
19 easily identified. I can understand the frustration
20 of the Department of Defense. It is impossible to
21 find. If my theory is correct -- and I did present it
22 to Thomas McDaniel, briefly -- it is rather complex in
1 its own right but I will get to the point.
2 If they did, in fact, radiate chemicals,
3 you have a radiochemical toxin vapor in the
4 atmosphere. And if they did -- and I do believe they
5 did -- include bovine viruses, which is your anthrax,
6 which is your mad cow disease, and they do find mad
7 cow disease in the Persian Gulf veterans on their
9 They call it LSE. When a human being gets
10 it, they call it CBE. Why are they calling it CBE if
11 it is LSE? Why are they calling it LSE if it is CBE?
12 You are confusing me. I am being disturbed by these
13 factors. I don't need any additional confusion.
14 There is a nerve virus involved in this.
15 It is also bovine. They took what -- the closest
16 thing that can contaminate man is cows. You know that
17 your anthrax is there. It is hard to detect because
18 everybody would have had it.
19 DR. TAYLOR: Mr. Modig, we are running out
20 of time. We would like to ask some questions.
21 MR. MODIG: I will conclude this and
22 anyone can feel free to talk to me at any time. I
1 wrote this theory up and put it on lime green copy
2 paper. And the reason I put it on lime green paper
3 wasn't out of a disrespect to any veteran who saw it.
4 It was out of, so somebody would stop and
5 ask me why they might have saw lime green rain. If
6 you have a radioactive factor into the atmosphere, as
7 the sun's rays, alpha, beta, and gamma rays bounce off
8 the ozone and come through and are filtered through
9 the -- our atmosphere, so your naked eye can see them,
10 the alpha, beta, and gamma rays that come into our
11 atmosphere being diffused and interrupted by alpha,
12 beta and gamma rays from a nuclear radioactive vapor
13 composition carrying a disease, would give you a lime
14 green rain. Thank you.
15 DR. TAYLOR: Thank you. Are there any
16 questions? Okay. This will conclude our morning's
17 session and we are scheduled to return at 1:30. Thank
19 (Whereupon, at 12:30 p.m., the hearing was
20 recessed, to reconvene this same day, August 6, 1996
21 at 1:30 p.m.).
1 A-F-T-E-R-N-O-O-N S-E-S-S-I-O-N
2 (1:30 p.m.)
3 DR. TAYLOR: We are ready to reconvene.
4 The first panel for this afternoon, the topic is
5 depleted uranium. We have with us George Voelz,
6 Stephen Shelton and David Hickman. Mr. Voelz -- Dr.
7 Voelz, I am sorry.
8 DR. VOELZ: Thank you. Good afternoon,
9 Dr. Taylor, committee members, ladies and gentlemen.
10 I am pleased to accept your staff's invitation to
11 comment on the health effects of uranium. Most of
12 this presentation is documented in a book chapter I
13 wrote on uranium about four years ago. I understand
14 you have a copy of it in your briefing materials.
15 Uranium is widely distributed in the
16 surface areas and soils of the earth's crust. We all
17 ingest small amounts of uranium in our food and water.
18 These amounts can be estimated by measuring uranium
19 content in urine samples because most of it is
20 excreted through the kidneys.
21 Urine samples are used to screen for
22 uranium exposures of workers. At the Los Alamos
1 National Laboratory where I work, some workers have
2 had uranium excretion levels that are higher than
3 would be expected considering their limited exposure
5 A small study was done to identify the
6 source of the uranium. It turned out that workers in
7 this situation had higher than average uranium
8 concentration in their home drinking water. There are
9 no effects identified from these exposures and no
10 corrective action has been required.
11 The lesson from this observation is that
12 natural environmental sources in some geographical
13 locations may attract attention in screening studies.
14 Comparison of occupational permissible exposure limits
15 can give us some idea of the toxicity of uranium
16 relative to other hazards.
17 The recommended eight-hour time weighted
18 average for soluble uranium is .05 milligram per cubic
19 meter of air. On a weight basis, this is the same
20 limit that is applied to lead, mercury, cobalt. It is
21 also the same air concentration limit for crystalline
22 silica, which may be present in such common materials
1 as sand.
2 For insoluble uranium oxide particles, the
3 permissible limit is .2 mg per cubic meter air, four
4 times the level for soluble uranium. Cadmium dust has
5 the same occupational limits. One can conclude that
6 the hazards from uranium is comparable to that of
7 other common industrial materials. Uranium is not
8 considered a super toxic material.
9 Uranium is unique in that it possesses two
10 mechanisms capable of producing health effects, names,
11 chemical toxicity and ionizing radiation. Of these
12 two mechanisms, the chemical effect on the kidney is
13 the more sensitive and limiting factor for exposure to
14 soluble forms of uranium. Permissible limits for
15 inhalation or ingestion of soluble uranium compounds
16 then are based on the uranium toxicity to the kidney.
17 By comparison, the radiation hazard from
18 internal depositions of uranium is less than chemical
19 toxicity. There are two principal isotopes in
20 uranium, uranium 235 and uranium 238. The radiation
21 dose rate from uranium is highly dependent on the
22 uranium 235 content.
1 There is still some debate on the uranium
2 235 content at which the radiation risk begins to
3 exceed the chemical risk. The general accepted value
4 is about 5 percent uranium 235 by weight. In natural
5 uranium ore found in the earth's crust, the uranium
6 235 content is about .7 percent whereas in depleted
7 uranium as used in the [unintelligible] projectiles,
8 it is about .3 percent.
9 Uranium which is absorbed in the blood
10 circulation within the body is eliminated rapidly
11 through the kidney in urine. 60 to 70 percent is
12 excreted through the kidney in the first day. About
13 20 percent is deposited initially in bone, which is
14 the principal storage site in the body. The rest,
15 about 10 percent is distributed to other organs,
16 especially the liver.
17 On average, the biological half-time of
18 uranium is about 15 days. That means that half of the
19 uranium has left by 15 days. But this value varies
20 with the particular chemical compound. About 2
21 percent of the intake remains in bone for several
1 There is no known chemical toxicity from
2 the uranium remaining in the bone. The risk to bones,
3 such as bone cancer, is related to the radiation dose.
4 Excess bone cancers have been observed in animals
5 exposed to high levels of uranium. This has not been
6 seen in humans.
7 Behavior of inhaled uranium particles is
8 dependent on the solubility of the particular uranium
9 compound in body fluids. If the compound is soluble,
10 uranium will be absorbed into the blood and will
11 follow the pathways just described.
12 If the particles are highly insoluble,
13 some percent of them will remain in the lung for
14 months or years. Chemical toxicity due to uranium in
15 the lung or from pulmonary lymph nodes has not been
16 identified. The radiation dose to the lung determines
17 the risk of induction of lung cancer.
18 As noted before, radiation dose is higher
19 for enriched uranium than for natural or depleted
20 uranium. I have identified the two organs primarily
21 at risk from uranium, the kidney and the lung. The
22 following is a brief summary of findings from human
1 studies related to these organs.
2 The study subjects are uranium workers.
3 The principal mode of exposure to these workers is by
4 inhalation of dust particles. First, I will talk
5 about kidney toxicity.
6 The critical organ after an uptake of
7 toxic levels of soluble uranium is the kidney. The
8 resultant kidney damage has been extensively studied
9 in animals. The injury is caused by chemical damage
10 to the kidney cells and especially tubular cells. At
11 low dose, no damage is apparent.
12 But upon reaching a threshold
13 concentration of about 1 to 3 micrograms of uranium
14 per gram of kidney tissue, acute tubular damage occurs
15 within a day or two. The changes become progressively
16 severe over the first five days. If no further
17 uranium exposure occurs and the initial dose is not
18 lethal, the kidney damage is apparently repaired.
19 Based on animal data, a 50 percent lethal dose in man
20 should be no lower than 1 to 2 mg of uranium per
21 kilogram of body weight.
22 In the 1940s and early 1950s, many uranium
1 workers were exposed to excessively high uranium dust
2 concentrations. Dr. Newell Standard, an expert on
3 uranium toxicity, says these exposures, and I am
4 quoting here, "were some of the worst conditions of
5 exposure with the largest number of persons exposed of
6 any section of the atom bomb project."
7 The exposures didn't add much to the
8 clinical knowledge of uranium toxicity. Except for
9 few accidental massive exposures, no toxic symptoms or
10 chronic illnesses were seen. Now, about 50 years
11 later, the evidence of chronic effects on the kidney
12 in man is still meager and inconsistent.
13 Several investigations of exposed workers
14 have measured increased urinary excretion of amino
15 acids and beta-2 microglobulins. The workers are not
16 symptomatic and the clinical significance of these
17 findings, if any, is unclear. Human epidemiology
18 studies of uranium workers have not identified a
19 significant risk of kidney disease.
20 Now, to lung cancer. Retained soluble
21 uranium particles, the soluble particles in the lung
22 are rapidly absorbed into the systemic circulation and
1 become a potential toxic exposure to the kidney as
2 described previously.
3 The radiation dose from inhaled insoluble
4 uranium particles present a different risk, namely, a
5 risk of inducing an excess of lung cancer. In this
6 case, the risk depends on the radiation dose to the
7 lung. The results of epidemiological studies of
8 uranium workers has been variable.
9 In uranium miners, lung cancer excesses
10 are generally considered to be due to inhalation of
11 radon rather than the uranium content of the ore.
12 Milling of uranium ore is also associated with mixed
13 exposures, including radon and dust containing
14 arsenic, vanadium, radium, and thorium as well as
16 Interpretation of the data from such mixed
17 exposures is complex and tends to provide weak
18 evidence against specific effects from uranium.
19 Studies of workers exposed to enriched uranium at
20 uranium production facilities provide the most direct
22 Chekaway , in a study some years back,
1 showed a slight excess of lung cancer in such a
2 facility which produces enriched uranium but the study
3 could not take into account the effects of smoking.
4 Publication this year by Lomis and Wolf updates the
6 Statistically significant increase in the
7 mortality rate from lung cancer was observed compared
8 with the U.S. white population. They concluded the
9 increase was work-related but recommended attention
10 should be given to exposures to radiation, beryllium,
11 solvents, and other agents.
12 Hookfair et al. found an increased risk
13 for lung cancer in workers with lung doses of 20 rads
14 or more from uranium but only in persons who were over
15 the age of 45 when first exposed. In a case-
16 controlled study of 787 workers from four uranium
17 processing facilities, Dupree et al. in a publication
18 last year concluded that there was no dose response
19 relationship between lung cancer and radiation dose to
20 the lung.
21 Limitations of the study included
22 uncertainties in estimating internal lung dose, lack
1 of smoking information, and the small number of
2 workers in the highest dose categories. These limited
3 and inconsistent findings on lung cancer do not
4 provide adequate evidence to quantify the risks
5 associated with chronic exposure to enriched uranium.
6 So in conclusion, one can conclude that
7 the studies of health effects to workers exposed to
8 uranium is meager and inconsistent. At these dose
9 levels, these occupational levels, they provide little
10 epidemiological support for kidney damage or excess
11 malignant tumors.
12 A similar conclusion was reached by the
13 Committee on the Biological Effects of Ionizing
14 Radiation of the National Research Council, National
15 Academy of Science in their 1988 Veer report. That
16 is usually referred to as the Veer 4 report. Thank
18 DR. TAYLOR: Thank you, Dr. Voelz. I have
19 just one question. Are the health effects from
20 depleted uranium any different from those known to be
21 caused by uranium?
22 DR. VOELZ: Well, as I said, the major
1 difference would be the radiation doses are lower in
2 the depleted uranium because it has a lower content of
3 uranium 235 so the radiation effect would be, for the
4 same weight of material, would be less.
5 DR. TAYLOR: In the depleted uranium?
6 DR. VOELZ: In the depleted uranium.
7 DR. TAYLOR: Do we actually know what some
8 of the health effects, then -- so they would be
9 similar or not as strongly identified?
10 DR. VOELZ: They would be similar to other
11 uranium in the sense that, except for the more highly-
12 enriched uranium, the limiting factor is the chemical
13 toxicity and in that regard, they would be similar.
14 So for -- and the primary organ then is the kidney.
15 DR. TAYLOR: Kidney. I had one other
16 question. You also mentioned about the fact that
17 similar to some of the others like lead that uranium
18 has some impact on the bone and can be stored in the
19 bone. And you also mentioned, I believe, there is a
20 time period that usually does not stay or does -- for
21 lead, for instance, it takes a long time before that
22 that is resident in the bone will go --
1 DR. VOELZ: Yes. Uranium is stored in --
2 by bone. It is about -- in an immediate exposure,
3 acute exposure, probably as much as 20 percent will
4 actually wind up being deposited for some period of
5 time. And of that 20 percent, most of that goes out
6 within the first few months and then you are left with
7 about 2 percent that is long-term storage and that
8 will last for years.
9 DR. TAYLOR: Do we know of any known
10 health risk or --
11 DR. VOELZ: No. And there doesn't seem to
12 be any -- from the animal work, there doesn't seem to
13 be any chemical effect in the bones so there you are
14 back to the radiation dose and the bone deposits are
15 primarily a radiation source to the bone and there you
16 might worry about increased bone tumors -- malignant
17 tumors. And that has been seen in animal studies at
18 high levels.
19 DR. TAYLOR: Any other questions of Dr.
20 Voelz? Mark?
21 MR. BROWN: Dr. Voelz, I think we have had
22 a uranium industry, uranium miners and fabricators,
1 people working with uranium in this country for 50
2 years or so. There have been a number of studies --
3 epidemiologic studies looking at the health effects
4 that this working group suffer.
5 Has there been any studies that are
6 outstandingly different? I mean, you sort of talked
7 about the trend of all the epidemiologic studies about
8 this group. Has there -- are there any studies that
9 would lead us to -- give us any more caution than what
10 you seem to suggest in your testimony?
11 DR. VOELZ: I think these studies are
12 complicated and, you know, lung cancers have been one
13 of the primary findings in miners -- understand miners
14 as well as in milling. And that has been complicated
15 by the fact that we have high radon levels in the
16 mines and in the mills. And it is a lung carcinogen
17 and alpha -- produces alpha dose -- alpha radiation
18 doses which, in fact, are generally higher than what
19 you would see in uranium.
20 So by and large, those effects you have
21 are attributed to the radon.
22 MR. BROWN: Rather than uranium.
1 DR. VOELZ: Yes. And that is confusing to
2 people because they know uranium miners get lung
3 cancer and yet probably uranium had little to do with
5 DR. TAYLOR: It is the radon.
6 DR. VOELZ: It is the radon in an enclosed
7 space, you know, when they weren't ventilating mines.
8 DR. TAYLOR: Mike?
9 MR. KOWALOK: Dr. Voelz, last autumn,
10 there was a issue of Life magazine where the cover
11 story was about Gulf War veterans who are concerned
12 about children being born with birth defects. And I
13 ask you, can you comment on what is known about
14 uranium exposures and birth defects?
15 DR. VOELZ: Birth defects -- I am assuming
16 these are what we would term congenital anomalies as
17 opposed to genetic changes and there are both of these
18 and they are quite different. But the congenital
19 anomalies occur primarily as a result of the case of
20 radiation -- to the radiation of the fetus at very
21 specific times, usually in the first three months of
22 the pregnancy.
1 Radiation, if it occurs just at the very
2 sensitive periods, can produce changes during this
3 period but you have to have doses that are, at least
4 in the medical profession, generally 10 rad or 10 rem
5 is sort of the level at which they feel they are
6 reaching a threshold where such findings could occur.
7 And so below that level, usually there isn't any
8 significant concern.
9 In uranium, you have got the problem of --
10 if you have inhaled or had an exposure -- chronic
11 exposure -- the radiation doses are really spread out
12 over very long periods of time so you don't have a
13 dose high enough within a few days to really be
14 concerned in terms of exposure to the fetus.
15 So from a radiation standpoint, this seems
16 like a very remote possibility. I am old enough so I
17 never say never, so I just simply say a very remote
18 possibility. But there have been studies of the
19 chemical effects of uranium in animals. It has been
20 done primarily in rats where if you give a fairly high
21 dose and in very specific times during gestation, in
22 other words, it would have to be specifically when the
1 organs are being developed but you can get a chemical
2 effect from uranium that has produced these effects in
4 But again, the human exposures aren't
5 acute where they are usually not at these timing
6 intervals. They could be, if you had a large accident
7 just at the right time but for example, in the animal
8 experience, they -- experiments -- they injected
9 uranium intravenously just at the right days in order
10 to produce this effect. And in the exposures that
11 people have, usually they are not that acute and not
12 that well-timed so that the limits are more spread out
13 over what happens over a longer time period.
14 So this again does not appear to be a
15 problem. So overall, I would rate that as a very
16 remote possibility.
17 MR. KOWALOK: And of the information that
18 you just went through, that was entirely maternally
20 DR. VOELZ: Internal?
21 MR. KOWALOK: Maternally.
22 DR. VOELZ: Maternal, oh.
1 MR. KOWALOK: Mediated. It was --
2 DR. VOELZ: Yes, of the fetus during
4 MR. BROWN: In other words, this was
5 experiments done with pregnant rats where the dose
6 was --
7 DR. VOELZ: Right. And they --
8 MR. BROWN: -- the rat was already
9 pregnant when the --
10 DR. VOELZ: They would do it certain days
11 of the -- as a matter of fact, it is so specific, if
12 you have enough information, if you give it on a
13 particular date, you can almost predict which organ or
14 which part of the extremity or something is going to
15 be affected. It is just that time-sensitive.
16 And if it is primarily in the first -- in
17 the case of humans, this would be in the first
18 trimester, the first three months.
19 MAJOR KNOX: So could it be a cause for a
20 congenital defect for a man to produce a child?
21 DR. VOELZ: No. Men, it would not be a
22 problem that way. Men would be a problem from a
1 genetic standpoint. I mean, they could have genetic
2 changes which could involve future children. And this
3 is a separate -- this is a different kind of a change
4 from the congenital change -- congenital
6 But again, the genetic effects, as with
7 radiation, is studied primarily by external radiation
8 like x-rays, medical people who give medical x-rays
9 and the atomic bomb survivors. And strangely enough,
10 even at very high doses, there hasn't really been
11 anything in humans to give us an idea.
12 Apparently, the human genome is so well-
13 protected with pair mechanisms we haven't seen that --
14 the genetic effects. And so our data is taken
15 primarily from a lowly mouse with the experiments that
16 you can design and actually our limits for genetic
17 effects are based on mouse experiments primarily. And
18 I don't think any of the uranium doses really have a
19 chance of producing that, simply if we look at the
20 distribution where the uranium is, it is in kidney and
21 bone and the rest of it really is pretty low level.
22 DR. TAYLOR: Thank you, Dr. Voelz. We
1 will move on and wait for other questions at the end.
2 Dr. Shelton?
3 DR. SHELTON: Thank you. Can we get the
4 overhead here?
5 Today, I want to talk about a report that
6 I participated in the preparation of during my tenure
7 as the interim director of the Army Environmental
8 Policy Institute. I was on loan to the Army from the
9 University of New Mexico. I am back at the University
10 of New Mexico and no longer in the employ of the Army.
11 I want to talk about the health and
12 environmental consequences of depleted uranium in the
13 U.S. Army. Next slide, please. And of course, this
14 is a presentation to this committee. I have got a
15 disclaimer in here. The Secretary knows that I tend
16 to value science over policy sometimes and so rather
17 than turn loose a loose machine gun, they asked me to
18 put this in.
19 Let me give you some background on DU as
20 far as the Army is concerned -- and I am focusing
21 primarily on the penetrator rounds, not tank armor.
22 Tank armor is fairly benign but I would be pleased to
1 answer any questions on tank armor that may come to
2 the floor.
3 Desert Storm was the first combat use
4 Congress directed the Army Environmental Policy
5 Institute to look at four specific items in language.
6 These four specific items were evaluated. However, as
7 the project evolved, the Congress informally requested
8 that we try to do essentially a cradle to grave
9 evaluation of the Army's program.
10 Next slide, please. We released a summary
11 report to the Congress in June 1994. A technical
12 report which backed up the assertions in the
13 congressional report was released finally in May 1996.
14 We found that on the four specific items tasked by the
15 Congress, we found that relative to the other
16 battlefield hazards that are on your battlefield, the
17 DU contamination is probably a relatively small
19 We found that remediation technologies
20 involved excavation, physical or chemical separation,
21 in-place stabilization of the uranium in the
22 environment. We found that -- the Congress asked us
1 to find ways to change the inherent toxicity of
2 depleted uranium.
3 Well, you can't change the inherent
4 toxicity of an element. If you consider radiation
5 toxicity a piece of this, theoretically, you could
6 slightly reduce that by further reducing the
7 concentration of 234 and 235 isotopes in depleted
8 uranium but the improvement is trivial. The chemical
9 effects are far more of a concern in most instances
10 than the radioactive effects, anyway.
11 In conclusion -- and please don't shoot me
12 in the back out there -- the Army contends it has done
13 an excellent job in attending to the environmental
14 health impacts of DU systems. And I fully concur with
15 that from the time the uranium comes into the Army's
16 control until it goes out the muzzle of a weapon. I
17 believe that to be true.
18 I also believe that they have been very
19 proactive in recovering rounds. Those are recovered
20 rounds off of Yuma Proving Ground and they have a
21 fairly high recovery rate at the Yuma Proving Ground.
22 As a result of this investigation,
1 however, the Army has initiated several efforts to
2 improve their management of DU. In general, their
3 report has recommended to the Secretary that the Army
4 establish a DU management office and consolidate and
5 coordinate all efforts and licenses associated with DU
6 and the Army.
7 Right now, there are 247 different offices
8 that in some way affect DU acquisition, storage,
9 research, development, maintenance, etc., in the Army.
10 And one hand often doesn't know what the other hand is
11 doing. We feel that needs to be rectified.
12 Revise Army regulations to link all phases
13 of the DU management life cycle. The Army, like all
14 of DOD, like much of the government, has trouble
15 funding out years when they are creating liabilities
16 today and that is a problem with DU. When you are
17 developing a system, you are creating a future
18 liability on ranges and in manufacturing facilities if
19 they are government-owned.
20 Complete life cycle costs of DU weapon
21 systems is a must. We need to know what the costs
22 are. People contend that there are alternatives to DU
1 because they are less expensive in remediation, less
2 of a health hazard, etc. That is fine but let's
3 compare apples with apples and look at the whole cycle
4 on both systems or all systems before we make those
6 The Army uses the term EA both as a
7 weapons system term -- environmental assessment -- and
8 as a range term and that has been a problem in dealing
9 with the public from time to time because EA is
10 normally tied to a location and not to a system. And
11 so we recommended that they rectify that problem.
12 In terms of test range and battlefield
13 issues, training. The Army has done a poor job
14 training troops on what DU is, what the hazards are,
15 and we recommended that they deal with that in
16 training the people who go out and try to find DU,
17 people who work on the weapons systems and also the
18 medical specific issues.
19 We had some information third- and fourth-
20 hand that some of the medical personnel in the Gulf
21 War were afraid to work on people who had been -- who
22 had received fragment wounds because they were afraid
1 of the radiation. And that needs to be dealt with.
2 Test ranges and battlefields, medical
3 surveillance. We need to look at these people that
4 were exposed to friendly fire incidents and through
5 maintenance incidents, not for five years, not for ten
6 years but we need to look at them as long as it takes
7 to understand the dynamic.
8 We need to develop better medical
9 protocols as I indicated earlier for managing DU
10 wounds and we need to support the research to look at
11 the consequences of low-level exposure. All of us
12 that work in this area from a theoretical standpoint
13 always sort of wring our hands and try to figure out
14 if these points we extrapolate, not interpolate,
15 beyond the data have any meaning at all. So it is not
16 a problem just for DU, it is all the way across the
18 We need to assess the exposure potential
19 for personnel, new guidance to define protective
20 techniques if necessary, standardized markings of all
21 the munitions. Early munitions were marked, Not
22 depleted uranium but stable-oid .
1 And there is an element within the
2 community that says, Well, let's just mark it stable-
3 oid and nobody will worry about it. That is not my
4 idea of a good thing to do, nor is it yours, I
5 suspect. And we need to conduct analysis to better
6 understand all of the potentials to leak this into the
8 From the environmental policy perspective,
9 the Army has done individual environmental
10 assessments, largely what we call an in environmental
11 engineering Fonzis -- no significant environmental
12 effect -- for their various munitions.
13 We have proposed that the Army consider
14 looking at an umbrella document that covers all the DU
15 penetrators, all the models for all the weapons
16 systems and use this as an umbrella program so that
17 the environmental procedures taken by weapons systems
18 developers don't vary from system to system.
19 We need to deal with disposal plans. The
20 Army is a nation-wide system. However, some of our --
21 our test ranges are located only in two places now,
22 Aberdeen Proving Ground and Yuma Proving Ground.
1 These testing locations have to be part of the
2 compacts -- state compacts, so there is a problem in
3 terms of volume in the compacts, as you might imagine.
4 We have another problem in that we have large
5 quantities of unspent R&D ammo -- DU ammo that we
6 can't figure out what to do with.
7 Environmental policy, develop a strategy
8 for managing ranges. Ranges are a very pervasive
9 issue. We are in the midst of a brack closure on
10 Jefferson Proving Grounds right now. Without applying
11 reason to the closure, applying only the letter of the
12 NRC regulation, it would cost 4- to $5 billion to
13 clean up Jefferson. That is unreasonable. Not
14 unreasonable as far as the Army is concerned but that
15 is an unreasonable expense of taxpayers' dollars.
16 We need, then, to address the long-term
17 liability issues. We need to separate high explosives
18 of DU and we need to require catch boxes. If you will
19 go on to the next slide. I am running him into the
20 ground here. These college professors talk too fast.
21 No, there is one before that -- the catch box.
22 A lot of people don't know what a catch
1 box is. This is one under construction at Yuma
2 Proving Grounds. It is back-filled with mason sand,
3 essentially, and built up another -- about that much
4 higher above that frame. And you fire -- that is
5 behind the target and it catches the DU ammunition so
6 you no longer contaminate a broad area of range, you
7 just contaminate the one catch box. Next slide,
9 We want to conduct -- we need to conduct
10 range contamination surveys and gather the data on
11 what we have got on our ranges. And all of this I
12 talk about for ranges, you can substitute battlefield
13 if we are working with a country such as Kuwait or
14 whatever to deal with problems in the former
16 Use risk assessment to deal with the cost
17 issues. We have to develop a risk-based approach to
18 management of environmental issues and we can provide
19 remediation guidance to DOD and DOE and foreign
20 nations as a function of our work.
21 I threw in a couple of slides. I am a
22 researcher. I got off into the policy area, have
1 often wondered why. This is a showpite . This is on
2 the Yuma range. That is a penetrator that has
3 oxidized into -- it is a mixed oxide +4 and +6.
4 The next slide is some work we are doing
5 in our lab at the University of New Mexico. On the
6 left side, you see large, sort of blank dots on the
7 microgram. It is an electron microgram. Those are
8 bacteria and the little round -- I don't have my
9 glasses on -- the round ones are the U in the +6 state
10 and the rods are +4 so it is reducing the uranium from
11 a soluble +6 to a insoluble +4.
12 And the caveat on all this -- the next
13 slide -- the caveat on all of this stuff is that
14 uranium -- depleted uranium is a weapons system that
15 the Army has chosen to use. And I didn't make that
16 decision. You didn't make the decision but the people
17 who did make the decision felt that it offered a great
18 deal of advantage to our people and that decision is
19 one that can be debated elsewhere.
20 In terms of dealing with the issue and
21 dealing with managing uranium, we have to look at the
22 risks, both environmental and human health risks and
1 the costs associated with those risks and then somehow
2 from those data, we have to promulgate reasonable
3 environmental policies. Thank you very much.
4 DR. TAYLOR: Thank you, Dr. Shelton. I
5 have just one question regarding the study of -- the
6 Institute's study of the health and environmental
7 consequences of depleted uranium. Were there any
8 findings or recommendations within that review that
9 are directly related or relevant to explaining the
10 symptoms being reported by the Gulf War veterans?
11 DR. SHELTON: Not -- none of the symptoms
12 that I am familiar with.
13 DR. TAYLOR: Any other questions?
14 MR. KOWALOK: I have a couple of
15 questions. This morning -- well, actually throughout
16 the committee's work, there has been a lot of talk and
17 concern among veterans' groups about an incident at
18 Doha, Kuwait, where a large ammunition dump fire and
19 a number of rounds of depleted uranium are believed to
20 have blown up and contaminated the area.
21 In the work of the AEPI in the course of
22 making that report, did you all make an effort to go
1 over to Doha or Saudi Arabia and look for?
2 DR. SHELTON: We requested permission to
3 go over and sample the Doha site. There was also an
4 embankment that was used to zero tanks -- tank guns
5 and approximately one-third of the total rounds fired
6 went into that embankment in the whole Desert Storm
7 event. And there is a couple of areas in Kuwait that
8 we wanted to look at.
9 We requested permission through the
10 Secretary. It went to State and came back. We
11 couldn't do that at the time. I understand since then
12 that there has been a group from CHPPM, the Army
13 laboratory at Aberdeen, Maryland, and they have done
14 some sampling but that is after my involvement with
15 this situation.
16 MR. KOWALOK: The other question I had was
17 a little bit more philosophical in nature but it
18 had -- it has to do with, in the midst of conducting
19 such a review about the risks of health consequences
20 of using some agent, whatever that agent is, what is
21 your experience as far as including community groups
22 such as groups who we now hear from who are concerned
1 about depleted uranium?
2 DR. SHELTON: Well, I think everyone here
3 is aware that the Army, the Department of Defense, the
4 Department of Energy -- all the federal agencies are
5 becoming more accountable for their actions to the
6 public and I think that is good.
7 When I was the director of the Institute,
8 I had a colleague who was well-trained in public
9 policy and she and I worked for two years to try to
10 begin a dialogue among all of the groups interested in
11 depleted uranium, from manufacturers to the grass-
12 roots public interest groups.
13 And we had begun this process. As you can
14 imagine, the Secretary was a little bit nervous about
15 that process but we had gone along and made convincing
16 arguments all the way through. Unfortunately, that
17 did not come to fruition until after I left to go back
18 to the University of New Mexico and there was a
19 incident where one of the grass-roots groups published
20 an article in Defense Environmental Weekly that got
21 into the Secretary's office. And everybody got
22 frightened. And the new director was a 20-year Corps
1 of Engineers guy and they said, No, we won't do it.
2 And so I didn't feel very good about that.
3 They tried to call me but I was in Russia at the time
4 and they canned it. So I thought we lost the high
5 ground. I had tried to create an environment for this
6 report with the congressional study and with the
7 dialogue where we were projecting a public image that
8 said we are open, we want to talk, and we are
9 concerned. And that is the way I felt and that is the
10 way my colleagues felt.
11 There are a continuum of opinion on how to
12 do that in the Army and I represent only one point of
13 view. And when I was the boss, I was able to put that
14 point of view forth but when I am not the boss
15 anymore, they can do whatever they want.
16 DR. TAYLOR: I think we need to move on to
17 Dr. Hickman and then we will come back for
18 questions -- additional questions at the end, of that
19 is okay. Dr. Hickman?
20 DR. HICKMAN: I would like to thank the
21 panel for allowing me to address them today. By way
22 of introduction, I have been a practicing health
1 physicist for approximately 18 years since receiving
2 my master's at Colorado State University. In that 18
3 years, I also went back for a Ph.D. at New York
5 My specialty in radiation production is in
6 internal dosimetry and in vivo measurement. I have
7 done this type of work for on the order of 15 years
8 now and in particular, bioassay. I am on several
9 international committees on whole body counting and on
10 calibration structures for whole body counting.
11 I am on ANSII committees as well and am
12 now a -- at Lawrence Livermore National Laboratory
13 have a dual role as both a researcher and as an
14 operational and technical specialist in our whole body
15 counting facility.
16 What I would like to cover with the panel
17 today is, what some of the techniques -- what are some
18 of the techniques we use to assess depleted uranium
19 exposure in the occupational environment. Keep in
20 mind that these exposures in the occupational
21 environment are extremely low exposures. They are
22 exposures that would not -- where you would not see
1 any acute health effects and definitely would not see
2 acute health effects in six year. So these are the
3 monitoring methods for the occupational environment.
4 Let's look at the most common methods that
5 are used. Typically, we use in vivo measurement
6 for -- and in particular, this is a measurement of the
7 lung for depleted uranium, particularly the oxide form
8 or what we call class Y. This means it retains in the
9 lungs for a period of years.
10 This is a certain chemical form. This
11 would be called under an occupational health guidance,
12 this would be called insoluble uranium. So in vivo
13 measurement in the lung is an appropriate technique
14 that we would use in monitoring workers who might be
15 exposed or have a potential for being exposed to
16 insoluble forms of uranium.
17 Urinalysis is also used. It is probably
18 the primary method used in the occupational
19 environment, both for soluble and insoluble and it has
20 reasonably good sensitivity levels. And of course
21 periodically, especially in the environments that we
22 deal with machining metals in the occupational
1 environment, you have a potential for wounds. You can
2 get puncture wounds, primarily in the hands, as are
3 usual location for such puncture wounds so we
4 oftentimes will do in vivo measurement of the wound.
5 Of course, if we confirm an intake by any
6 of these methods or a deposition of uranium through a
7 wound, we would do additional sampling. We
8 continue -- or we would use a mixture of these types
9 of sampling and we may even use some special
10 alternative techniques to help us assess what the
11 potential amount of uranium that was incorporated into
12 the body or the amount that was, as part of the
14 Intake is a little different than
15 deposition. Intake starts at the nose or mouth
16 whereas deposition is something as once the material
17 is in a compartment where it is direct access to the
18 bloodstream. So uptake is the word for that.
19 So there is some -- I have to apologize
20 because this is a highly technical specialty in my
21 field and so if I get into some terminology, I am
22 sorry but it is -- this is not something where you can
1 take somebody off the street to do this type of work.
2 One measurement is used as a tool to
3 directly measure the intake of a radionuclide. In
4 other words, if we can measure the material in the
5 lungs or in the body using our highly sophisticated
6 detection systems, we can know that there is material
7 in that location. It is a direct measurement.
8 With depleted uranium, we are measuring
9 what we call low energy photons. These photons have
10 energies of about 63 and 93 KEV and they are actually
11 photons that are associated with the first daughter of
12 uranium, thorium 234. Thorium 234 becomes an
13 equilibrium with uranium 238 within a matter of months
14 after the U-238 has been separated. So -- and there
15 is no reason to believe that the thorium 234 would
16 preferentially dissolve or be removed from a uranium
17 particle in preference to the uranium except possibly
18 on the surfaces of the particle.
19 So it is not as if biological lung fluids
20 would go in and seek out in the middle of a uranium
21 particle, the thorium 234 and remove it preferentially
22 to the uranium. That is just not an appropriate
1 physical process as we know it. So using thorium to
2 infer uranium is an accepted practice in the
3 occupational environment and has proven to be
5 Just to give you an idea of what a
6 typical -- this is actually a state of the art type
7 lung measurement system. It has multiple detectors.
8 It has an array of six detectors, three detectors over
9 each one. Again, this is highly sophisticated
10 equipment. It is not something that you just plug
11 anybody into and let them play with it. They are --
12 DR. TAYLOR: Can you explain -- before you
13 go on --
14 DR. HICKMAN: Yes.
15 DR. TAYLOR: How is that done? I mean,
16 for measuring -- just a brief explanation.
17 DR. HICKMAN: Sure.
18 MR. BROWN: And how long it takes.
19 DR. HICKMAN: Sure. Basically, the
20 patient or the worker is placed in the chair and we
21 place the person -- they recline at a 45-degree angle.
22 This allows us to flatten the chest fairly well. And
1 we place these detectors over the lungs. We have a
2 particular placement scheme utilizing the sternum and
3 the clavicles.
4 DR. TAYLOR: To identify the location?
5 DR. HICKMAN: To identify the locations.
6 And we then -- the person sits there and actually in
7 our facility, we have a headset for a radio or his CDs
8 and they can listen to the radio or CDs and they sit
9 there for 40 minutes. It is noninvasive. It is only
10 measuring the radiation coming out of the body. It is
11 not putting radiation into the body in any shape for
12 form. It is only measuring radiations coming out of
13 the body.
14 Obviously, that process can be complicated
15 by other materials in the body -- medical isotope are
16 oftentimes in the occupational environment a real pain
17 to deal with. The reason we utilize this type of
18 system is just because of that. We will occasionally
19 have workers who are undergoing various medical
20 procedures which would use radioisotopes in those
21 procedures and we still need to monitor them for the
22 isotopes that they may be exposed to in the workplace.
1 These types of detectors are state of the
2 art, highly sophisticated, able to resolve differences
3 between the various radionuclides. There are other
4 types of detector systems and I don't mean to say that
5 they are any worse at all. They are just as good if
6 you know what you are dealing with at the time of the
8 So that basically is the technique. We
9 will get into a little bit more about some of the
10 complications associated with that. As I have already
11 mentioned -- go ahead, next slide -- as I already
12 mentioned, that we infer the uranium activity
13 utilizing thorium 234 and when we go to calibrate our
14 systems, we have to use calibration structures that
15 are very human-like or realistic.
16 Livermore has really developed the de
17 facto standard that is used throughout the industry to
18 calibrate these types of systems for lung measurements
19 and this is the Lawrence Livermore National Laboratory
20 Torso Phantom. Inside are realistic lungs. You can
21 have kidneys, a realistic liver, and so on, so we
22 have -- it was actually designed by consensus
1 committee in the industry and then built at Livermore.
2 This Phantom is not cheap, either, so it is not
3 something you just pick up off the street.
4 When we look at our calibration and our
5 ability to detect the thorium 234 in a human subject,
6 the detection level will depend on the stature of the
7 patient. Basically, the patient is emitting natural
8 radiations from their body. Potassium 40 complicates
9 our measurements slightly.
10 And also everybody has slightly varying
11 chest wall thicknesses. Since these detectors are
12 placed on the front of the chest, the chest wall
13 thickness will vary. To do a very accurate
14 measurement, we will actually use ultrasound to
15 measure the chest wall thickness under each detector
16 area and then calibrate our system. And therefore, we
17 calibrate our systems on the basis of chest wall
19 Basically, we can see within the lungs
20 anywhere from 2.6 to 22 mg of uranium.
21 MR. BROWN: Excuse me. Does that mean in
22 a single particle or distributed evenly throughout the
1 lung? What does that --
2 DR. HICKMAN: Our assumptions in
3 calibration are distributed evenly throughout the
4 lung. With a multiple detector system like we have,
5 if we saw a particle, we would see a real preference
6 of one detector over all of the other detectors.
7 In routine operations, we do not see this.
8 The concept of a single particle with all of this
9 activity means it is a very big particle.
10 MR. BROWN: Pretty big particle.
11 DR. HICKMAN: And if it is a big particle,
12 it usually is going to clear and either be exhaled or
13 swallowed down the GI tract and excreted through the
14 feces very quickly so it is not our experience to
15 single particles.
16 There are commercial services that can
17 perform these types of measurements. Their detection
18 levels are usually a little bit higher. These
19 commercial services are usually fairly portable. They
20 are usually like mobile vans. They can be taken from
21 one area to another but they have a varying degree of
22 detection because the natural background changes.
1 Natural background in Denver is quite
2 different than the natural background in California
3 where I am from. So the detection limits will vary in
4 these types of systems and so that is one confounding
5 factor in making these types of measurements.
6 Costs for such a count are fairly high.
7 They are expensive measurements. They can be anywhere
8 from 200 to $300 per patient and you can vary the cost
9 slightly based on the number of patients being
10 measured. The more patients you measure, usually the
11 less the cost because it costs less to do the set-up.
12 The degree of quality that is specified in
13 setting up any contractual agreement with the
14 organization that is doing these measurements will
15 affect cost and so on so these -- and any additional
16 contract specifications so these things can drive the
17 cost and they can even get even higher than 600 if you
18 were to get highly specific in your contract
20 Techniques throughout the country are
21 fairly -- I won't say they are standardized; however,
22 they are consistent with one another. People will use
1 slightly different techniques in their measurement
2 process; however, we have done inter-comparisons over
3 the last 25 years and we tend to agree with one
4 another very well. So for the most part, we agree.
5 With regard to commercial situations, you
6 do have to keep in mind, what you pay for is what you
7 get. It very much is an industry type scenario. If
8 you were to look at possible locations to do these
9 types of measurements, there are only -- there are
10 really only a handful. They are not necessarily
11 conveniently located and they aren't necessarily near
12 any large cities, which you could have populations.
13 Some are, some are not.
14 This is just off the top of my memory of
15 locations that potentially could do this type of
16 measurement. And these are mostly occupational
17 environment areas. One of them in California is the
18 commercial vendor and again, they would drive -- they
19 drive trucks to uranium mills, mines, so on, and make
20 these kinds of measurements.
21 What are some of the strengths and
22 weaknesses of in vivo measurement? Well, first of
1 all, it provides a direct measure of the radioactive
2 materials in the body. That is a definite strength.
3 The detection levels for occupational situations are
4 reasonable. That is assuming annual exams, which is
5 what we normally do in the occupational environment.
6 When we take these results, what do we do?
7 We estimate intake from these results. When we do
8 that, we need fewer assumptions. When we have a
9 direct measurement, we need fewer assumptions in
10 estimating the intake. And the other advantage that
11 in vivo measurements have is that they provide instant
12 results. If you are person who loves instant results
13 and self-gratification, this is the way to go although
14 it is very expensive.
15 The weaknesses, obviously cost. It is
16 costly. It requires the patient to be still for 30,
17 40 minutes. Usually with a worker, that is not too
18 hard but for some people and people especially
19 suffering from illnesses, this can be very difficult.
20 It requires good quality assurance,
21 highly-trained technical staff and the techniques are
22 not necessarily standardized. Although they are
1 consistent with one another, the results tend to be
2 consistent, the techniques are not necessarily
4 What we do with bioassay results is we
5 simply want to assess the intake. And what would you
6 do if you were to collect this type of information?
7 You simply would take the measurement or measurements
8 on each person and evaluate the intake. And then you
9 would compare that intake to some level of intake that
10 has been determined to cause specific illnesses,
11 illnesses very much along the lines of what Dr. Voelz
12 was talking about -- or possible effect.
13 This type of evaluation on top of the in
14 vivo measurement is also costly. A recent study
15 looking at plutonium workers, 141 cases, resulted in
16 approximately a $500 per case analysis. So the
17 results need then additional work in order to give
18 anything that would be meaningful in the radiation
19 protection field.
20 DR. TAYLOR: Dr. Hickman, we would like
21 for you to wrap up soon so that we could have some
22 kind of questions, too. Thank you.
1 DR. HICKMAN: All right. The real
2 question really is, from an occupational point of
3 view, we have to assess, well, who gets monitored and
4 who doesn't? And our real question always is, is it
5 feasible that there could have been or that there can
6 be significant exposures? And that is the real
7 question, I think, in the situation that you have
9 Before addressing or taking on any sort of
10 in vivo measurement, it seems more likely to address
11 the question, is it likely that there are or were
12 significant exposures? And then, of course, we have
13 to define significant. What do you mean by
15 So with that, I will leave it to
17 DR. TAYLOR: Thank you. I have a question
18 to start. I have heard a lot about whole-body
19 counting and you talked specifically here about
20 counting in the lung, the radionuclides. In terms of
21 technology, availability and cost, is it feasible to
22 use whole-body counting to test Gulf War veterans for
1 DU exposure?
2 DR. HICKMAN: Whole-body counting is a
3 generic term and used loosely. It can mean lung
4 measurement. It can mean a scan of the whole body.
5 Whole-body counting is where you are scanning the
6 whole body, is a cheap procedure. It is designed to
7 detect photons beyond 100 to 200 KEV. It would not
8 detect the photons that you would need to detect for
10 MR. RIOS: Dr. Shelton?
11 DR. SHELTON: Yes, sir.
12 MR. RIOS: What are the characteristics of
13 DU as used in these weapons systems that make it the
14 choice of the Army?
15 DR. SHELTON: The specific gravity, the
16 density, if you will. These weapons depend on kinetic
17 energy, which is the mass or weight of the projectile
18 and the velocity together. Gun tubes are limited in
19 terms of the velocity you can attain so if you put
20 something like depleted uranium with a specific
21 gravity of 19, roughly, you can get roughly twice as
22 much energy in that at the same velocity as you could
1 with lead, for example.
2 One of the pyrophoric issues, as it turns
3 out, it is really not an issue in terms of the weapons
4 performance. The sheer strength is the greatest
6 DR. TAYLOR: One of my concerns, given
7 that I come from the work environment setting where we
8 do a lot of employee training and providing
9 information on exposures and what the risks are, and
10 you mentioned your report on recommendations that were
11 made, Dr. Shelton, that they would expand -- one of
12 the recommendations was to expand training to service
14 DR. SHELTON: Yes, ma'am.
15 DR. TAYLOR: Who received this information
16 and is this to the Army directly?
17 DR. SHELTON: This was tasked out of the
18 Secretariat to the ACSM for implementation. And as
19 I said earlier, I have not been an employee of the
20 Army for -- on loan to the Army for over a year so I
21 am not privileged to know where they are since they
22 are internal programs but it is my understanding that
1 those programs are, in fact, ongoing.
2 DR. TAYLOR: I would be curious, one of my
3 interests is to find out just how much more training
4 will be available to the servicemen to understand some
5 of the health risks associated with depleted uranium
6 and some of the other risks that heard about in terms
7 of --
8 DR. SHELTON: Well, really there are
9 fundamentally two risks that we don't understand in
10 terms of exposure. Now, the medical end, I am not in
11 a position. I know enough to be dangerous there. But
12 one area we don't understand is how DU migrates into
13 the environment.
14 We don't understand the thermodynamics,
15 the kinetics of speciation in soils, which means, is
16 it in a soluble or insoluble state and how does it
17 change as a function of time and of soil chemistry and
18 of moisture and all that. So that is one area that
19 the Army is trying to better define and in fact, the
20 University of New Mexico is finishing up a project
21 now, trying to look at some of those issues.
22 The other area is the exposure to high-
1 density aerosols, particularly within a vehicle that
2 has been struck by a penetrator. And there are
3 several things here. First, one could criticize the
4 Army for not considering that before the Gulf War.
5 However, I submit that the strategic
6 planners for kinetic energy penetrators estimated the
7 risk of survival in a direct hit from a penetrator was
8 less than a tenth of 1 percent when in fact, our
9 experience shows us that was baloney. The true
10 survival rate was about 65 percent; about 40 percent
11 in the tanks and about 75 to 80 percent in the
13 So it is a problem that is a bad problem
14 but it really is a pretty good problem to have, to be
15 honest. However, we need to define that. When a
16 penetrator hits steel with that much energy, it is a
17 high temperature impact. And during the pyrophoric
18 event that follows, not unrelated to the weapons
19 action but just very small particles burning, aerosols
20 are created.
21 There is some evidence that some of those
22 aerosols are in unusual oxidation states. In the
1 environment, we see 4 and 6 -- +4 and +6. And
2 everything goes to that pretty quick in a natural
3 environment. I don't know what it doesn't allow. He
4 doesn't know what it doesn't allow. He doesn't know
5 what it doesn't allow. Nobody knows. It hasn't been
6 really looked at and it is very hard to recreate that
7 kind of situation. And I think that is one of the
8 areas that concerns me the most.
9 MR. BROWN: Dr. Hickman, in your
10 discussion of that assay for lung concentrations of
11 uranium, I guess one thing impressed me was, it is
12 really not very sensitive, is it? You mentioned 2 to
13 20 mg was the detection limit so you would have to
14 have inhaled a good slug of it.
15 But what my question is, is if you -- I
16 didn't hear it. Maybe you said this and I just didn't
17 hear you but if you find occupationally, if you are
18 monitoring workers in the uranium industry and you
19 find someone who has got, say, just at the detection
20 limit or maybe to ten times higher than that, what do
21 you do, then?
22 I imagine you take that person off that
1 job or look into the exposure situation. But I guess
2 my real question is, are there any therapies? Are
3 there any treatments for somebody who has apparently
4 absorbed a dose like that? Can you do anything for an
5 individual who may have inhaled such a large dose?
6 DR. HICKMAN: Well, actually given the
7 frequency that we monitor and the level and depending
8 upon when the intake was, how far back in time, we can
9 actually see below what is called an annual limit of
10 intake. An annual limit of intake is an occupational
11 level and it has what we consider to be a minimal risk
12 for the radiation worker.
13 I have heard the risk factor be compared
14 to the risk of an officer worker dying in his office
15 from an accident such as a bookcase falling on him.
16 You know, this is the level of risk that we deal with
17 in the occupational environment for radiation workers.
18 So in reality, we are fairly sensitive for
19 what we need to do.
20 MR. BROWN: You mean in terms of the
21 toxicity of the agent?
22 DR. HICKMAN: Yes. So actions -- the
1 follow-up actions would be continued monitoring. And
2 for that reason, we would probably take them off of
3 their work schedule because we don't want any
4 additional confounding factors in our measurement
5 until a point where we can get enough data to feel
6 comfortable with an intake assessment, so it would be
7 multiple measurements in time.
8 And that could be several days or it could
9 be several weeks, depending upon the degree and the
10 amount. So that is our typical process in dealing
11 with that. We would take additional samples; urine
12 sampling would continue to be done and so on.
13 So until we can get -- the more data we
14 can get, the more comfortable we feel with the intake
15 assessment. Once we assess the intake, we can then
16 compare it to the annual limit and that will determine
17 whether or not the worker must remain out of the work
18 situation for that period of time or continue on.
19 MR. BROWN: I guess my question, though,
20 is that the obvious thing is to remove the individual
21 from the exposure. But is there anything you can --
22 is there any treatment that one could go through to
1 have -- you know, can you -- some drugs, I don't know.
2 DR. HICKMAN: There are treatments for
3 various radionuclides at various exposure levels.
4 Most of those treatments -- and I think Dr. Voelz
5 could probably address this better than I can. Most
6 of those treatments -- those treatments are most
7 effective if performed immediately after the exposure,
8 within hours or days.
9 So there are some treatments for very high
10 exposure cases that are available for various
11 radionuclides, including uranium.
12 MR. BROWN: I mean, I guess my question
13 is, if you found a Gulf War veteran and you find high
14 levels of uranium in their, say, lungs with the type
15 of counting you do, regardless of whether that is a
16 reasonable expectation or not, is there some treatment
17 that you could then think of offering that individual
18 or not?
19 DR. HICKMAN: Not a highly effective
20 treatment, no.
21 DR. TAYLOR: We are running out of time.
22 MR. BROWN: I am sorry.
1 DR. TAYLOR: I didn't allow -- there was
2 a question here.
3 MR. KOWALOK: I had one last question for
4 Dr. Hickman. Getting back to this panel's interest in
5 Gulf War veterans, with the experience in the Gulf,
6 exposures to depleted uranium were not likely to be
7 chronic. And second, fortunately, the clinical data
8 on Gulf War veterans who have reported symptom are not
9 reporting renal effects, which are known to be
10 associated with exposures to uranium.
11 Given those two points, is it biologically
12 appropriate to monitor or provide in vivo counting to
13 a population of Gulf War veterans five or six years
14 later after an exposure?
15 DR. HICKMAN: The -- I believe for
16 insoluble, if we are talking insoluble, the lung would
17 be involved. You potentially may see something but it
18 is not really a good technique, in my mind, to utilize
19 given six years down the road. It isn't really a
20 very -- it isn't a sensitive technique.
21 Plus the other question is, if you are not
22 seeing effects that would be characteristic of the
1 radionuclide, why go monitor for it? That doesn't
2 make any sense to me. So I would tend to say, No, I
3 would not use this technique.
4 DR. TAYLOR: Yes, Dr. Voelz?
5 DR. VOELZ: I had a comment to that.
6 Usually in this type of situation, I think you would
7 try to get more information on exposures and you would
8 probably do that with your highest exposed
9 individuals. And with the research project which I
10 understand is going on at the University of Maryland
11 with veterans who were in vehicles that were struck
12 and probably had the highest aerosol potential
13 exposure of the Gulf War veterans, you are getting
14 data from counting and so I think before I would
15 venture an answer to that question, I would like to
16 see what that data from those highest exposed people
17 are because you would have some information there.
18 MAJOR KNOX: Have any of you been involved
19 with that, the depleted uranium patients that the VA
20 is seeing at this time?
21 DR. VOELZ: I was on the advisory
22 committee for AFRE when they first started looking at
1 these research projects on these wounded Gulf veterans
2 so I am fairly familiar with the project.
3 DR. HICKMAN: I was unfamiliar with the
5 DR. SHELTON: One of the co-authors who
6 wrote the medical chapter in the AAPI report was Col.
7 Daxson, who headed the AFRE program until about a year
9 DR. TAYLOR: Okay. I think -- thank you
10 very much. And we are going to take a brief break,
11 five minutes. Lois Joellenbeck from the staff will
12 come up prior to our next panelist regarding -- will
13 come to the table. Okay.
14 (Whereupon, a short recess was taken.)
15 DR. TAYLOR: We would like to get started
16 again so that we can remain somewhat on schedule.
18 MS. JOELLENBECK: At the most recent full
19 committee meeting that was held in Chicago in July --
20 early July, staff reported to the committee several
21 different risk factors that were in the Gulf.
22 On the topic of the oil-well fires, staff
1 reported that high levels of respirable particulate
2 matter during the Kuwaiti oil fires were not
3 associated with high levels of polycyclic aromatic
4 hydrocarbons. Committee members sought further
5 information and clarification if this issue. Today's
6 presentations are a fairly specific response to that
7 interest. And the memo in your book also addresses
8 this question.
9 Dr. Heller, who will speak first, led the
10 Kuwait oil fire risk assessment carried out by the
11 U.S. Army and will discuss the findings of that team,
12 including the findings related to polycyclic aromatic
13 hydrocarbons and particulates.
14 Dr. Mauderly directs the Inhalation
15 Toxicology Research Institute and sits on the Clean
16 Air Science Advisory Committee and Science Advisory
17 Board of EPA. He will share with us an understanding
18 of the issues related to particulate matters.
19 DR. TAYLOR: Thank you. Dr. Heller?
20 DR. HELLER: Good afternoon, Dr. Kidd
21 Taylor and distinguished committee members. I am Dr.
22 Jack Heller, senior scientist for the Deployment
1 Environmental Exposures Surveillance Program at the
2 U.S. Army Center for Health Promotion and Preventive
4 I am also the Center's team leader for the
5 Kuwait oil fires health risk assessment and other
6 issues relative to environmental exposures in the
7 Persian Gulf. I have been actively involved with
8 these issues since January 1991, including numerous
9 trips to the Persian Gulf.
10 I wish to thank the committee for the
11 opportunity to expand on my previous testimony that
12 described in general terms our efforts in this area.
13 If my remarks on a particular issue are too brief, it
14 is only because I have been asked to cover so much
15 material in a short period of time.
16 Following my prepared statement, I will be
17 happy to address any of the issues I have discussed in
18 depth. I have a lot of slides and they are probably
19 going to be run through pretty quickly so any time you
20 want to stop, just say stop and we can go on from
22 The destruction of more than 700 oil wells
1 during the conflict in the Persian Gulf raised
2 concerns about potential health effects to the
3 Department of Defense troops and civilians exposed to
4 oil fire smoke. It was the concern with potential
5 long-term health effects that prompted our study.
6 The environmental monitoring study that
7 the center conducted characterized the concentration
8 of air and soil pollutants that Department of Defense
9 personnel were exposed to during their stay in the
10 Gulf region.
11 The USACHPPM monitoring effort commenced
12 on 5 May 1991 and continued until 3 December 1991. At
13 the start of our environmental monitoring, there were
14 approximately 580 oil wells on fire. The data
15 collection continued until all the fires were
16 extinguished on approximately 6 November 1991 and
17 continued until 3 December 1991 to obtain one month of
18 background data.
19 Ambient air monitoring stations were
20 established at four locations in Saudi Arabia and six
21 locations in Kuwait. The locations were selected
22 based on the fact that they were major sites where
1 Department of Defense troops were stationed long-term.
2 If I might add, two of the sites in Kuwait
3 closed rather quickly. The one in Camp Freedom,
4 troops left that about ten days after we arrived, so
5 we closed down that site. And the one at the Abdali
6 refugee camp up on the Iraqi border was only open,
7 again, for about 14 days. It was run by the Red Cross
8 and the Red Crescent and we were asked to shut down
9 our activities because we were military personnel. So
10 that is why that one was opened just such a short
11 period of time.
12 More than 3,800 ambient air samples were
13 collected. These samples were analyzed for 52
14 separate parameters including metals, volatile organic
15 compounds, polycyclic aromatic compounds, and
16 particulates. Of particular note were the low levels
17 of polycyclic aromatic hydrocarbons detected in the
18 air samples.
19 If I can just digress for a moment. When
20 we started sampling, we were using industrial hygiene
21 technology. We were using polyurethane foam and XAE
22 resin with low-flow pumps since everybody assumed
1 there were going to be huge levels of polycyclic
2 aromatic hydrocarbons.
3 We stopped getting any data. When all our
4 data was coming back as nondetects, we started using
5 our big -- excuse me, TSP and PM10 air samplers which
6 ran a volume of between 1- and 2,000 cubic meters of
7 air a day, so we had a much larger volume.
8 The only problem using the TM10 samplers
9 was, it is not an approved EPA method for PAHs because
10 it will strip off some of the more volatile PAHs and
11 that is when we went to the TO13 methodology on using
12 the PM10 samplers and that is the approved methodology
13 that will capture all of the PAHs and won't strip them
14 off. And you can see from the data we did get more
15 detects of the lower boiling point PAHs when we
16 changed to that methodology.
17 Results from ambient air samples were used
18 to calculate exposure point concentrations for health
19 risk assessments. Risk assessments were conducted for
20 each of the air monitoring sites were Department of
21 Defense personnel were located. As you can see, what
22 we are going through very quickly are from Khobar
1 Towers, which is in Saudi Arabia. Another site to
2 look at was Camp Doha. Those are the two sites that
3 were opened the longest.
4 Just some examples of the levels of
5 volatile organics that we detected. The levels of
6 heavy metals off our PM10 samplers are also there. We
7 have looked at all the toxic heavy metals in our work.
8 The methodology selected for the risk
9 assessment is US EPA guidance developed for
10 comprehensive environmental response compensation and
11 liability act sites, also known as Superfund. This
12 methodology consists of an exposure assessment that
13 examines the potential pathways of exposure and
14 determines the concentration of chemicals individuals
16 This step is followed by a toxicity
17 assessment and risk characterization where the troop
18 exposure concentrations are compared to known toxic
19 end-point values to determine if the exposure exceeds
20 these values. These calculations result in a
21 quantitative estimate of health risk based on the
22 contaminant concentrations. Both a potential excess
1 cancer risk and a noncancer hazard index are
3 Results from the health risk assessment
4 performed on the oil fire exposure data indicate low
5 potential for long-term health risks. The excess
6 cancer risks resulting from exposure to measured air
7 contaminants in the Persian Gulf range from seven in
8 10,000,000 to two in 1,000,000; well within USEPA's
9 acceptable range of one in 10,000 to one in 1,000,000.
10 And most of the cancer risk was coming from inhalation
11 of volatiles and inhalation of heavy metals, if you
12 were looking for the particular things that were
13 driving the risk.
14 Noncancer risk in the Gulf did slightly
15 exceed the USEPA hazard index standard of one ranging
16 from .6 to 5 with the majority of the risk due to
17 inhalation of benzene. However, health standards are
18 set to be protective of the most sensitive individuals
19 in a population, such as the very old; not a healthy
20 young population such as Department of Defense
21 deployed to the Persian Gulf.
22 I might add the benzene levels we detected
1 are probably no worse than you would breath in the
2 average U.S. city. In addition to that, the reference
3 dose we used to calculate the toxic effect has a --
4 well, used to have a safety factor of about 100 built
5 into it and that is under review. I was trying to get
6 the latest reference concentration from USEPA but that
7 is being revised. But again, it has got a large
8 safety margin built into it so when you -- even when
9 you exceed a hazard index of one until you start
10 exceeding it by something like 50 or 60, you really
11 shouldn't have health problems with a healthy group of
13 Since this risk assessment was produced in
14 1994, it has not been updated. This will occur when
15 the smoke modeling efforts are finalized and the
16 exposure and toxicity data for this effort are
18 In addition to ambient air modeling,
19 personal sampling using industrial hygiene methods and
20 equipment was also conducted. An additional 785
21 samples were collected using this methodology.
22 Sampling included volatile organics, polycyclic
1 aromatic hydrocarbons, coal tar pitch volatiles,
2 acids, and particulates.
3 As with ambient air samples, health risks
4 were considered small when sample data was compared to
5 eight-hour threshold limit values. As you can see,
6 even looking at our maximum samples, none of those
7 exceeded an eight-hour threshold limit value.
8 For compounds with parameters that have a
9 current USEPA national ambient air quality standard,
10 results of the ambient air sampling were compared to
11 these standards. With the exception of respirable
12 particulates, all other measured parameters were
13 detected at levels below national ambient air quality
14 standards. These included lead, sulfur dioxide,
15 nitrogen dioxide, and ozone.
16 Respirable particulates, which are those
17 particles less than 10 microns in diameter exceeded
18 USEPA standards on almost a daily basis. Much of this
19 particulate matter was not a result of oil fires but
20 was sand-based and generated by the high winds
21 prevalent in the Gulf region much of the year.
22 In addition to the health risk assessment
1 report, this center is almost modeling veterans'
2 exposures to oil fire smoke using a Persian Gulf troop
3 location registry developed by the Department of the
4 Army and Joint Services Environmental Support Group.
5 DR. TAYLOR: Can you hold it just a
7 DR. HELLER: Sure.
8 DR. TAYLOR: That doesn't go with what he
9 is discussing right now. I am a little confused.
10 DR. HELLER: Oh, okay. Those are -- those
11 go with, when I was talking about particulate levels.
12 Those are the mean particulate levels at all the
13 monitoring sites we had.
14 DR. TAYLOR: Of all the sites -- okay.
15 DR. HELLER: Those are the max and min
16 PM10 concentrations at all our monitoring sites. And
17 then this is just a graphical representation.
18 Compared to the national ambient air quality standard
19 at 150 and a significant harm at 600, where our levels
20 were on a daily basis over the time frame we were
22 This is the same thing at Camp Thunderock
1 in Kuwait, which is at Doha in Kuwait. And again as
2 you can see, if there was something high, there were
3 high particulate levels. This is just looking at the
4 levels of lead compared to the national ambient air
5 quality standard of 1.5 and we never did get
6 exceedences of lead contaminants collected on our
8 And this is lead at Camp Thunderock in
9 Kuwait again. No exceedences of national ambient air
10 quality standards. Then the other things we looked at
11 were, as I said, sulfur dioxide. And again, this is
12 maximum sulfur dioxide concentration so a maximum
13 never even exceed the national ambient air quality
14 standard, let alone a mean.
15 And we did the same for nitrogen dioxide
16 and for ozone. So again, the only thing that really
17 exceeded standard -- and that was almost on a daily
18 basis -- was our particulate levels -- respirable
19 particulate levels.
20 DR. TAYLOR: Which was largely due to the
21 sand and not the oil fire?
22 DR. HELLER: Which was -- a lot of it was
1 sand. There was, depending on the day -- it could
2 have been 5 or 10 percent -- would have been soot or
3 combusted carbon. Again, surprisingly, we would have
4 expected more polycyclic aromatic hydrocarbons
5 associated with that but the carbon was completely
6 combusted and there were no -- just no PAHs associated
7 with it or else very low levels.
8 Let me then --
9 DR. TAYLOR: Is that surprising to you?
10 I am just curious. Was that surprising?
11 DR. HELLER: Oh, it was -- as I said, when
12 we went over, we took industrial hygiene methodology
13 thinking it is not going to be a problem. We are
14 going to be able to detect things. And then as I
15 said, as we went from one level to the next, again
16 finding low levels, even when we could draw 2,000
17 cubic meters of air through a pump in a day and the
18 average person will only breathe about 20 cubic
20 So yes, it was surprising. And I think
21 one of the things was a lot of the particulate was
22 completely combusted that came out. And the other
1 thing, I wasn't there -- we didn't get there until May
2 and so I can't speak for before then but the whole
3 time I was there and in the oil field areas, which was
4 the first time I was over there was about 30-something
5 days, it was a ground-level fumigation where the plume
6 actually touched ground for a period of about six
7 hours. One time, one night at Camp Freedom before it
8 closed down.
9 The rest of the time, you would look up
10 and it would be dark but it was basically the plume at
11 12- or 14,000 feet and so a lot of the contaminants
12 did widely disperse. So I think a lot of what we were
13 measuring is just the industrial activity in Kuwait
14 and the industrial activity in Saudi Arabia, the
15 natural sand, the metals associated with the natural
17 If you look at our lead levels, our lead
18 levels tended to go up as the fires went out in Kuwait
19 and that is because more and more vehicular traffic
20 went in. They burn unleaded gasoline so we think most
21 of our risk we were measuring was basically coming
22 from industrial activities or natural background
1 associated with the sand.
2 As I said, in addition to the health risk
3 assessment report, the center is also modeling
4 veterans' exposure to oil fire smoke using a Persian
5 Gulf troop location registry developed by the
6 Department of the Army and Joint Services
7 Environmental Support Group.
8 Our center is using this data base in
9 combination with a geographic information system to
10 estimate troop exposures to pollutants and will be
11 conducting health risk assessments of various groups,
12 service members that were exposed to oil fire
14 The GIS integrates data features to
15 include modeled air concentration data from the
16 National Oceanic and Atmospheric Administration,
17 satellite imagery data from the National Center of
18 Atmospheric Research and exposure and toxicological
19 data from the Environmental Protection Agency. This
20 system is termed the Troop Exposure Assessment Model,
21 or TEAM, and is ongoing.
22 At the present time, a majority of the
1 data have been entered into the system. Both
2 satellite plume and model plume boundaries of over 270
3 days from February through October 1991 have been
4 digitized into the system. Pollutant-specific oil
5 fire emission factors have been derived and integrated
6 into the system. Updates on these are ongoing.
7 Complete unit identification code location
8 data for the Army, Navy, Marine Corps, and Air Force
9 consisting of 489,000 records have been entered into
10 the TEAM data base. At the present time, data gap
11 filling efforts are underway to locate units for which
12 no data has been found.
13 In addition, the Defense Manpower Data
14 Center Desert Storm personnel roster of over 757,000
15 individuals is also in the TEAM system. Recently, we
16 have incorporated the Comprehensive Clinical
17 Evaluation Program, or CCEP program, data into the
18 system and all the data bases are compatible and able
19 to interface. We are also currently updating the
20 exposure factors and toxicological data in the system
21 using the USEPA's Integrated Risk Information System,
22 health effects summary tables, and exposure factors
2 In addition, we are also working with the
3 National Oceanic and Atmospheric Administration to
4 improve the oil file modeling data and risk
5 calculation methodology. This ends my remarks and I
6 would be glad to answer any questions from the
7 committee members at this time.
8 DR. TAYLOR: Thanks, Dr. Heller. We are
9 going to move on and then ask questions at the end of
10 both of the presentations. Dr. Mauderly?
11 DR. MAUDERLY: I appreciate the
12 opportunity to talk to you this afternoon. I am Joe
13 Mauderly. I spent my career since leaving the
14 military in 1969 trying to understand and put into
15 context human health risk from inhaled particles.
16 I worked on radioactive particles and
17 soots and mineral particles, among others. I have not
18 nor has my institution been involved in making any of
19 the measurements in the Gulf area. My comments are
20 based solely on the information that I received from
21 Dr. Heller that you have just seen on the nature of
22 the particles.
1 And my comments will also have nothing to
2 do with other agents that might have been inhaled in
3 the area, such as chemical or biological agents. They
4 have strictly to do with the ambient particles that
5 the people were exposed to when they were working.
6 I was asked to talk to you in regard to
7 these questions. I was asked to explain what
8 particles are and I don't think that should be
9 difficult. Why they are of a health concern, what
10 effects are expected from short-term -- that is,
11 short-term occupational of a few months -- exposure to
12 particulate matter which is low in pH and metals, as
13 you have just heard, whether or not there might be
14 susceptible individuals, what might be the mechanisms
15 of action, and in relation to the current U.S.
16 environmental standards, on what are the standards
17 based and what are the current research issues. Now,
18 that is quite a menu and I will just hit a few points.
19 I think largely I was asked to talk
20 because many of you may be aware that there is
21 currently considerable controversy about ambient
22 particles in the United States, particles in the
1 cities and health effects that they might be causing,
2 and the curiosity is whether or not there might be any
3 link. So let me explain that.
4 First of all, let's deal with particulate
5 matter. It is very straightforward. Particulate
6 matter in the air is a very broad class. It is very
7 diverse. It is a large number of materials that might
8 exist either as liquids or solids suspended in the
9 air. And of course, there are man-made sources and
10 natural sources.
11 There are those that are emitted directly
12 in the air and there are also those that appear by
13 atmospheric transformation such as acid particles
14 which are developed from SO2 in the air and that sort
15 of thing. So particles are really a very diverse
16 class of potentially toxic materials.
17 Now, to understand their suspension in the
18 air, this might be useful although many of the things
19 I will show you have to do with ambient urban
20 particles, contextually they do relate to the kinds of
21 particles that we are concerned about.
22 You have the particles that are
1 mechanically generated, largely in the larger size
2 range from 1 or greater microns. This is typically
3 called the coarse mode. Your dust would be included
4 in that class. Of more current concern in the U.S.
5 urban area are finer particles which are emitted or
6 condensed to form particles in the 1/10 to 1 micron
7 range or very tiny, ultrafine particles that tend to
8 coagulate together and form this accumulation mode of
9 particles. So there are different size ranges of
10 particles and different materials in those ranges.
11 Now, it is important to think about
12 dosimetry. And I think in thinking about the Gulf War
13 health issues, it is important that we think about
14 dosimetry. What might have been the dose of these
15 particles to the lung? And I would like to help put
16 that in context.
17 We know a great deal about dosimetry. We
18 know a great deal about the deposition of particles in
19 the different portions of the respiratory tract and
20 there are really very few controversies today about
21 that. So if we know the material that is in the air
22 and the time that the people are exposed and what they
1 are doing during that time, we can calculate doses
2 pretty accurately.
3 This is just a figure taken from a recent
4 model which has proven accurate for total deposition.
5 You can see there is a minimum. This is particle
6 diameter, aerodynamic diameter, versus the fraction of
7 each diameter that would deposit in the respiratory
9 There is a deposition minimum around 3/10
10 to 5/10 microns. Nasal, oral, pharyngeal, laryngeal
11 deposition is, of course, quite high. Large
12 particles, many of them land in the nose and you have
13 experienced that working in dusty or dirty places.
14 But in the ultrafine particles, by
15 diffusion, also a lot deposit in the nose.
16 Tracheobronchial deposition, of key interest if we are
17 thinking about airway irritation and asthmatic types
18 of responses. Then we would be worried about airway
20 And there is a maxima of ultrafine
21 particles and you can see that the airway deposition
22 is not very large for the larger particles. Pulmonary
1 deposition would be the deposition that we are most
2 concerned about. We are thinking about long-term
3 effects, lung disease, lung irritation, difficulty
4 breathing other than constricted airways.
5 You can see there is a maximum of about 20
6 to 25 percent at about 2 microns in diameter and then
7 a minimum, another maximum of below 1/10 micron. So
8 that is just an illustration that we do know quite a
9 bit about dosimetry. Now, to put things in context,
10 I hope you won't be offended by the comparison I am
11 making here to aspirin tablets but I think it is
12 useful to put these doses in context so we can deal
13 with them later.
14 I come from Albuquerque. The typical
15 particle concentration on an annual basis is about 35
16 mcg per cubic meter. That would be PM10. PM10 is a
17 particle size cut-off where 50 percent of the
18 particles are collected at 10 microns. It does not
19 mean that there aren't larger particles in the sample
20 but the 50 percent cut-off for the efficiency of
21 collection is at 10 microns.
22 An individual living in Albuquerque and
1 exposed 24 hours a day at 35 mcg per cubic meter would
2 deposit about 100 mcg in particles per day and that is
3 not very much. In a 70-year lifetime, though I would
4 hope most of us would exceed that, we are talking
5 about something on the order of 3 grams.
6 To put that in context -- and if you will
7 bear with me, I used this for a public information
8 talk some time ago and that is why I was using aspirin
9 tablets -- that is seven common aspirin tablets.
10 Still a small amount of material.
11 Compare that to underground coal mining
12 where the dust standard is 2 mg per cubic meter
13 respirable dust. A miner working eight hours a day at
14 modest to heavy activity would deposit over 7,000 mcg
15 per day or in a 20-year working lifetime, about 36
16 grams. And in fact, in looking at lungs of miners,
17 one can extract 15 to 30 g of dust from the lungs
18 commonly. So that is probably a pretty accurate
20 Cigarette smoking, of course, on the hand,
21 it is a different type of material but the particulate
22 material from the cigarette smoke, a one-pack a day
1 smoker smoking a 10 mg tar cigarette would deposit
2 over three pounds of material in a smoking lifetime.
3 Well, that is just to put dose into
4 perspective. Now I would like to go on and talk a
5 little bit about the nature of particles and why we
6 are concerned about them. We are concerned about size
7 because as you just saw, that controls deposition --
8 controls the fractional deposition in the respiratory
9 tract and also the movement of materials once it
10 reaches the respiratory tract. That is, whether the
11 particles are cleared by natural clearance mechanisms
12 that try to keep the lung clean or whether they move
13 through cells and tissues to other locations.
14 The shape of particles can be important.
15 Certainly, fine particles have a much higher surface
16 area per unit of mass than coarse particles. So if we
17 are interested in surface phenomena, fine particles
18 would be of more interest.
19 Aspect ratio is important for fibers.
20 Long, thin fibers seem to be more toxic than short,
21 fat fibers. Solubility is important. The retention
22 in the lung. And also the ability of particles to
1 gather water and grow as they are inhaled and the air
2 is humidified.
3 The composition, of course, one would
4 imagine that that is very important. Acids are
5 cytotoxic. They damage cells. Different types of
6 crystals like silica can be very active and so the
7 crystallinity in the crystalline structure particles
8 is very important.
9 Antigenicity, immune responses. If you
10 suffer from hay fever, you know the antigenicity of
11 pollens is a terrific issue for you. Organics has
12 been spoken of today. Typically, we are interested in
13 cancer when we are talking about organic species
14 associated with particles, their mutagenicity and
15 ability to initiate a cancer process.
16 Metals can be very toxic to cells. They
17 can also be immunoreactive and they can cause cancer.
18 So this is just a laundry list, if you will, of
19 different particle characteristics that we are
20 concerned about. Now, it is very important to relate
21 these characteristics to the types of material that
22 people were exposed to in the Gulf.
1 This is another size diagram of a small
2 size and large size particles with a minimum about 1
3 micron. And we see here that the larger size
4 particles are largely crustal materials -- aluminum
5 silicates -- earth materials, if you will.
6 The smaller particles -- and this is even
7 in urban areas -- the smaller particles is where we
8 find the fine carbon, the metals that we are concerned
9 about, the acidity, the sulfur compounds, and it is
10 thought that the finer particles tend to be more toxic
11 than the coarse ones.
12 DR. TAYLOR: Just one question, going back
13 to that one.
14 DR. MAUDERLY: Yes.
15 DR. TAYLOR: The silica, the crystalline
16 silica from the dust or the sand would be included
17 into the large mass particles?
18 DR. MAUDERLY: The silicaceous [sic]
19 particles from windblown sand would be largely in the
20 large particle size. Yes.
21 DR. TAYLOR: All right.
22 DR. MAUDERLY: And Dr. Heller, I am sure,
1 could tell you much more about that.
2 Now let's relate what we have just learned
3 to national ambient standards although I warn you that
4 I don't think what we are talking about here are
5 city -- urban environmental standards. We are talking
6 about occupational exposures in a military situation.
7 But just to remind us, the PM10
8 standard -- that is, particles with a 50 percent size
9 cut-off at 10 microns, the current standard in the
10 United States is 50 mcg per cubic meter as an annual
11 average -- arithmetic mean -- and 150 mcg per cubic
12 meter on a 24-hour average and that would be the
13 second highest reading. One exceedence is allowed so
14 the second highest concentration would be 150 mcg.
15 Now let me tell you something about the
16 basis for the current particle standards in this
17 country and what some of the recent concerns are. The
18 standards that we have today that have been set in the
19 past have been set largely because of concerns for
20 acute death and mortality. A lot of that was taken
21 from the experience in London where there was a
22 tremendous smog incident and high mortality and also
1 bronchitis and deteriorations of respiratory function,
2 primarily in children and certainly asthmatics.
3 These would be short-term, high-level
4 exposures would give rise to those concerns. The
5 annual particle standard is set more from a concern of
6 long-term deterioration of lung function. Does of the
7 ability of our lung to function deteriorate more with
8 age with heavy particle exposures than it ordinarily
10 And chronic respiratory symptoms. The
11 annual standard was not set primarily for cancer
12 although there is a very small cancer signal. With
13 urban particulate, that signal is very small. So that
14 is the basis for the past standards.
15 I am going to skip that one here in the
16 interest of time and get on to the concern that you
17 might have heard about and that is concern for short-
18 term mortality during high particle episodes in the
19 United States within the current standard.
20 That concern was raised primarily by the
21 report from a study of Philadelphia data of
22 hospitalizations, mortality, and other effects versus
1 daily total suspended particulate, which is all
2 particulate collected on the filter. That is larger
3 particles in addition to PM10.
4 Daily deaths within the city excluding
5 homicides and accidents during the 1970s controlled
6 for weather and other variables. And the mean
7 concentration was not very high, 77 mcg per cubic
8 meter as an average and that is total suspended
9 particulate. So the current PM10 standard may not
10 have been exceeded at all although it wasn't measured
11 during that time. Even on the high days, we are only
12 talking about 380 as the highest single 24-hour
14 There was a statistically significant
15 relationship between daily spikes of the particle
16 concentrations and daily deaths. Although no one
17 could tease out of the data from death certificates
18 and hospital reports who might have been affected by
19 those particles, the relationship was solid.
20 In dealing with susceptibles, then, this
21 is what we know of susceptibles. And this is very
22 similar to the other epidemiologic data that have been
1 produced worldwide. What I am showing you are the
2 sentinel studies that triggered the concern.
3 There have been a lot of data collected
4 since these studies and they seem to verify these
5 findings. That is, when we look at the risk of death,
6 a risk of 1 being no change from the annual average
7 daily death rate, seeing about a 1/10 increase in risk
8 during these high particle days, we can see that death
9 from chronic obstructive pulmonary disease,
10 bronchitis, asthma is counted in that category in some
11 cases; another, emphysema.
12 Chronic obstructive pulmonary disease gave
13 the highest signal. Pneumonia, cardiovascular disease
14 also seemed to be more prevalent on those days whereas
15 cancer was not. In fact, there would be no particular
16 relationship you would suspect between daily particle
17 excursions and cancer, which is a long-term process.
18 The other thing is that older people seem
19 to be at greater risk. There was a greater signal for
20 those 65 years and older. So the answer to the
21 susceptibility is that there is no present indication
22 that ambient particle levels of the type we see in
1 this country are an acute risk for mortality in other
2 than elderly people or people with cardiorespiratory
3 problems -- compromised hearts and lungs.
4 The other concerns that we see which may
5 relate, again, back to what would we expect to see in
6 the Gulf if particles were a problem. This is a study
7 I will show you some results from in which a group of
8 studies were combined. Studies that were done in the
9 United States, in Europe, all converted different
10 measures of particles to their best estimate of what
11 the comparable PM10 level would be. And there is a
12 list of the different measures that were used.
13 We saw again in this study -- I say, we,
14 the scientific community -- that total mortality
15 seemed to be related to daily particle concentrations
16 about a 1 percent increase in mortality for a 10 mcg
17 per cubic meter increase in particles. And you have
18 to understand that that is a result of a graph with a
19 straight line drawn through the points and that is the
20 slope of the line.
21 That does not mean necessarily that no
22 matter how low the particle concentration, each 10 mcg
1 gives you that 1 percent in mortality. That is the
2 slope of a straight line drawn on a graph.
3 Respiratory and cardiovascular mortality. Again, 1 to
4 3 percent. So the signal was higher for chest
5 problems so we would expect, if there were problems,
6 that these would be chest problems.
7 Symptoms. Coughing, difficulty breathing,
8 other kinds of symptoms. Again, a 2 to 5 to 8 percent
9 increase in symptoms with increases in ambient
10 particles, all of them respiratory symptoms.
11 Hospital usage. You would expect that
12 more people would be treated for respiratory disease
13 if all of these effects were coherent. And in fact,
14 you do see a 1 to 3 percent increase in hospital
15 admissions and emergency room visits during high
16 particle days. So these are small percentage
17 increases, all for respiratory complaints, and really
18 all of them people with pre-existing pulmonary
20 Chronic effects is another concern. And
21 chronic effects have been seen in epidemiological
22 studies of particles in cities. I will use this for
1 an illustration. There was a study in six cities. It
2 is quite well-known. It has gone on for a number of
4 A large number of subjects were followed
5 for a long time and mortality rates were compared
6 among those cities. And we are getting here really
7 more at life span than we are daily mortalities.
8 Again, the particle concentrations were typical of
9 current U.S. ambient concentrations.
10 This is simply a graph of the six cities,
11 each with an initial. The mortality rate ratio, which
12 is the ration of the mortality in the cleanest city to
13 that of each of the other cities. So the cleanest
14 city -- this happened to be Portage, Wisconsin -- was
15 pegged at 1. This is for all particles, total
17 Now, in considering whether or not coarse
18 particles or fine particles are more dangerous, they
19 did have some data in this study in which they could
20 look at fine particles and you can see that these data
21 line up in a straighter line with fine particles. And
22 this is one signal that there seems to be a tighter
1 relationship between fine particles and these health
2 effects than there does coarse particles.
3 Now, the current concerns driving our
4 particulate standards in this country. We have both
5 occupational and environmental standards. And I will
6 not go into them in detail except to say that in
7 occupational standards, we are mostly concerned about
8 irritation, inflammation, airway reactivity,
9 aggravation of asthma, pneumoconiosis, which is a
10 general term for a dust lung disease of fibrosis with
11 an accumulation of dust in the lung that occurs over
12 a long period of time; and in some occupations, with
13 cancer when the particles that are being inhaled are
14 known to be carcinogenic.
15 The environmental concerns are both short-
16 term and long-term. Short-term, mortality. The data
17 that I just showed you and others like it are driving
18 the concern for the short-term standard at this point.
19 Also, lung symptoms and hospitalization.
20 Long-term, life shortening. Again, the
21 data that I just showed you is exemplary of the data
22 that is being used now to try to set an appropriate
1 annual standard in addition to some bronchitis and
2 lung function effects, primarily in children.
3 So that is what is driving the current
4 ambient standards. What is the mechanism? Well, I
5 will only use this slide to explain one point, and it
6 is my next to the last slide, and that is that we
7 don't know the mechanisms for many of these things.
8 There is a host of different conditions
9 that could be caused by inhaled particles but most of
10 those occur in the cardiorespiratory system. Some of
11 them, with heavy metal or organic exposures, materials
12 that could be leached by the particles travel through
13 the blood to other organs, could cause problems in
14 other organs.
15 But certainly the kind of particles that
16 we are talking about that were measured in the Gulf,
17 we would be concerned about respiratory symptoms. One
18 of the interesting things that is occurring now in
19 terms of information needs is that we know that when
20 particles are collected by alveolar macrophages, which
21 are scavenger cells that are in the lung to collect
22 particles, these macrophages send out a variety of
1 chemical signals. They attract inflammatory cells
2 from the blood. They release growth factors which
3 cause the lining cells of the airways to divide and
5 They cause fibroblast cells within the
6 lung tissue to proliferate and elaborate fibrinogen,
7 which causes fibrosis, and they have oxygen radicals.
8 These are highly reactive chemical species that were
9 probably teleologically designed to kill bacteria when
10 we inhale them but are elaborated when other particles
11 are inhaled. And these species are damaging to cells.
12 An interesting thing that seems to be
13 appearing now is that we are learning that these
14 chemical signals can travel beyond the lung and
15 potentially reach the heart. And there may be some
16 heart effects, some electrocardiogram and heart muscle
17 effects from these chemical signals that are generated
18 in the lung, which may explain the connection between
19 particle exposures and cardiovascular disease.
20 Now, in summary, I make these comments.
21 First of all, to answer the question I was asked,
22 health concerns for exposure to particles which are
1 low in metal and organic content would largely be
2 limited to the cardiorespiratory system. It is hard
3 for me to envision from my viewpoint how these kinds
4 of particles could be causing effects outside of the
5 cardiorespiratory system.
6 The second point, and I think it is an
7 important one, is that the way that these exposures
8 should be thought of is that they are analogous to
9 short-term occupational exposures to dust with a
10 little bit of soot. If we look at the dose that might
11 have been accumulated -- and I went through some
12 calculations flying up here today -- in the Gulf, if
13 the ambient particle concentration was 300 mcg per
14 cubic meter -- and in many cases it was lower than
15 that -- if it was 300 mcg per cubic meter with normal
16 deposition and ventilation, assuming 24-hour day
17 exposure at modest activity -- and I am sure there was
18 some sleeping that went on -- but let's assume there
19 was modest activity 24 hours a day for six months.
20 The amount that would have deposited in the deep lung,
21 according to the models that we believe in, would be
22 about 300 mg. 300 mg is about the size of one aspirin
1 tablet, for reference.
2 A coal miner, working for six months at
3 the 2 mg respirable coal mine dust standard eight
4 hours a day, five days a week for 26 weeks at modest
5 activity would deposit 500 mg. If an individual is
6 working at a construction site moving dirt, using
7 diesel-powered earth-moving equipment, inhaling a
8 mixture of crustal materials, sand, dirt, with a
9 smidgen, if you will, of diesel soot which I think
10 would be very analogous to the materials that were
11 measured by Dr. Heller and his colleagues, at the 3 mg
12 per cubic meter respirable dust occupational standard
13 that exists in the United States, assuming again an
14 eight-hour day, five day a week exposure for that same
15 six months, working at the construction site, would be
16 750 mg.
17 Now, don't be put off my those numbers.
18 They are range-finding to make my point. And my point
19 is that these were certainly elevated particle levels
20 compared to what we see in U.S. cities. They are very
21 modest particle levels compared to workplace limits in
22 this country and other countries.
1 If you want to think about what these
2 exposures were likely to do, then think about someone
3 spending an equivalent amount of time working,
4 building a road or at a construction site where there
5 was some diesel powered equipment but most of the
6 material were earth crustal windblown materials.
7 And would you expect an individual working
8 for a few months or weeks or a year at that kind of an
9 occupation to have the kinds of effects that are being
10 reported as illnesses potentially related to the Gulf
11 War experience? Don't misunderstand me. I am not
12 saying that those illnesses don't exist.
13 I am just saying that within the context
14 of my experience, it is hard for me to relate the kind
15 of exposures Dr. Heller was talking about to those
16 illnesses. Thank you.
17 DR. TAYLOR: Just to make sure that
18 everyone understands. You are saying, based on the
19 particulate exposures that were reported, it would not
20 be related to Gulf War illnesses that are being
21 reported or the symptoms related to Gulf War?
22 DR. MAUDERLY: I am not an expert on Gulf
1 War illnesses so I am treading on thin ice here.
2 DR. TAYLOR: Or the symptoms.
3 DR. MAUDERLY: But my understanding is
4 that a very small portion of the reported illnesses
5 have to do with lung problems.
6 DR. TAYLOR: Right, cardiorespiratory.
7 DR. MAUDERLY: Or heart problems. They
8 are usually other kinds of problems. And what I am
9 saying is, our current understanding of health risk
10 from inhaling the kind of materials that were measured
11 do not suggest that those other kinds of problems were
12 likely to be related in the particle exposures.
13 If there had been respiratory problems --
14 and there probably were in some very sensitive
15 individuals -- respiratory problems at that time --
16 DR. TAYLOR: Or persons with asthma or
17 some other existing condition could have --
18 DR. MAUDERLY: Exactly true. With -- on
19 a particularly dirty day, I am sure there was some
20 coughing and perhaps some problems. I am talking
21 about the persistent illnesses that have been reported
22 following that experience. And it is hard to envision
1 that there would be a connection there.
2 DR. TAYLOR: Thank you very much, Dr.
3 Mauderly. Are there any questions? (No response.)
4 I have one for you, Dr. Heller. In your presentation,
5 you described the ongoing modeling --
6 DR. HELLER: Yes.
7 DR. TAYLOR: -- of veterans' exposure.
8 Has your work today suggested any risk levels from the
9 oil fires which is significantly different from those
10 presented today?
11 DR. HELLER: No. I don't think we are far
12 enough to really do that. What we are going to try to
13 do when we get all the data and NOAA gets their
14 refined information is try to find the groups that
15 were the most exposed, maybe the most 1 percent
16 exposed, and we get as much of the troop location data
17 as we can and then try to look at that group through
18 either the CCEP or the VA and see if we can see
19 anything in it with the people who are having health
20 problems. But I don't think we are far enough along
21 to have really done that yet.
22 DR. TAYLOR: Do you know how long it will
1 take or when will this modeling effort be completed
2 and this information available to the veterans?
3 DR. HELLER: I am hoping within a three-
4 month period of time, is what we are trying to do, to
5 get all the data in so we can do that. Again, we had
6 actual set of modelled efforts. We had actual
7 sampling going on at sites that were anywhere from a
8 half a kilometer -- which is what Ahmadi Hospital was.
9 You could see burning oil fires right there -- to
10 those at Camp Doha, which are probably 12 to 15 miles
11 from the northern fields.
12 And so I don't expect to see a change
13 because those two locations would have been some of
14 the most exposed individuals you would have had and we
15 had maching at Doha for eight months and Ahmadi
16 Hospital, I think it was two or three while the fires
17 were burning in the Ahmadi field.
18 So even though we are going to do that
19 analysis as required by public law 102190, I don't
20 think we are going to find a group that is going to be
21 worse off than the people that were stationed there.
22 But I would think we will have the data to be able to
1 look at that within three months, we will have all
2 that data. And that will be obviously reported out
3 like everything else we have, is, whoever wants it, it
4 is available to.
5 DR. TAYLOR: I just have one more
6 question. You mentioned that most of your samples --
7 your air sampling was taken after -- I guess after oil
8 well fires were started initially?
9 DR. HELLER: Yes. They were started -- I
10 think start date is about the 28th of February and we
11 started the beginning of May. So we really missed the
12 March/April time frame.
13 DR. TAYLOR: I am just curious. Would you
14 think off the top, would there have been a difference
15 if you had been there earlier and the measurements
16 that you --
17 DR. HELLER: There are two things to look
18 at. One, not many fires got put out so there was as
19 much source material as there -- I think there were
20 603 when they started. When we were looking at them,
21 there were still 580. The thing that would have
22 changed would have been the meteorological conditions.
1 There may have been some more ground level
2 fumigations. And so that is what we are hoping the
3 modeling will do because it is a model that looks at
4 the height. Not only, you know, the vertical but the
5 horizontal. So we will look at that two-month period
6 and when you see what we get when we do our modeling,
7 just get different colors where the exposure would
8 have been the greatest and hopefully we could identify
9 those periods for that two-month period where there
10 would have been more exposures and calculate that.
11 I know there was one day when we did do
12 sampling right when there was a plume fumigation and
13 that just -- again, pH levels not that high, just not
14 very high levels of contaminants. So I just think
15 even during that period, that wouldn't have happened
16 often enough to have caused a great exposure but we
17 are going to obviously look into that during the
18 modeling period. And we are sorry we couldn't have
19 gotten there sooner.
20 DR. TAYLOR: Questions?
21 MS. JOELLENBECK: Yes. Dr. Heller, are
22 you satisfied from the data that you have collected so
1 far that the veterans aren't -- don't have elevated
2 risk to cancer from the oil well fires?
3 DR. HELLER: Yes. As I said, our
4 predicted risk from all the carcinogens we looked at,
5 the major volatile organics, the heavy metals that
6 they would have inhaled that are carcinogens and the
7 polycyclic aromatic hydrocarbons and it looks like an
8 excess cancer risk of between 7 in a population of
9 10,000,000 to the worst case, which was about -- we
10 would have had two excess cancers in a population of
11 about a million and that wasn't even close to the
12 fires. That was in Dhahran, I believe, coming mostly
13 from industrial exposures.
14 So I do not look, at least from what we
15 measured in the way of industrial contaminants, cancer
16 being a disease usually of long intubation period, to
17 see a great epidemic of cancers among Gulf War
18 veterans 15, 20 or so years from now.
19 MS. JOELLENBECK: Did other organizations
20 or outside experts -- outside of the Army -- have a
21 chance to review the risk assessment that you did?
22 DR. HELLER: Yes. We sent it out for peer
1 review to the Environmental Protection Agency, both
2 their Cancer Assessment Group and their people who
3 look at environmental monitoring. It was looked at by
4 the National Academy of Sciences, both the Institute
5 of Medicine and the Committee on Toxicology.
6 It was looked at by CDC. It was looked at
7 by the Surgeon Generals of the three services and I
8 guess in a more cursory way, just the kind of effort
9 we were doing, by the Government Accounting Office and
10 the Office of Technology Assessment.
11 DR. TAYLOR: Any other questions? Thank
12 you very much. We have a little time left. Is Ken
13 Ellison still in the audience?
14 VOICE: No, he left.
15 DR. TAYLOR: Okay. Trent Millbreck? Mr.
16 Martinez? I am sorry we don't have a podium.
17 MR. MARTINEZ: That is all right. I was
18 beginning to wonder if I was going to get an
19 opportunity to speak so I started to write down my
20 testimony to tell you more or less what happened down
21 there that I observed.
22 First of all, I want to thank the panel
1 for being here. And I can just imagine how tedious it
2 is to sit there and listen to testimony after
3 testimony of different kind of experiences people went
4 through during the Persian Gulf war in addition to
5 what these other men have talked about here. It must
6 be something to go from place to place and have to sit
7 there and do that but I commend you for that very
8 much. And I thank you for the good work that you are
9 doing and I hope that the end results will be
10 something that will definitely be profitable to all
11 the people that were there.
12 First of all, I would like to kind of
13 briefly start out with my childhood. I was born in
14 the San Luis Valley about 200 miles south of here
15 where I was raised on a farm for approximately 14
16 years and then we moved into Colorado Springs when my
17 folks were forced from coming from being migrant
18 workers in the fields of the San Luis Valley to work
19 construction in restaurants in Colorado Springs where
20 I received high school education and proceeded on to
21 college for two years and then I got married.
22 My wife and I -- I would like to say that
1 I was -- had a very successful, beautiful childhood
2 with a lot of good memories. My mom and dad stayed
3 together for -- until they both died. They were very
4 good role model examples of parenting and responsible
5 parents, after having to raise eight children. They
6 definitely were hard-working people that I am very
7 proud of. I learned a lot from them and I thank God
8 for parents that taught me how to work hard and how to
9 be responsible.
10 My wife and I have five children. They
11 are -- all five of them are my wife and I's children.
12 We have three kids in college, two in high school and
13 we are very proud of our girls. They are all five
14 girls and I have a grandson that is the greatest child
15 in the land. And I was very thankful that I got the
16 opportunity to go to Saudi Arabia.
17 I am a United States Army support group
18 volunteer as a civil service employee to go to Saudi
19 Arabia and help support our troops just like we do
20 here in Colorado in Fort Carson, Colorado. My civil
21 service employment record is 24 years and some months.
22 I have worked diligently to do good work
1 for my government. My father always taught me that if
2 I didn't have my own business and I had to work for
3 somebody else that I needed to provide good service,
4 make by boss shine so that I could shine. And I
5 always use that as a rule of thumb.
6 I have received, thanks to God, a lot of
7 certificates and awards that I could fill half that
8 wall with that I have at home in service to my
9 country, in service to the troops that I have a great
10 deal of respect for in all areas of our armed forces.
11 When I first learned of the Persian Gulf
12 war our government was looking for volunteers to go to
13 the Persian Gulf war and support our troops, I jumped
14 at the chance. I didn't have the opportunity to serve
15 in Vietnam because I had an industrial accident two
16 weeks prior to going to Vietnam. I was going to be
17 with the United States Marines Special Forces. I lost
18 three fingers of my right hand and that prevented me
19 from going to fight over there.
20 I don't know if that was good or not. I
21 think God had a good lookout after me because losing
22 three fingers is nothing to compare to what a lot of
1 my friends went through and are going through after
2 coming back from Vietnam. Nevertheless, the desire in
3 my heart burned to go overseas.
4 DR. TAYLOR: Mr. Martinez, not trying to
5 rush you or anything but if you can sum up.
6 MR. MARTINEZ: Yes. I am getting to that.
7 Kind of threw me off course there.
8 DR. TAYLOR: Sorry.
9 MR. MARTINEZ: Anyway, when we got up
10 there, we first went through MBC training in
11 Maryland -- Aberdeen, Maryland. We received the same
12 shots basically that everybody received while there,
13 including the, you know, the military.
14 After we landed in Saudi Arabia, we were
15 given boosters which we were told to keep confidential
16 and that they refused to put in our medical records.
17 We started to work seven hours a day, seven days a
18 week. After I was there two weeks, I was promoted to
19 work leader in a welding shop. A month and a half
20 later, I was promoted to supervisor of the welding
21 shop where I had 21 civilians and seven military under
1 We were asked to fabricate 300
2 [unintelligible] extensions for the airport and for
3 other areas of Saudi Arabia, over 200 different kinds
4 of gun mounts for trucks of all kinds, ramps to load
5 and unload C-LANS and so on. During the time that we
6 were there, I would like to kind of emphasize the
7 environment and exposure we were up against.
8 We worked in SASCO in -- 20 miles, I think
9 it was, east of Dhahran where we worked. It was a
10 very heavily industrialized area with a lot of
11 different kind of shops. They were extremely dirty
12 and filthy and obviously, the Saudi people are very
13 rich; however, they don't put no emphasis on good
14 environmental conditions for the health of people.
15 There was a lot of water pools that were
16 stagnated with green stuff on top. Flies all over the
17 place. The flies were dealt with by using two
18 different methods to try to get rid of them. They
19 used to use DDT once a week by the Saudi Arabians, to
20 go around the compound and spray.
21 Another substance was a granulated green
22 and fluorescent orange type of substance they put all
1 over the place. Flies would eat it and they would go
2 into convulsions, jump up and finally die. And the
3 wind blew constantly over there. We were exposed to
4 a lot of the stuff that blew from the ground from
5 those substances along with the air pollution and a
6 camel farm that was right next to us that was full of
7 camel feces and piles of dead bones from camels. And
8 a lot of people would get sick to the point where they
9 couldn't eat for days whenever the wind would blow in
10 our direction.
11 We were able to see the sun come up after
12 ten o'clock and go down at 3:30 in the afternoon.
13 That is how heavy, 75 percent of the time, the
14 pollution was in the air. After I came back, I became
15 very ill. A year and a half, I sat on my sofa after
16 coming home from work and I couldn't get up. All I
17 would do is sit there and just meditate on what I went
19 It was hard for my family. I became
20 irritable, very moody. My wife and my five kids
21 noticed that. They were telling me that I was
22 forgetting a lot of stuff. They would ask me to do
1 things and I would forget. They would ask me to, you
2 know, go out and do some activities.
3 I have always been a very physical person.
4 In high school, I was a wrestler, a football player,
5 and a gymnast and all my life, I took good care of
6 myself. I used to run five miles a day. Prior to
7 going to Saudi Arabia, it was like nothing. I came
8 back and I couldn't even run a mile and a half. To
9 this day, I am running about two miles and it is very
10 difficult for me to do so.
11 I underwent four or five psychological and
12 psychiatry tests. I was diagnosed with stomach
13 problems, rashes on my feet, my groins, my head, skin
14 discoloration. I had surgery on my right shoulder
15 from an injury I sustained over there.
16 Just so many things that we went through
17 and in 1993, my mother was murdered and I had to deal
18 with that -- and my wife. You know, somebody came to
19 her apartment, stabbed her in the throat, put a knife
20 in her throat all the way to her back and I had to
21 deal with -- my wife and my five kids through all of
22 that until the man was sentenced to life in prison.
1 And the only thing I would like to ask of
2 you people, the committee, there is two things that I
3 want, personally, and it has been asked before, is
4 that our government own up, for crying out loud, for
5 the responsibilities that they are responsible for and
6 stop trying to deny what really went on over there
7 just like they did with the Vietnam war.
8 I think it is time that they own up and
9 compensate people. And I am not talking about money
10 in this particular situation. I am talking about
11 owning up to their responsibility of taking care of us
12 and the families, especially the widows and fatherless
13 that have nobody to take care of them.
14 Another issue that was not addressed at
15 all today that I would like to address is we as
16 civilians were the only group among all armed forces,
17 including the two -- what are they called -- reserves
18 and the other. Anyway, we were the only ones excluded
19 from getting our taxes back. I would like to get that
20 back because it belongs to me.
21 I worked over there hard for 279 days with
22 two days of rest and the government, I feel, owes me
1 my taxes. Everybody else got them except civil
2 service employees. I would like for you to talk to
3 President Clinton and whoever else will listen to set
4 a committee if they don't have one already to look
5 into that. I could certainly use that money in
6 addition to the interest they owe me so I can further
7 educate my kids so they will someday be productive
8 citizens of our country and be able to help the people
9 in need and those who are less fortunate than we are.
10 Thank you very much.
11 DR. TAYLOR: Thank you. Are there any
12 questions of Mr. Martinez? Thank you, Mr. Martinez.
13 Well, this is the time for our committee and staff
14 discussion. Is there any additional discussion at
15 this point that we need?
16 MS. GWIN: I would just like to say that
17 our next full committee meeting is in Washington, D.C.
18 on September 4 and 5.
19 DR. TAYLOR: Any other comments,
20 questions? This meeting is adjourned. Thank you.
21 (Whereupon, at 4:00 p.m., the hearing was