DoD Persian Gulf War Veteran's Illnesses Investigation Team Testimony to the Presidential Advisory Committee, October 18, 1995

Col Koenigsberg:

I am a Director of the Department of Defense's Persian Gulf War Veterans' Illness Investigation Team. The investigation team initiative was directed by the Deputy Secretary of Defense in March of 1995; the team was established in June and is to function for a period of two years under the authority, direction, and control of the Assistant Secretary of Defense for Health Affairs, Dr. Joseph. Our charter is to integrate and analyze classified, declassified, and unclassified operational, intelligence, and medical information to explore all reasonable possible causes for illnesses related to service in the Persian Gulf War. We will examine unit logs, command reports, battle damage assessments, supply and logistics records, encampment procedures, and many other types of records, reports, and files. Every classification level and category of information is available to the team.

On our toll-free hotline number, 1-800-472-6719, we are soliciting veterans to give firsthand accounts of events or conditions that may be related to Persian Gulf illnesses, and we are soliciting theories from health care providers. We will review and evaluate this information and any additional information we develop.

The twelve-person investigation team is multi-disciplinary. We have people with medical, operations, intelligence, and support backgrounds. I am a physician, and my most recent assignment was as Director of the Armed Forces Medical Intelligence Center at Fort Detrick. We also have a pharmacist, epidemiologist, preventive medicine physician, chemical/biologic weapons expert, operations expert, and a special investigations officer. We have a chemical engineer intelligence analyst on loan from the National Ground Intelligence Center, and expect to have a permanent intelligence analyst soon. We have a line support officer with command personnel and operations background, a secretary, and an enlisted administrator will join us this month and a senior substantive advisor with a background in research who has been identified.

A large part of our job is to coordinate with other Department of Defense, Federal, and non- Government agencies. The graph that you see over here on the side shows many of these agencies with whom we deal. We are a resource to these agencies, and they are a resource for us. Not only will we investigate events and possible exposures which may be related to Persian Gulf veterans' illnesses, we are also the primary conduit for new information from Iraq and elsewhere to help focus the efforts of the clinical and research programs.

Let me give you a little more insight about our process for conducting inquiries and analyses. As indicated, a high volume of information will come to us from many sources. The DoD alone estimates that up to 10 percent of the 15.9 million pages of operational Desert Shield/Desert Storm documents are expected to have some relationship to health data. We initially evaluated over 9000 pages of documents and reports which were placed on the GulfLink database in addition to a huge amount of material previously compiled by the Department of Defense. Then there are the other databases we use or will use as they come on line, such as the Environmental Support Group's unit locator file, the Center for Health Promotion and Preventive Medicine's geographic information system, Health Affair's comprehensive clinical evaluation files, and several of the databases managed by the Defense Manpower Data Center.

Many theories of particular interest for investigation are already well-known, and we have begun to reevaluate them with these new databases as they come on line. The team does a regular review and analysis of our 1-800 incident reporting line database, and as of October 16th, we had 419 callers reporting 571 incidents or conditions. Currently there is no clustering by unit, incident type, incident date, or location on the calls that we've received. The information is, however, routinely cross-referenced with other matters that the team is investigating such as the effects of sand exposure, Scud attacks, chemical and biologic warfare target damage assessments, et cetera.

As an example, a caller reported that on a give date he witnessed several dead animals and suspected some unusual terrorist activity in the vicinity of their encampment in Bahrain. We first confirmed the duty service and Persian Gulf service of the individual through the Defense Manpower Data Center, Desert Shield/Desert Storm files. We verified the unit's exact location on these dates with the Environmental Support Center's unit locator database. We will now cross-reference all of this with the Scud attack database, the enemy chemical and biologic warfare facility list, the coalition air war battle damage assessment reports. We will also review documentary evidence such as unit logs, veterinary reports, and intelligence reports to see how all of this fits together. We will analyze whether any of these factors overlay with each other and, in combination with each other or alone, could have resulted in the reports of the dead animals, the unusual enemy activity, or the veterans' illnesses.

We have also checked to see if anyone else from the same unit or other units in the area made similar incident reports for similar dates or locations. We will now check the medical and personnel data files to see if we can find a cluster of people with similar medical problems from these units or nearby units which could have had a potential for the same exposure.

Now I would like to give you some details about specific areas we are already investigating, which in turn should provide some idea of the wide scope that is involved in this. A persistent theory is that due to the targeting of chemical and biologic weapons production, filling, and storage sites, inadvertent release of agents occurred.

To determine if there was a potential threat to Coalition forces, we coordinated with the Air Force to get a copy of its new comprehensive database of all airway targets when it is available. The Air Force began compiling this database shortly after the war. It is derived from air tasking order and target lists, which assign specific units to bomb specific target locations. The database, containing data from all services, provides descriptions of the targets, known weather, mission diverts, and bomb damage assessments. We will link this data with data already released on GulfLink to determine times when possible downwind hazards could have occurred. In addition, reported incidents of chemical agent alarms are being cross-checked for possible connection to when the chemical and biologic warfare facilities were bombed. This should give us an idea of whether there were specific instances that could potentially have exposed Coalition forces to chemical or biologic agents. We are also searching intelligence resources to develop a complete list of actual and suspected CBW production, storage, and weaponization sites which were not targeted or bombed.

As another example of how we are keeping an open mind on the various theories being advanced, we are beginning an investigation of the hypothesis that one specific military unit may have possibly been exposed to low levels of nerve agent from a bombed chemical warfare storage facility around the same time as the reported Czech detections. The unit was a in a different location than the Czech detectors, but the unit and the Czech detectors were both approximately the same distance from the possible targeted weapons facility.

Let me mention that we are also investigating the use of insecticides such as DEET and permethrin. It has been suggested that the insecticides could have become more toxic when combined with others or with the pyridostigmine bromide that some soldiers were taking.

We are examining several related issues such as whether it is likely that individuals were exposed to more than one of these substances at the same time. Non-governmental researchers, not our investigation team, are evaluating delayed neurotoxicity. One of the investigation team's roles is to provide operational and intelligence information to supplement the Government and non-governmental research efforts.

Due to the numerous reports of chemical agent warning alarms that were subsequently determined to be false positive, we are investigating the operation and deployment of these detectors. It should be noted that initial detection alarms are designed to be overly sensitive for a quick response while trading off for specificity. Backup detection equipment is more specific but less responsive to confirm the actual presence and identification of a chemical agent. Battlefield interference also confounds detection capabilities.

We intend to investigate and prepare a report addressing the military chemical warfare detection capability and specific data on specific reports of alarms. We are also studying the SCUD propellant additive, red fuming nitric acid, RFNA, which is not totally expended before impact. At the time of launch, a SCUD missile contains about 8000 pounds of RFNA and 2000 pounds of kerosene. When the missile reaches full speed and the engine shuts off, there is a residual of as much as 300 pounds of RFNA and over 100 pounds of kerosene. Volatile residual RFNA could have escaped, especially if the missile did not fully detonate, causing a vapor hazard.

When released, RFNA is a reddish brown cloud. It's fumes can be suffocating and poisonous. It is an irritant to the skin, mucous membranes, eyes, and respiratory system. Acute exposure symptoms, which may be delayed up to as much as 30 hours, include dizziness, headache, nausea, general weakness, chest tightness, and difficulty breathing. In some reported incidents, chemical agent alarms and acute symptoms similar to those experienced with RFNA exposure were associated with reported SCUD attacks.

Using a list of actual SCUD launches and impacts, we will examine these reported incidents to discern if RFNA or another of the substances used in the SCUD might have contributed to the acute symptoms of our service people.

New information that Iraq has released to the United Nations makes it clear that Iraq had a mature biologic warfare program. We are evaluating the effects of identified biologic warfare agents and investigating whether there is any possibility that biologic warfare agents could have been employed or accidentally released through collateral damage.

We also have an investigative interest in silica, especially the fine microparticle size silica that exists in Saudi Arabian sand. Medical research has linked silica exposure to immunosuppression and autoimmune diseases such as rheumatoid arthritis. We believe that silica inhalation and absorption by U.S. troops deserves further research attention.

We are awaiting more data now from Rolls Royce/United Kingdom on studies of silica damage to jet engines on the British Tornado aircraft used in the war, soil analysis data from the United Nations, and a review of CHPPM, or the Center for Health Promotion and Preventive Medicine, soil samples.

Dr. Pamela Asa, an immunologist from Mid-South Arthritis Treatment Center in Memphis, Tennessee, sent Department of Defense a paper theorizing that vaccine adjuvants could contribute to the Persian Gulf illnesses. A correlation was drawn between the use of silicon vaccine adjuvants and human autoimmune disease, based on silicon breast implant research. Our initial investigation disclosed U.S.-produced vaccines use only aluminum salts as adjuvants because of concerns about the safety of silicon-based adjuvants. There is no evidence that aluminum adjuvants are related to autoimmune disease, but we requested the Army's Medical Research and Materiel Command review this matter. At the request of the Army, an additional review was conducted by an expert on the staff of Johns Hopkins Hospital. It is the opinion of the Army research and the Hopkins consultant that there is no clinical relationship between adjuvants and the Persian Gulf veterans' illnesses.

A theory on mycoplasma infection was introduced in veterans' publications and subsequently in a talk to DoD and VA researchers by Drs. Garth and Nancy Nicolson from the University of Texas. Because the mycoplasma organism is so unique, detection and treatment are extremely difficult. DoD, VA, CDC, and civilian scientists are exploring with the Drs. Nicolson the existence of mycoplasma in Persian Gulf veterans and attempting to determine whether it is possible to intentionally manipulate the organism as was suggested. The investigation team's part is reviewing related and intelligence and operational data, trying to determine if the organism can be weaponized.

We are investigating the effects of chronic exposure to oil well fire smoke and petrochemicals in general. We will review data on the Kuwaiti oil fires compiled by the Center for Health Promotion and Preventive Medicine, and we are looking for epidemiologic studies of oil industry workers and oil well firefighters.

The 193rd Air National Guard unit in Pennsylvania, with a high rate of illnesses, is of interest to the investigation team. The unit is part of an ongoing study by the Centers for Disease Control and Prevention. Our investigative efforts to date include coordination of Environmental Support Group and Defense Data Management Center data to determine the demographics and locations of deployed personnel, interviews of deployed personnel, coordination with CDC, and coordination with unit physicians. Future efforts include further evaluation of the unit's deployment, mission, equipment, in coordination with the Centers for Disease Control.

We are working across a wide spectrum of information. Many of our investigations will lead to final conclusions and reports to the public. Other investigations will provide avenues for further research, and some, in addition, will produce results useful for planning future deployments.

We are certainly happy to provide your staff with any further details, if you require, and I thank you for allowing me the opportunity to present this information.