The Board noted in its Interim Report that OSAGWI described the contributions of organizations that helped OSAGWI collect and evaluate information, but OSAGWI did not explain the methodology it used in its environmental exposure reports. We recommended that OSAGWI should "clearly demonstrate how it evaluates the information it amasses to reach the conclusions presented in its environmental exposure reports."

OSAGWI has subsequently modified its stated methodology to include a purpose statement and a full discussion of its investigational framework. The Board believes that the revised statement of methodology fully reflects OSAGWI procedures and enhances the value of the exposure report to the reader.

The Board found that in each of its reports OSAGWI made assessments regarding environmental exposures that were consistent with available evidence.

Chemical Agent Resistant Coating (CARC), February 24, 2000; revised and republished on September 28, 2000. This report reviews vehicle-painting operations in the Persian Gulf during and following the Gulf War. U.S. troops and a few government employees painted thousands of military vehicles with desert tan CARC paint in theater during Operation Desert Shield to make them more difficult for the Iraqis to see and to help protect them from chemical warfare agents. Many of the same vehicles were painted olive drab again prior to retrograding them to assignments outside the Persian Gulf after the war. OSAGWI�s environmental exposure report addresses the hazards that some CARC painters were exposed to during these operations and the health effects that some of them experienced. OSAGWI determined that only spray-painting operations posed a hazard to personnel and that only a very limited number of personnel participated in such operations (estimated 200 plus a smaller, unknown number of soldiers from small paint operations).

CARC contains several compounds that may cause short- and/or long-term problems for personnel involved in spray-painting operations who lack appropriate protective equipment. OSAGWI determined that the 325^th Maintenance Company performed most of the spray-painting, with some U.S. Army civilian employees and the 900^th Maintenance Company accounting for the remainder. The civilians had experience with CARC and brought protective equipment with them. They purchased additional equipment in Saudi Arabia for their paint operation and reported no adverse health effects. The 900^th Maintenance Company assumed control of the civilian operation in February 1991, and its personnel also cited no ill effects from painting operations. The 325^th Maintenance Company established two high-volume paint sites in December 1990. The unit had no experience in CARC painting and initially used inappropriate protective equipment, although the company eventually obtained proper respirators and compressors. Since their return from Saudi Arabia, some members of the 325^th Maintenance have reported adverse health effects. Privacy considerations prevent OSAGWI from examining medical and compensation records. However, some personnel have been diagnosed with respiratory conditions, such as asthma, that have been associated with CARC exposures (though in other populations asthma generally developed in workers who had been exposed for at least twelve months to several years).

The Board concurred with OSAGWI�s characterization of potential CARC exposures as consistent with available evidence.

The Board recommended that OSAGWI consider its investigation complete, amend the report to explain more fully its many efforts to disseminate lessons learned to the military community, and then change the report title to read "Final."

Environmental Exposure Report: Depleted Uranium in the Gulf, July 31, 1998. This report includes a primer on DU, describes DU exposures in the Persian Gulf, and provides a general discussion of the health consequences of such exposures. OSAGWI also describes ongoing DU research in this report. OSAGWI contracted with the RAND Corporation to provide medical information and relied on investigations by the Center for Health Promotion and Preventive Medicine (CHPPM) for estimates of radiation doses to exposed troops. OSAGWI determined that the RAND literature review and the CHPPM reports, data, and assessments, along with the more than fifty years of medical research on uranium, clearly do not support claims that DU has caused the undiagnosed illnesses that some Gulf War veterans are experiencing.

The Board found that OSAGWI�s assessment is consistent with available information. The Board noted several minor shortcomings that do not affect that assessment. The Board recognizes that Depleted Uranium in the Gulf is an interim report and understands that OSAGWI will revise the report based on comments it receives as well as forthcoming research. Recommended changes include:

• OSAGWI should use as its "bottom-line" conclusion the more accurate statement on page 10:

• The Board recommended that OSAGWI more fully discuss the levels of exposure of Gulf War veterans to DU and DU's toxicity to the kidneys. OSAGWI has concurred with these recommendations.
• The Board believes OSAGWI should have its DU report subjected to scientific peer review by non-DoD experts to ensure its availability to agencies that require that level of review. OSAGWI has since identified experts in the field, suggested by the Board, who will participate in the review of the next DU report.
• The Board recommended that OSAGWI fully discuss appropriate environmental standards of DU exposure (e.g., occupational radiation workers vs. general public exposures to radiation) for military personnel. OSAGWI agreed with the Board and will broaden its discussion of environmental standards in its next report.
• The Board indicated its intention to review the then newly released RAND Corporation report A Review of the Scientific Literature As It Pertains to Gulf War Illnesses, Volume 7, Depleted Uranium upon the release of OSAGWI�s second DU report. The Board has since examined the RAND report and considers it to be an important contribution to the issue of DU and Gulf War illnesses. The report confirms OSAGWI�s assessment that existing evidence does not support claims that DU has caused Gulf War illnesses.

The Board has continued to examine the issue of depleted uranium, and the Board still believes, after reviewing available evidence to date, that exposure to DU is unlikely to be the cause of the unexplained illnesses or diagnosed illnesses affecting Gulf War veterans.

Environmental Exposure Report: Oil Well Fires, October 13, 1998; revised and republished on September 28, 2000. This report compiled all available information that described burning oil wells in Kuwait during the Gulf War, the subsequent efforts to extinguish the fires, exposures to oil fire emissions, and possible health consequences to those exposures. OSAGWI relied on the 1998 RAND Corporation Review of the Scientific Literature as It Pertains to Gulf War Illnesses, Volume 6, Oil Well Fires, for parts of its discussion of health effects. OSAGWI relied on risk assessments conducted by CHPPM (formerly the U.S. Army Environmental Hygiene Agency [EHA]) to assess the possible consequences of exposures to oil well fire emissions.

During January and February 1991, Iraqi troops set over 600 Kuwaiti oil wells on fire. The EHA began collecting environmental samples (air and soil) in the theater of operations on May 3, 1991, and its successor, CHPPM, conducted a series of health risk assessments based on this data in the intervening years. The EHA draft interim report of June 19, 1992, included monitoring data through September 15, 1991, and the February 18, 1994, final report included data through December 3, 1991. In this final report, the EHA concluded, "the potential for significant long-term adverse health effects for the exposed (DoD) troop or civilian employee populations is minimal." However, the report also stated that levels of particulate matter "may have presented the potential for acute respiratory health effects in the very young, the very old, and in personnel with pre-existing airway disease." In addition, the EHA recognized very early two major limitations of its health risk assessment: air monitoring data were collected at only ten fixed sites (only half in or near Kuwait City); and EHA sampling did not begin until three and a half months after the first fires were ignited. Therefore, the health risk assessment was augmented with modeling to estimate exposures over the entire duration of burning oil well fires and over a greater area than is reasonably represented by the actual air monitoring data.

CHPPM released a draft "environmental surveillance health risk assessment" on June 29, 1998, that included troop unit locations in the calculation of exposure terms and a separate assessment based on modeled daily air concentrations for twelve substances in oil well fire emissions that were used to calculate risk numbers. The report concluded that "all troop unit excess cancer and non-cancer risk levels were below respective EPA safe risk levels. In other words, the environmental exposures troop units received from oil fires and other industrial sources in the Gulf region were not expected, by themselves, to cause health effects."

OSAGWI used these and other studies to write a report directed at veterans, policy makers, and other non-scientists. OSAGWI cautioned the reader not to consider the report to be definitive and that further investigations needed to be completed before one could fully assess the long-term health effects of oil well fire exposures. However, OSAGWI correctly decided to provide veterans with the best information available in 1998 rather than have past and present service members wait several more years. Based on the results of the various studies, OSAGWI stated in its initial interim report that:

The Board generally agreed with OSAGWI assessments. However, it noted that CHPPM calculated non-carcinogenic inhalation risk numbers for only three of the twelve substances modeled and did not include risks from inhalation of particulate matter, soot, sand, or raining oil. CHPPM and OSAGWI have worked closely with the Board since February 1999 to resolve the many Board questions and recommendations surrounding this complex environmental and human health and exposure issue. Although the Board initially expected greater scientific rigor in OSAGWI�s follow-on report, the Board accepted that the intent of the OSAGWI report is to summarize extant information pertaining to oil well fires for all veterans and other interested members of the public who may not have technical or scientific training. OSAGWI agreed with the Board recommendation that the second interim report on oil well fires would clarify the objective of the report.

The OSAGWI Environmental Exposure Report: Oil Well Fires II integrated Board and other comments together with more recently completed research such as updated and finalized air monitoring and modeling information. The Board staff has favorably reviewed these reports and supporting information, especially the CHPPM oil well fire exposure analysis and health risk assessment data. In addition, OSAGWI expanded its methodology section to clarify fully the overall purpose of the report, provided fuller documentation, and enhanced the readability of the report. More important, OSAGWI correctly decided to discuss soot and other oil well fire-related particulate matter in a separate environmental exposure report that addresses all natural and man-made particulate matter. Accordingly, Oil Well Fires II focuses on the smoke that the burning oil well produced. The report, like its predecessor, determined that contaminant concentrations (less particulate matter) in the smoke were below those known to cause short- or long-term health effects and that, except for the possibility of exacerbating some pre-existing respiratory conditions, one would not expect exposures at the levels observed to result in long-term human health effects.

The Board found OSAGWI�s assessment to be consistent with available evidence. However, additional research must be completed and assessed before OSAGWI can issue a final report. Ongoing efforts include CHPPM�s investigation of "oil rain" exposures and revision of its risk assessment.