PRESIDENTIAL SPECIAL OVERSIGHT BOARD
FOR DEPARTMENT OF DEFENSE INVESTIGATIONS OF
GULF WAR CHEMICAL AND BIOLOGICAL INCIDENTS
Tuesday, July 13, 1999
P A R T I C I P A N T S
Senator Warren Rudman
Rear Admiral Alan Steinman
Lieutenant General Marc Cisneros
Senator Jesse Brown
Admiral Elmo Zumwalt
Dr. Vinh Cam
Ms. Ann McGuire
Dr. Bernard Rostker
Mr. Robert Walpole
Mr. Edward Bryan
Mr. Paul Sullivan
Mr. William Frasure
Mr. Dan Fahey
Mr. Kirt Love
Dr. Naomi Harley
Major General Robert Claypool
Rear Admiral Michael Cowan
Mr. Mark Gebicke
Mr. David McLain
Ms. Dee Dodson Morris
Mr. Larry Fox
C O N T E N T S
Senator Warren Rudman
Dr. Bernard Rostker
Depleted Uranium Training
Ms. Dee Dodson Morris
CIA Update on Potential Chemical Releases
Mr. Robert Walpole
Mr. Edward Bryan
Mr. Paul Sullivan
Mr. William Frasure
Mr. Dan Fahey
Mr. Kirt Love
RAND Review of Scientific Literature
on Depleted Uranium
on Depleted Uranium
Mr. Ross Anthony
Dr. Naomi Harley
Armed Forces Radiological Research Institute
Depleted Uranium Studies
Depleted Uranium Studies
Dr. David McLain
GAO Review of OSAGWI
Mr. Mark Gebicke
P R O C E E D I N G S
SENATOR RUDMAN: Good morning. I'll call the meeting to order and ask everyone to get settled.
This is the fourth public hearing that the Board has held. In April of this year we met in San Antonio under the chairmanship of General Cisneros, and most recently in June here in Arlington where we held a brief one-day hearing at which the Board hear from Dr. Haley on some of his research.
We're holding today's hearing to hear testimony from the Defense Department, the CIA, and other witnesses prior to issuance of our interim report in August -- that would be next month.
I've asked the Department of Defense Special Assistant Dr. Bernard Rostker to come before us today to address a conceptual phase-out plan for OSAGWI's investigative operations.
After we have heard Dr. Rostker's testimony and discussed the conceptual phase-out plan, the Board will determine after the interim report what recommendations, if any, it will make concerning discontinuation of the OSAGWI investigative activities, and I underline "investigative."
We will study the conceptual phase-out plan and present our recommendations in the final report.
Today we'll also hear from the CIA on their investigations of potential chemical releases as a result of coalition bombing activities during Desert Storm. And from the Office of the Secretary of Defense Health Affairs and the Joint Staff on issues related to pre- and post-deployment health screening.
There is continuing attention to the subject of depleted uranium. This afternoon we will hear from Dr. Naomi Harley, an authority on radiation physics, and also from the Armed Forces Radiological Research Institute about DU. And of course we will hear this morning from individual veterans who have asked to address the Board.
I mentioned our interim report which is due almost nine years to the day following the August 2, 1990 invasion of Kuwait by Iraqi forces. There has been little information uncovered to date by any organization that has been what I would call a smoking gun. That is information that would give us additional insight into the potential causes of these undiagnosed symptoms of our veterans that are collectively known as Gulf War Illness.
By contrast there has been significant medical research conducted, and that research must continue to go forward. The Defense Department's medical research program will continue without dependence on investigation of Gulf War incidents. Hopefully that research will continue to use the Gulf War experience for hypothesis generation and design of future medical research.
The Board supports continuing medical research into the causes of undiagnosed Gulf War illnesses as research always holds the promise of discovery. Our veterans deserve continuing scientific inquiry.
On the other hand, in response to the President's directive to leave no stone unturned in the search for events that may have a relationship to those ill veterans who served in the Gulf, the Defense Department continues to investigate chemical and/or biological events or suspected events during the Gulf War that may be associated with the undiagnosed illnesses that are affecting our veterans.
To date there appears to be little information that suggests causality between Gulf War chemical or biological events and servicemen's or veterans' health outcomes. That is the universally held belief. This observation neither diminishes the investigative efforts of the Department nor suggests that our veterans are not ill. It goes into causality.
Investigative efforts have been diligent and determined, yet have identified no watershed events or circumstances able to offer indisputable evidence that links service in the Gulf or low level chemical/biological exposures in the Gulf, to Gulf War Illness.
While the Defense Department's efforts have been educational and informative, the Board would like to hear if the Defense Department has a plan to shift its efforts from these retrospective investigations to a harmonious integration of the medical aspects of troop health surveillance, monitoring and care with the operational deployment of troops in both training and contingency situations. I look for testimony today that will address this issue.
We are interested in the Department's plans for the future for integration and application of the lessons learned to date from the Gulf War investigative activities into future servicemember medical surveillance, care, screening, and deployment.
Before we begin, we have a very distinguished and very hard working panel, and I want to give each of them an opportunity to make whatever remarks they would like to make before moving to our first witness. I will first call on my Vice Chairman. Jesse, if you'd like to go ahead.
SECRETARY BROWN: Mr. Chairman, I will reserve my remarks until after I've had an opportunity to hear the testimony. Thank you.
SENATOR RUDMAN: Thank you, Mr. Vice Chairman.
ADMIRAL ZUMWALT: I'll follow the same policy.
SENATOR RUDMAN: Dr. Cam?
DR. CAM: I'll do the same thing.
SENATOR RUDMAN: General?
LIEUTENANT GENERAL CISNEROS: I just want to report, Mr. Chairman, that we did have that meeting. As you indicated, I was the chairman of the meeting in San Antonio, and I felt that we had a very good turnout and a very good dialogue. I also reserve any further comments.
SENATOR RUDMAN: Admiral Steinman?
ADMIRAL STEINMAN: I just want to say it's a pleasure to be working with this committee again, and I, too, will reserve comments for the time of questions from our witnesses.
SENATOR RUDMAN: Thank you all.
Board member Command Sergeant Major David Moore had a death in his immediate family on Sunday and is unable to be with us today. Our thoughts and prayers are of course with him.
With that, we are ready to begin our hearing. We'll hear from our first panel if Dr. Rostker and his team would come forward.
I guess I should introduce Ms. Ann McGuire from the White House who is sitting to my far left and who is the designee from the Office of Cabinet Affairs at the White House who, of course, oversee our work along with the DoD.
DR. ROSTKER: Senator Rudman and members of the Presidential Special Oversight Board. It's my pleasure to be here today to talk to you about the future of the Office of the Special Assistant for Gulf War Illnesses or OSAGWI.
The Department of Defense remains committed to the three-part mission that has been at the center of OSAGWI since it was established in November of 1996. Our mission is to ensure that veterans of the Gulf War are appropriately cared for; to ensure DoD is doing everything possible to understand and explain Gulf War illnesses; and to put into place all required military doctrine, personnel, and medical policies and procedures to minimize any future problems from exposure to biological and chemical agents or other environmental hazards.
Over the last two and a half years we have progressed from a startup organization, borrowing resources from other organizations within the Office of the Secretary of Defense, to a mature organization included in the President's budget and fully funded through normal budgetary channels.
You, the Board, have requested that I discuss today our out-year budget projections. I am providing separately the five year budget projections we prepared for the OSD Comptroller's office.
This resource plan is based on the following assumptions. We will complete all current investigations. We will meet all previous commitments to the President's Advisory Committee, the General Accounting Office, and the Board. We will republish all interim narratives as revised or final narratives. We will meet all current outreach and town hall commitments. We will maintain the ability to effectively interface with veteran service organizations, individual veterans, and their families. We will refine and monitor lessons learned through the new Lesson Learned Directorate. We will leave in place a caretaker organization to continue to respond to our mission.
As I believe your own experience has already shown, it is difficult to be definitive in making these budget projections. To be effective we both need the flexibility to adjust workload and deadlines based on the unique and evolving demands.
As we sit here today I cannot tell you what issues you might raise as you continue to review our work or how much effort it will take to respond to your suggestions and requests. I can't tell you what issues the VSOs or congressional committees or the ongoing GAO review of depleted uranium might raise. I can only assure you that the Department is committed to spend whatever is necessary to complete our mission and properly serve our veterans.
Putting aside unforeseen demands, I can explain the baseline budget projections submitted to the Department.
As we matured as an organization and reported on the most notorious cases of suspected chemical agent exposure we expanded our focus from reporting on what happened in the Gulf, the so-called mission of leaving no stone unturned, to overseeing implementation of recommended policy revisions.
A significant recent change has been the establishment of the Lessons Learned Directorate. This new group has been staffed primarily by downsizing other parts of the organization, and they will be a substantial part of the long-term core organization.
As we move forward we will continue outreach and communications with veterans and their care providers. The veterans data management group will remain and will be reduced in size in keeping with the anticipated reduced volume of investigative calls, and the assumption that there will be a reduction of incoming calls with a reduction in large-scale public release of information. Available phones and the reprogramming capacity of a central telephone switch will allow us to increase the pool of extensions assigned to the 1-800 number if that is necessary.
The core organization, as we provided in our budget projection, would contain an outreach communications group, an administrative team, and a document management team. The latter to handle the national archive and record administration requirements, and the large number of Freedom of Information Act requests that we receive.
We will maintain an operations and security group to maintain physical and information security.
We anticipate the need for a smaller, more generic investigative group of government personnel supplemented by contractors to provide the expertise required to enable us to respond to inquiries from individual veterans and the media.
The most important change will be in the Investigative and Analysis Directorate, the IAD staff. This organization has been at the heart of OSAGWI. It will be substantially scaled back over the next several years. Here, however, we have a wide range of options and we look to the Board, the VSOs, the Congress, for help in determining which is the best option.
For example, should we complete all 33 ongoing case narratives or only, and I put this in quotes, "significant" cases -- those where we have made a commitment to the PAC to investigate and publish our results? Should we continue to investigate even if our preliminary analysis suggests that chemical agents were not present? The Board's judgment will become even more critical when you hear in a few minutes from Mr. Walpole of the Central Intelligence Agency concerning their continued review of chemical, biological and radiological exposures of Gulf War veterans.
Given the current work of IAD and the CIA, there are a number of ongoing projects that I do recommend we continue through to completion. Our work on pesticides, while not likely to provide the epidemiological data needed to provide a link between application and illness of specific individuals, should help us understand how pesticides were used and possibly misused during the Gulf War -- an important issue for our Lessons Learned Directorate and for the Department of Defense.
In the area of chemical exposures, I believe it is imperative to complete and republish estimates and lists of those allied forces that may have been exposed to chemical agents as a result of the destruction of rockets at Khamisiyah. We are likely to notify some that we previously sent letters to that based upon new information we now judge that they were not exposed. We are likely to notify others that previously did not receive notification letters that they may have been exposed. These new estimates will reflect a better understanding of where our troops were located, the amount and potency of agent release, new weather modeling, and the effects of weather on agent decay.
A complete remodeling of other releases that the CIA will discuss is more problematic. When we changed weather models as a result of the Institute of Defense Analysis Panel's recommendation, the PAC staff insisted that for consistency we reassess all previous analysis done by the CIA. We have been working with the CIA and they have been working with UNSCOM to better refine the dates of specific events, the weather at the time of the events, and the amount and potency of agent release. The CIA will talk to you about these releases later today.
The CIA has also made judgments concerning the likelihood that agent reached friendly forces. However, my office has not independently verified their analysis. I might say that the consensus view of representatives from major VSOs at a recent meeting that we held just yesterday was that we should continue to model these releases. We are, of course, prepared to do that.
The final question I'd like to put before the Board is what should finally become of OSAGWI. This is an issue I've talked to the VSOs about and I am forwarding with the budget projections we provided the Comptroller, I'm forwarding a number of letters I've received from major veterans' service organizations and military service organizations concerning their views of the future of the organization.
The present budget projections, for example, assume that after the last case narrative is published we will maintain a caretaker organization rather than close the doors on OSAGWI. These caretakers could update the narratives wherever new information is uncovered, respond to veterans' inquiries and provide a dedicated focal point for questions concerning Gulf War illnesses from the media.
Alternatively, one could argue that the ultimate lesson to be learned from the Gulf War is that the Department of Defense needs a permanent but more generic version of OSAGWI to deal with issues of deployment. You might come to this view if you believe that the issues facing OSAGWI were not unique to the Gulf War, but were the forerunner of a new focus by American troops on non-traditional outcomes. Also if you believe the Department needs a group that cuts across existing organizational lines reporting directly to its most senior leaders rather than being handled within the Department's traditional structure.
In summary, we have projected a continuation of OSAGWI. This is only one model that we could follow. We look to the Board to determine if this is the right model.
Thank you very much for giving me the opportunity to discuss this with you today. I'd be pleased to take any questions and after that I'll be followed by Ms. Dee Morris, the head of our Lessons Learned Directorate, who will report to you on depleted uranium training.
SENATOR RUDMAN: Thank you very much, Dr. Rostker. Let me start out with a few questions.
It seems to me that in order to answer really the second question that you posed to the Board this morning, and it's a very good question, and that is what is the future of OSAGWI, you have to really get back and answer the first question that you asked in your statement which essentially, if I have the order correct, was how much more should, I believe you refer to them are IAD, do.
It seems to me that that's something that this Board needs a lot of help on from your organization and from anyone else who would like to contribute, and let me explain what I mean by that.
We are investigating physically events that took place now almost ten years ago. From my own life's experience dealing with evidence, I can tell you unequivocally that when you get to the tenth year you're getting pretty stale. No matter how good your models are, you start to get into real reliability problems in terms of recollection, memory. And what normally happens is that subsequent events shape recollection over the years. So what somebody thinks is their present recollection is really a present recollection, not a recollection of what took place ten years ago and there's a great of difference in those two things. The kinds of things that lawyers are arguing about in court all the time.
I am very concerned that it's not the amount of resources that we expend on this issue because as the Vice Chairman said to me just before we started, these are all costs of war, and if we have to do whatever we have to do for the veterans -- that's not even the issue. The issue is to spend whatever resources we have wisely.
So one of the things that we want from you over the next several months is a detailed analysis of the probable cause that exists to proceed on each of the 33 remaining cases.
It seems at least to me, and I'd like to know how the rest of the panel feels, that we ought to take the best minds that we have in this organization and the CIA, look at these 33, do a probable cause analysis on each, and then come back to this Board and say here is our analysis. We believe that these 11 should be completed, but the others really, even if they're completed, the benefit you might get from that is fairly slim. So that, to some extent, would shape the future. I'd like your response to that.
DR. ROSTKER: I think you have to put it in a broad context, and I will get to very specifically what you've asked.
The assumptions that we provided in our budget projections to the Defense Department were really built around two imperatives for the organization. The first is meeting our commitments.
We made commitments largely to your predecessor organization, the President's Advisory Committee, to carry on a range of analysis. Those commitments were made at a time when that Board was very questioning of the Defense Department, very critical of the handling of information, very demanding that, for example, every report of a positive 256 kit detection, regardless of supporting information, had to be documented. Every one.
So when we made our budget projections it was on the basis of continuing that level of commitment. There are many of those commitments that I do not believe will be fruitful, either on the basis of previous research and investigations or on the basis of our preliminary analysis. And I would ask you to weigh those, again, in reference to what you hear from the CIA later today.
SENATOR RUDMAN: Let me just interrupt you at that point before you continue your answer and tell you that I happen to believe, and I have not polled this panel, but I believe that this panel two years later is charged with the responsibility of saying to you what the PAC thought at the time based on the information available at the time might have been reasonable. We think today it is not.
I don't think that we're bound to accept everything the PAC said. We know more today because time has passed.
DR. ROSTKER: That's the guidance I'm looking for.
SENATOR RUDMAN: We have to help to reach that conclusion with you.
DR. ROSTKER: There is a corollary to that issue of commitment, and that is from the eyes of the veteran.
Veterans are asking of the Department, have been asking of the Department, really two questions. First of all, do you care? And the flip of that is no one's taking me seriously.
So as we explored this very issue with the veterans service organizations yesterday, it was also very clear that still veterans in the rooms, those would be the people who would be the most informed, were bringing up, well, I was at so and so and my buddies think this and you haven't investigated it yet. That view has to be taken seriously. We're not about to, I don't want to pull the plug on serious veterans' concerns, even if our best judgment is that this would not be related to Gulf War illnesses.
In the regard, there was an explicit discussion about the bombing campaign and our commitment to the PAC to use the quite advanced meteorological models that have been developed. It was the consensus of the veterans groups in the room that in that area, even though the CIA will tell you they do not believe agent reached -- and we would concur -- that agent reached friendly forces, their assessment and recommendation was to continue those levels of analysis. We're pretty well finished with that so it's not something that will impact the long term of the organization, but I think it represents a mindset.
The second issue that I think comes into the future work is republishing existing work. Here the Board is very helpful.
Every one of our case narratives and information papers and environmental exposure reports have been issued as interim documents because we strongly wanted feedback and corrections and dialogue. I must be candid with you, one of the disappointments is that we've had very little of that. Your predecessor organization did not comment at all. The General Accounting Office, and you will be hearing from their representatives later, did an absolutely outstanding job in reviewing our documents, as has your staff.
We need to take those corrections and suggestions and republish. I do not want to see this organization leave for the public record material that we know is incorrect.
SENATOR RUDMAN: Let me interrupt you again there, Dr. Rostker, and please excuse the interruptions, but I think it's more orderly that we do it this way.
DR. ROSTKER: Please.
SENATOR RUDMAN: I think it's important for the public, and this is a public hearing, to understand the process. Our staff has very vigorously contested some of the things that we have found written, and your staff has very vigorously come back and said no, we think we're right and here's why, and it's been a very good give and take done in the spirit of finding out the truth as the truth can be found. And so when those are finally published in their final form, they will have the imprimatur of your organization and this organization.
DR. ROSTKER: Yes, sir.
SENATOR RUDMAN: Which is, I believe, what the President meant when he gave us our charge.
So I think it's important for people to know there is an ongoing interchange. Sometimes it gets a bit tense, but we're all working to the same goal, and that's to try to produce the most accurate report that we can, knowing what we have, and I think it's important the public understand that.
DR. ROSTKER: Exactly.
We focused initially on the most important events. I used the word in my prepared statement "notorious events" because they had really reached that point. They had taken on myths of their own. I think we made very substantial contributions. I'm often amused at some of the criticisms of DoD, for example, the Fox vehicle being prone to false alarms.
When we started, the Fox vehicle was a magnificent vehicle that could never have a false alarm, and now we understand its true operating characteristics, and that's an important piece of information both for understanding the Gulf War but also for managing the future.
So we have made, I think, a very substantial contribution as has the reviews of our work.
But as we go over the next year or two, the issue of republishing I think is extremely important and we need to do justice to your comments and we need to leave in the public domain the most accurate accounting of what happened in the Gulf.
That leads me to the third issue, and ultimately do we fade away completely as an organization? Or is there a need for a caretaker organization? In discussing this issue with the VSOs there was a lot of sentiment, and you'll see this in the letters --
SENATOR RUDMAN: I want to talk about those letters at the end of your testimony.
DR. ROSTKER: A lot of sentiment and appreciation for the communications that have occurred between individual veterans and my office.
Is that a function that should stay? It is, let me tell you, a very expensive function because those people are as good as the systems that back them up in terms of retrieving information. And in this day and age maintaining a computer system is a heavy expense.
When we set up the organization, if you'll allow me a moment, I was shocked at the cost because in the old days, which are not too many years ago, you hired a person, you got a desk, you had a telephone and maybe a typewriter. Today you need a fiberoptic network and a network administrator and a help desk and computers and an Oracle database to retrieve the, my Deputy told me this morning that we have received over eight million pieces of information. Almost half the cost of the organization today is the administrative systems that back up our analysts, but also back up our veterans contact managers and their ability to serve veterans.
So I pose the final and last question, and that is do we stay? Do we go? Do we stay in a diminished role to serve the veterans? Or do we become transformed into a broader organization to worry about these types of issues as we move forward with more and more deployments, more and more activities?
I think this is a consensus outcome that I'm seeking with the Board, with the VSOs, and within the Department of Defense.
SENATOR RUDMAN: It seems to me that on that last point there is going to be a great interest in the Congress, and I'm sure in the Administration and subsequent Administrations, as to what ought to be done. There are many who would say that we already have organizations within the Department of Defense that could assume the responsibility by creating, if you will, another unit within them.
I know Dr. Cam has written a letter to us talking about the future and what OSAGWI might become.
I think it's early for us to really reach any conclusion, but there is no question that some of the functions are going to have to remain at DoD. The question is where can they remain in the most efficacious way? I'm not sure what the answer to that is, but I'm sure the Secretary of Defense has got some views on that as well.
DR. ROSTKER: Yes, I'm sure he has.
SENATOR RUDMAN: So we will obviously talk to him.
DR. ROSTKER: One of the nice factors in having this discussion is that no matter what happens, I won't be here in the sense that the Administration will change in about 20 months, and I think the question of the long term is something that we leave to our successors and not something that any of us have a personal stake in from a bureaucratic sense.
SENATOR RUDMAN: Let me just ask you two more questions and then turn to the panel.
How much time do you need to give us a probability, a probable cause analysis on the 33 remaining cases and your recommendations?
DR. ROSTKER: I think we can do that very quickly?
SENATOR RUDMAN: In a couple of months?
DR. ROSTKER: Very much so. In fact I said to the Board at your first meeting that I knew of nothing in our files that would contradict UNSCOM's conclusion that no agent was sent south of Khamisiyah. The CIA will say today they believe not only that, but that there were no measurable releases in terms of exposure of friendly forces even from the bombing campaign.
If we reassess that with the new weather models which are almost completed and are in the work agenda for this year, I think at that point I would not hesitate on the chemical and biological front to be quite definitive of all of the remaining work.
There are issues of other potential causes, for example CARC paint and others, which are well developed, and I would have to sit down with the staff and go over those additional things.
I did indicate in my statement that we should very much complete the work on pesticides. That survey of several thousands randomly selected Gulf War veterans is ongoing and the analysis will go into the fall and winter, and I think that will make a substantial contribution.
SENATOR RUDMAN: I want to just say to the panel because, as you know, we cannot meet as a panel without opening to the public, so I will now address this to the panel more than anyone else.
It's my sense that it might be a very good thing to do. We have a report due in about a month, and I expect, Mike, that we're going to have that probably ready to send over to DoD and the White House mid August?
MR. MICHAEL E. NAYLON: Yes, sir. The 21st.
SENATOR RUDMAN: There is nothing that says that we can't do a supplement to that, a small supplement to that. Even though it doesn't call for it, we're free to do whatever we want to do as long as we meet the statutory deadlines, and in this case the Executive Order deadline.
I'm going to suggest to the panel what we do is we have Dr. Rostker get what I've asked him to submit to us at the earliest moment. We get that, we absorb it, we meet, we talk about it, and then we do a supplementary report to the Secretary of Defense and to the White House essentially saying here's what we recommend in terms of these 33, which should be completed for analysis.
My concern is that if we continue to do analysis on things that really aren't going to produce very much that we're going to detract from some of the more important missions that are referred to in these letters from the VSOs. So I just want to submit that to the panel for your thought, your consideration, and we can make a decision on it, but it's something that I think would be helpful.
Finally, and then I'm going to turn it over to the Vice Chairman. I think the responses from the VSOs are very interesting, and I just want to talk about them for one moment.
The VFW says, and I'm just going to excerpt what I think are important things here and paraphrase some. "We believe that two of your missions, investigate possible chemical exposures and evaluate environmental hazards, are essentially completed. It seems to us that there are no more issues to be studied in these two areas with the culmination of all the identified requested case studies undertaken by your office over the past three years. We have no further suggestions for DoD involvement as related to chemical/environmental hazard exposure. The focus as we see it has shifted in the last year to the need for scientific and medical research, particularly in support for the possible establishment of presumptions for disability service connection correlated to duty in the Persian Gulf War."
That's the VFW. That's a major VSO. That's a pretty conclusive statement signed by their Executive Director, Mr. Steadman.
Then you get to the Disabled American Veterans and they say that your office must "continue to hold face to face meetings with the various veterans organizations on a regular basis." They talk about the history, the fact that there are a number of veterans who are seriously ill. Then they say, "You have two main missions. First, it must focus on finding answers to the cause or causes of these illnesses; and second, to provide recommendations as to how our government/military can avoid these or similar problems in future deployments." That's their view. A major organization.
Then the American Legion. They say it's their judgment that OSAGWI should "evolve into an organization that remains independent of the Joint Chiefs and the services; conducts outreach to current and former service members; oversees that appropriate changes are made to joint service doctrine in light of lessons" and so forth.
Then at the bottom they say, under investigation, "Your mission was to leave no stone unturned in the search for the cause or causes of Gulf War illnesses. The investigative effort did provide Gulf War veterans, their families and the public with an abundance of information regarding a number of not well understood environmental agents present in the Persian Gulf. However, in spite of a vigorous effort the OSAGWI succeeded only in eliminating possible causes of these illnesses. More critically, this effort has not helped sick veterans get well."
They talk about the cost, they talk about outreach and lessons learned. But it's interesting, they also are focusing now on the health and what do we do for the veterans issue.
Then there's one from the Non-Commissioned Officers Association, and that one is not quite as clear as to what they believe, but they do say "specifically and perhaps most importantly is to continue the needed research effort to conclusively resolve the issue of undiagnosed illnesses."
Well the research effort is only tangentially connected to those remaining 33. They're talking about the medical research effort.
The next one we have here is from the National Military Family Association, and they believe "Since the long term effects of service in the Gulf War are still unknown, and there are still countless veterans who are not aware of the programs available to them, we encourage you to continue your outreach efforts."
Finally, there's one here, I think it's the last one. There are two more. There's one from the National Guard. "The increasing pace of your outreach visits to Army, Marine and Air Force installations and to civilian communities provide important contact. I recommend future visits include sites used by the Guard during their annual training."
They do not specifically give the kind of a recommendation the others have. They do talk about "The U.S. Department of Veterans Affairs recently authorized VA hospital care, medical services, and nursing home care for veterans exposed to a toxic substance, radiation or other conditions resulting from the combat operations in Serbia and Kosovo," et cetera. That is the extent of theirs.
I believe there might be one other. The Gulf War Resource Center has challenged your credibility, has called for your resignation on several occasions, and doesn't think that you really have done a very good job. They're pretty concerned about, they think you have a lack of candor on depleted uranium.
I certainly don't share that. I think there were things that you can do and do better, but that's not a question of candor, that's a question of how you do your job.
They end up by saying, "Thus the recommendation of their group is to keep OSAGWI open and complete ongoing investigations especially in the depleted uranium and chemical warfare agents incident to overhaul the failed and tarnished leadership," et cetera.
And certainly I would agree that we need to do more research on the DU and some of the chemical warfare agents.
So it's interesting, there is a common thread through most of these, certainly the major VSOs, which essentially says we think you ought to be turning more now to health and research and a little less into case reconstruction.
DR. ROSTKER: I would --
SENATOR RUDMAN: Do I state those accurately, Dr. Rostker?
DR. ROSTKER: Absolutely. The set of comments closest to my personal view are those of the American Legion, and I would reiterate what you read, if you'll indulge me.
SENATOR RUDMAN: Please.
DR. ROSTKER: That is their judgment that OSAGWI should evolve into an organization that remains independent of the existing structure in DoD. They cite the Joint Chiefs and the services, but I think what they're trying to say is the existing being a catalyst that cuts across. Conducts outreach to current and former servicemen after deployments so that the orientation would be deployments. Then oversees the appropriate change are made to joint and service doctrine in light of lessons learned from past, current, and future deployments. That's why it's important to be independent.
So I think the American Legion has captured very much my own thinking in those three bullets.
SENATOR RUDMAN: Mr. Vice Chairman?
SECRETARY BROWN: Thank you, Mr. Chairman.
Doctor, I thank you so very much for sharing your observations with us this morning. I found them very helpful.
I have basically one question I'd like to ask you at this point. Do you think that it is fair to just fade away, to use a cliche, I think you used it, when veterans are still sick? When active duty personnel are still being deployed to environments similar to the Persian Gulf?
DR. ROSTKER: We started as an organization designed to investigate the specific incidents of chemicals on the Gulf War battlefield, but we evolved into a broader organization that provided substantial access to the Department, to veteran service organizations, that has been, as you will hear from Ms. Morris, a catalyst for change. I think that is an important function, and I think that talks to an evolving of the organization into a more generic charter that can serve veterans now and into the future.
SECRETARY BROWN: You mentioned that you thought the American Legion's letter kind of reflected your overall philosophy here. Using that as kind of a backdrop or maybe as a precedent, I'm going to say that I liked the letter from the Disabled American Veterans. Not because I spent 27 years with them.
But I liked the second paragraph from the bottom of the first page. It says, "As I see it, your office has two main missions. First, it must focus on finding answers to the cause or causes of these illnesses. And second, it must provide recommendations as to how our government/military can avoid these or similar problems in future overseas deployments/wars."
Now that's important to me as a former national service officer. I spent all of my life, all of my professional life trying to prove that an illness or an injury was related to an individual's active military service.
Here a person goes into the military, he is in great health, by policy, by regulation, he's presumed to be in good health in the absence of evidence to the contrary. Then he or she comes out. Then the quality of life just diminishes. It continues to erode.
So as I see it, it's our overall job to see if there's a relationship between the drastic differences -- quality of life before he went in, or her life before she went in, and the quality when they came out. That is why this question on whether there is a relationship between their present problem and whether something happened to them in the military is very, very important, because it has to do with the quality of people's lives once they have answered the nation's call. That's why that's very, very important to me.
Obviously the second part to that is important because we don't want to put our sons and daughters in future circumstances if we can avoid that.
So given that kind of backdrop, it just seems like to me that we need to think about whether we have answered those two questions before we start talking about whether it is just time to fade away.
DR. ROSTKER: We are, as you know, not the entire effort of either the federal government or even the Department of Defense to try to answer these questions. To the extent that the answers to these questions lie in medical research, my office has never been engaged in original medical research.
Yesterday at our meeting with the VSOs someone made that point -- how could you consider going out of existence when there are still sick questions and unanswered questions. And my answer was I have to be able to tell you that I could continue and spend the government's money wisely as compared to other ways of answering the question.
If the answer is we are in existence to continue to look for chemical exposures that I do not believe occurred based upon the overwhelming material that we bring forward, I don't think that's a wise use of resources. I think we better serve the veterans by looking to other areas, by better financing our medical research programs.
So whether we continue or not continue does not reflect the commitment of this Administration or this Department to the well-being of veterans. It just talks about the unique charter of OSAGWI and its ability to, at this point, provide input and answers to that first question.
We have clearly evolved to be more focused, increased focus on the second question. The ultimate answer is after we bring the investigations down, are we the right place for interfaces with the veterans community on the war? On the war and a focal point for future deployments? Or should those tasks be absorbed into the existing bureaucracy of the Department? That's something we will search out in the Department.
But as the Chairman said, I'm sure he and the Secretary will have personal views as to how best to accomplish that.
SENATOR RUDMAN: Let me just follow up to the Vice Chairman's question.
I always thought, looking at your budgets and your time spent, that the great majority of what you folks did over the last few years, and you did it very well, was to try to investigate the incidents and the scenarios and recreate them.
Now my view is, and you tell me if you agree or disagree, and I don't know how the Vice Chairman feels. He used to run the VA, so he knows more about it than I do. My sense would be if we were starting at square one today and we said okay, we've done all the investigating we can, there's nothing else to investigate, we've reached these conclusions, we just don't know how to do any more. What we now want to do is try to find out what we can about these illnesses, and here's a billion dollars to spend to find out, I'd sure rather give it to the VA and the NIH than the DoD to do that kind of research. Could you respond?
DR. ROSTKER: I agree. I would, again, since we've been citing the comments from the veterans organizations, associate myself with the comment of the VFW. It says we believe that two of your missions -- investigating possible chemical exposures and evaluating environmental hazards -- are essentially completed. I think that is right.
We have a commitment, and we've been working very well with your staff, to redo the depleted uranium paper.
SENATOR RUDMAN: Pesticides.
DR. ROSTKER: And the depleted uranium. I don't believe it will change our conclusions. We will use more judicious language that appear on page 44, but you've pointed the way, and comments on page 10. We can build a stronger paper by building in the work done by the Rand Corporation. But I believe that the VFW also has this right, that investigating possible chemical exposures and evaluating environmental hazards are essentially complete.
SECRETARY BROWN: Thank you.
SENATOR RUDMAN: General Cisneros, do you have any questions at this time?
LIEUTENANT GENERAL CISNEROS: Yes, sir. I do.
Dr. Rostker, in preparing for this session coming down here, I was reflecting on our very first meeting with you and then the recent articles that have come out. The issue that I want to bring out here is that thinking back when we first met with you, I thought it was a very important comment that you said, our mission is to leave no stone unturned.
But since that time to now there seems to be even more polarization on this whole issue. I'm not going to comment one side or the other because I'm trying to see through all of that, but it seems that the polarization is even greater now, and I'm leading up to a question.
We're now talking about the main emphasis here, about what's the future? Do your organization and our report and so forth.
My question to you is in view of this polarization, if you would like to comment on it, but is there a possibility or is there any effort at all to try to find a credible element, acceptable to both sides of the equation, both the DoD side and the groups who have been very critical to this whole process, in your view is there a possibility --
We're looking into where are we going to put our future resourcing, to try to come up to a determination of some of these issues.
You just made a comment that you didn't think your opinion would change on DU. That's probably going to itself cause a lot of controversy, just the remark you just made. And I'm not saying you're right or wrong, I'm just trying to get through all of that.
Is there a possibility as we look forward where do we go, it seems to me that one of the biggest challenges for this group is going to be to report to the President about how do we proceed forward to make sure that we have the trust and confidence of the American public.
There was a CNN report this morning about the continued erosion of the vast distrust of government. You have Hollywood movies coming out. We're all part of a conspiracy. I'm sure at some point we're going to be depicted as part of that conspiracy to hide something. It's obviously an insult to many of us, probably including you, when our integrity is impugned like that.
But getting beyond the emotion of it, what do you feel regarding an element or a group that could be accepted perhaps to go through all these aspects of DU and these other issues?
DR. ROSTKER: I think your comments are strictly on DU. I find a high degree of support and a consensus on many of the issues that we have reported on. As you know, your staff has assessed the DU paper and we will be making changes to that. They're basically issues of clarity.
We have brought forth independent work. You will hear several of those additional pieces of information on your schedule today.
So if there has been a polarization it's in the issue of depleted uranium. I don't think it extends to other parts of our work.
And let me be very candid. We have bent over backwards to bring in the most objective findings we can. We have followed through on leads that have been suggested. For example, we have contracted with CHPPM to do the issues of resuspension that have been raised. In response to the claims that we had polluted battlefields we've sent CHPPM, the Environmental Health Office, and the Army out to take soil samples throughout Kuwait.
Regardless of any information we bring forward. Regardless of the scientific papers brought forward, we're attacked.
The scientific literature is, I would say, largely misrepresented, and I believe for political ends. Now if that's a polarization I'm not going to shrink from that. I'm not going to be bullied into saying something I don't believe. I'm not going to be bullied into discrediting a munition that saved thousands of American lives because of its superior performance on the battlefield because of the pacifist view of a few people. I will stand by that. Now if that creates polarization, then so be it.
But I would be hard pressed to note any other areas where there is widespread disagreement, and I don't even think there's widespread disagreement on depleted uranium. I think there is a small and vocal group that makes that presentation.
In terms of organizations to adjudicate or look at the issue, you have your own staff. That's why there is an oversight board. I lay my material before you, others will lay their material. You have to make a judgment.
Similarly, there is an ongoing General Accounting Office review, and I'm sure they will do a credible scientific job.
So as far as depleted uranium, it has been very unfortunate, and I have been attacked and vilified over the issue. I stand by the record of the organization.
When we were criticized for being too global in our final statement on 44 and the Board suggested a more appropriate statement on page 10, I immediately agreed because I think it is a more appropriate statement. But that statement on page 10 is not acceptable to those who believe that DU is a fundamental cause of illnesses, pollution, all kinds of stuff that is, in my judgment, not supported by the scientific literature.
But let me ask you, this afternoon you're going to have Dr. Naomi Haley here. Pose the question to her, is DU the cause of unexplained Gulf War illnesses.
LIEUTENANT GENERAL CISNEROS: Thank you.
SENATOR RUDMAN: Admiral Zumwalt?
ADMIRAL ZUMWALT: Mr. Secretary, as you know, at the most recent public hearing we heard the latest summary from Dr. Haley of the results of his research. All the members of this panel have now at one time or another heard that, and I know you have as well.
I want to read a page and a half long letter that I just received this morning, and I apologize therefore, that it hasn't gotten out to the members of this panel or to you, and I will take care of that right after the meeting. But I want to read the letter from Dr. Jonathan Samet who was invited along with two of his associates from the School of Hygiene and Public Health at Johns Hopkins, to listen to that research briefing, and who was asked then to submit their combined comments and this I take it is representative of all three views, but signed by the head of the department, Dr. Samet.
"Dear Admiral Zumwalt, Thank you for the invitation to participate in the recent meeting of the Presidential Oversight Board. I was fascinated by Dr. Haley's presentation and work. The Board is grappling with complex issues at the interface of science and policy. In this letter I will summarize the remarks I made in person to the Board. I will not directly address specific potential limitations of Dr. Haley's work as this ground has been well covered in comments in the peer reviewed literature.
"In reading and interpreting these comments, however, I would offer the reminder that observational data is always subject to potential biases, leaving every study subject to reasonably held criticism.
"To recapitulate the story of Dr. Haley's research as told by him on Tuesday and as gleaned from a reading of his papers, he has moved rapidly from a descriptive study to a search for exposures causing various Gulf War syndromes, and even to the potential genetic basis of these syndromes. He also mentioned clinical trials of therapeutic agents. The pace of this work is breathtaking and perhaps warranted by the needs of the Gulf War veterans. On the other hand, needed confirmatory work by others has not yet taken place.
"Consequently, above all I recommend that the Board actively encourage independent replication of Dr. Haley's work. To date his publications are based on a selected sample of a single unit, leaving open the possibility that unexplained biases may underlie some aspects of his findings. Studies already carried out might be used at least in part for this purpose.
"For example, data from the Iowa study might be used to replicate Dr. Haley's syndrome classifications. In fact sharing of his data for analysis by others might enhance the credibility of his findings.
"In spite of Dr. Haley's enthusiasm, I do have concern about some of the findings. As I pointed out earlier this week in my remarks to the Board, Dr. Haley has been using poorly specific outcome measures, symptoms and syndromes, and exposure variables that represent surrogates for unknown agents. There must be misclassification (error) affecting both exposures and outcomes, and consequently the finding of extremely strong association between the outcome measures and the punitive exposures is surprising.
"For example, the use of flea collars is likely to be an inaccurate indicator of exposure to the insecticides in the collar.
"One explanation for the findings that cannot yet be discarded is the possibility of information bias. That is persons who report symptoms are also more likely to report exposures.
"Dr. Haley has outlined an ambitious program of research. Assuming that his research agenda moves forward, I suggest that a coordinated program of research be developed that will assure replication by others at each stage. Lacking such coordination there is every potential for further contentious debate that cannot be appropriately resolved with evidence.
"Additionally, appropriate oversight should be developed for Dr. Haley's program to assure that proper peer review and guidance is maintained throughout. Like many projects on controversial topics with substantial public policy implications, independent oversight enhances the credibility of the research and the researcher.
"Finally, I want to reiterate my suggestion that the Board take any steps possible to assure the development of an appropriate, coordinated research agenda on the health of the Gulf War veterans. I am certain that such efforts have been made but they often fail. Dr. Haley's work shows the need for coordination among investigators with the opportunity for replication.
"As I mentioned, the work of the National Research Council committee that I chair on particulate matters represents one useful model.
"Once again, thank you for the opportunity," et cetera.
As you know, there's been a great deal of interest in his research on the part of the veterans community. I would appreciate your comments on what I consider a very good non-partisan view from an undoubtedly highly credible group of experts, and what actions you think might follow with regard to the future.
DR. ROSTKER: I think as you know, I was instrumental in securing funding from the Department of Defense for Dr. Haley. I took a team down to Dallas to meet with Dr. Haley and to review his work. Let me reiterate, I'm not a physician, but I am a social scientist. The basic tenets of experimental design are common to both disciplines.
At our meeting I encouraged Dr. Haley to expand his sample, to build a reference frame that would be more appropriate to answer the questions concerning Gulf War illnesses, and not just focus on those in his initial sample.
So those are, my own views are exactly comparable to the views of John Hopkins.
I would add one additional point.
Dr. Haley consistently cites the presence of Soman on the battlefield, and at least in private meetings here in Washington, as reported to me on at least one occasion, cited my work and the work of my organization as proof that Soman was on the battlefield affecting the SEABEES at Al Jubayl. That is not correct.
We do not see even low levels from the Khamisiyah release going that far south. Moreover, the demographics, times in theater and the like have not been correlated with that release. On various occasions Dr. Haley has also cited that since he's found damage there must have been Sarin on the battlefield and therefore there was Sarin on the battlefield. That circular logic escapes me.
So I don't know the source of the contamination that Dr. Haley relates to.
His correlations in his original published work were on self-reported impressions about exposures. There was a lot of myth going on. We published case narratives concerning that. One of the case narratives in fact was reviewed by the General Accounting Office.
So we neither they nor we at this point, and I think I can speak for them, you'll have a representative here, in terms of the possibilities of Sarin at Al Jubayl, we would say is unlikely. We can never be sure.
So that is another troublesome aspect of Dr. Haley's work. We just can't find with any degree of certainty the source of the contamination that he cites as being present.
ADMIRAL ZUMWALT: Mr. Chairman, I have one other comment I'd like to make, unrelated. I thank Dr. Rostker for that answer.
As you know, Mr. Chairman, I worked very diligently on the Agent Orange issue, and I believe that part of the problem we have with the polarization that exists on this issue is a residue of the, after-effects of the battle that took place with regard to Agent Orange. A battle which led to the discovery that the government had in writing in the early '80s, at the level of the Bureau of the Budget, specifically requested government agencies not to find a correlation between Agent Orange and disease. That's been documented, a published document is available by Congress. That investigation and that conclusion, which was shocking to many of us, led many veterans, including me for a long time, to be suspicious just in general of the processes of government with regard to veterans.
Mr. Chairman, I had the opportunity before I ever became a member of this Special Oversight Board, to conduct my own personal investigation as to what was going on because I wanted to be sure that there was no process set up like the previous process. I had at least three meetings with Dr. Rostker before I became a member of this panel. I talked to a wide number of people in the Pentagon. I have not been able to find a single instance that I believe in any sense represents the kind of cover-up effort that was a deliberate policy in the early '80s with regard to Agent Orange.
I can understand why the holdover and the residue of that earlier battle makes some people suspicious, but I for one believe that although like you, Mr. Chairman, I don't always find myself in total agreement with the papers that have come out of OSAGWI, I believe that Dr. Rostker and his staff are doing their very best to try to come up with sound conclusions and to react to the insights of others.
SENATOR RUDMAN: Thank you, Admiral Zumwalt.
In my view in this country, nobody speaks with more authority on these issues than Admiral Zumwalt who is a retired Chief of Naval Operations. He probably did more to get to the bottom of that issue back in the '80s than anyone else. I share the Admiral's expressed views.
I'll turn to Dr. Cam.
DR. CAM: Secretary, I have two questions for you.
Could you tell us what has helped and what has not helped OSAGWI in carrying [out] its mission. Please also mention the issues of implementation.
My second question is, do you have statistics on mortality and on how many veterans reported specific symptoms under different categories? I know that figure of 100,000 have been affected, but I think that's more the result of the mapping studies. We really need to have a firmer grip on the magnitude of the problem.
Another point is do you have a sense of how many are sick but still on active duty and not reporting about their situation?
DR. ROSTKER: First the issue of what has helped or not helped.
I would say that the commitment of the Defense Department to get at the bottom of particularly the issues of chemicals and biologicals, was very helpful. John White, the then Deputy Secretary of Defense, asked me to take on this assignment. He provided everything I needed -- resources, a charter. I have never been constrained either by innuendo or policy or resources from following every reasonable lead over any issue.
That does not mean that we have always produced papers that people have agreed with 100 percent. But they have been honest and we have sought and continued to seek constructive criticism so that we can turn out the best possible job.
What has been most disappointing has been, I think two things. One is the suspicion that General Cisneros talks about in terms of many of our citizens. And that extends even into the Congress.
The case of the famous missing logs I think is instructive. I think it hurt all of us in the Defense Department to see General Schwarzkopf and General Powell, let me use the word, "dragged" before the Congress to account for their personal logs. When the congressional staff went through their personal logs and found no smoking guns, it was an embarrassing moment, I think, for all of us. I think that is part of the legacy, as Admiral Zumwalt talked about, of Vietnam.
I think what is also very disturbing is a small group of people that prey on the fears of veterans. You can see it on the Internet particularly. Charges of 80,000 child birth defects; massive numbers of people dead. This is just pure fantasy. I don't know why people do that. It hurts us, but most importantly it hurts the veterans. It scares them. And that is not fact.
The Department has not republished in the last several years the accounts, this gets to your second question, from the health registries. That is not in my purview. As a matter of research, those tabulations were not very helpful.
Mortality information is maintained through the VA with the support of the Social Security Administration, and I think someone here has -- Diane, what's the approximate figure?
LTC LAWHON: 5,773.
DR. ROSTKER: 5,773. As of December, the most prevalent cause is automobile accidents. That information is available.
In terms of people on active duty who are sick. That is one of the things we have focused on in our base visits and town hall meetings, and I know you have been there.
I got the Army Chief of Staff to issue an all-hands emphasizing the importance for service members to seek appropriate medical care. There is no question in my mind that there are still veterans and non-veterans of the Gulf War on active duty who do not seek appropriate medical care for fear that they will be separated.
The experience with the health registries suggests that the vast majority of those who go in for health evaluations, if there is something wrong, have a diagnosis, and there are treatments connected or not connected with the Gulf War. But it is also true that under the system we run, if you are incapacitated and it becomes a knowledgeable, physicians become aware of it, you can be separated. There is no confidentiality between the military doctor and the military patient. That has a chilling effect on service personnel who may be ill and they don't come forward. That's unfortunate. We give them every opportunity to come forward, but I have no idea how many would just be -- I wouldn't even know where to start a guess.
DR. CAM: You really didn't respond to the last part of my first question which is give us some comments on the issues of implementation. What are some of the success stories and some of the difficulties. Like the questionnaire. Do people really fill out those questionnaires before deployment? And when they come back do they have a follow-up?
DR. ROSTKER: We have been selective in some of the issues we have taken on, and we have not directly delved into some of the force health protection issues like the pre-screening and the post-screening. We've raised that as an issue, but we have not in our current capacity, because our capacity today is still largely as the historians looking at the Gulf War.
I think the issue you raise is very much what a redirected OSAGWI or deployment organization could do.
We have been, and you'll hear in just a few minutes about depleted uranium training. We have been at the forefront of pressing this upon the Department.
We shouldn't have to. The directives have been clear, and they've been clear for a number of years. But the reality is that without us pressing and without, frankly, the further prestige of also being the Under Secretary of the Army, we would be less accomplished than we are today in moving forward universal depleted uranium training.
Last month I gave a speech at the Worldwide Chemical Conference pressing the chemical core leadership for changes in chemical doctrine in two areas. One is recordkeeping and false alarms, and the other is low level chemicals. That's another area that we have pressed forward and taken the lead in the Department to look for change.
DR. CAM: Is the fact that you are more of an advisory group kind of an impediment on the implementation issues?
DR. ROSTKER: We do not have a specific charter at this time to monitor ongoing implementation. We have where we've seen problems communicated those problems to the responsible officers within the Department. We've chosen a number of areas to be particularly proactive in, namely areas where there is not ongoing organizations. Those have particularly been in depleted uranium training and in chemical warfare doctrine, but have not been in the health delivery areas.
DR. CAM: Thank you.
ADMIRAL STEINMAN: Dr. Rostker, I have a comment and two brief questions.
DR. ROSTKER: Yes, sir.
ADMIRAL STEINMAN: There are those who have criticized you personally and those who have attacked the Office of the Special Assistant for failure to aggressively investigate Gulf War illnesses. Indeed, some have even called for your resignation or removal. I want to state that I do not agree with that opinion. On the year that I have served as a member of this Presidential Oversight Board, I've found you and your staff to be motivated and diligent and responsive to our Board's oversight responsibilities. And while there have been instances where I or other members of the Board have found occasional fault with OSAGWI, they do not alter the overall positive contributions I feel you and your staff have made towards the problem at hand in addressing our veterans' illnesses.
The questions I have. Two questions. A brief one, would you comment on whether your status as Under Secretary interferes with your ability to manage OSAGWI or vice versa?
DR. ROSTKER: I think it's been a tremendous advantage, particularly in that the Department of the Army is the executive agent for a number of the issues that we deal with, specifically, again, depleted uranium training and chemical doctrine, chemical equipment. These are all things that the Army has been given the executive agency of.
It has served me extremely well to be able to deal with those issues from the added vantage point of the Under Secretary.
Moreover, it has given the Under Secretary, if you will, the advantage of intimate knowledge of these issues, one that one would not normally have sitting on the top of a multi-million person organization.
I sometimes feel like the character in the Mikado who at once is the chancellor of the exchequer, but then is the attorney general and is advising himself about fiscal matters and the propriety of fiscal matters. But it actually has been extremely valuable.
I know there have been a few times when I have been unable to make town hall meetings, but the staff that I've trained is fully capable of handling that. I think out of 23 town hall meetings I've made 21. I have no lack of confidence in General Vesser and the other members of my staff to carry forward in those situations. In fact, I should be faulted if I created an organization in which my deputy or even people below that were not fully capable of representing the views of the organization and answering questions. I take pride in that.
So I think it is unambiguously clear, certainly to me, that putting these two organizations together -- In fact I would add that in internal discussions about the Department, about the future of the organization, I've also suggested that if we were to take on a deployment role that consideration be given to make that a double-hatted to the Under Secretary of the Army for exactly the reasons that I've talked about here today.
ADMIRAL STEINMAN: The last question concerns chemical warfare agents. We're aware that the French government recently declared, formally declared in a letter to DoD that after thorough analysis of their chemical alarms, they've declared all of their chemical alarms are false alarms.
What's the status of the Czech alarms?
DR. ROSTKER: This will be out in a new version, but a further and more complete reading of the technical evaluations of the Czech equipment suggests that in certain modes, in fact the modes that were reported to be used during the Gulf War, the equipment also can false a lot. That doesn't mean these were false alarms, although we have never been able to suggest a source. But this additional information will be incorporated in the revised Czech/French detection paper.
I think we've said it was credible and didn't use our five point scheme. The Board has asked us to revise that and use that scheme. I think we will call it indeterminate at best at this point.
ADMIRAL STEINMAN: Okay.
SENATOR RUDMAN: Any other questions? Mr. Vice Chairman?
SECRETARY BROWN: No.
SENATOR RUDMAN: Admiral?
ADMIRAL ZUMWALT: No.
SENATOR RUDMAN: Doctor?
DR. CAM: No.
SENATOR RUDMAN: General?
LIEUTENANT GENERAL CISNEROS: No.
SENATOR RUDMAN: Admiral?
ADMIRAL STEINMAN: No.
SENATOR RUDMAN: Let me just conclude your part of this by saying we will take about a ten minute break before Mr. Walpole appears.
DR. ROSTKER: Sir, we still have a presentation by Ms. Morris on depleted uranium.
SENATOR RUDMAN: You have another presentation? I didn't know that.
DR. ROSTKER: Yes.
SENATOR RUDMAN: How long will that take?
MS. MORRIS: About 15 minutes.
SENATOR RUDMAN: All right. That's fine. We will probably still take a break.
But before you testify, and that will be the end of your presentation?
DR. ROSTKER: Yes, sir.
SENATOR RUDMAN: I want to say to you, Dr. Rostker, speaking for myself, and I've had probably more contact with you than any other member of this panel, I want to just add an exclamation point to Admiral Steinman's comment.
I have found occasions that I've disagreed with methodology. I have found you occasionally a bit testy, but I am known to accuse anyone of being testy. But I have found you and your organization to be forthright, hard working, and trying to find the truth.
I want to comment about some of these organizations that tend to make ad hominem attacks on you on a regular basis. They're free to do that, but they do not enhance themselves with this Chairman of this Board. I have seen too much in my political life of personal attacks on people for beliefs they have.
I think it is irrelevant, it is inappropriate, it's not helpful, and to those veterans who think they're being served by those groups, in my view they are being disserved by those groups. That is my opinion, and I express it as my opinion.
MS. MORRIS: Good morning Senator Rudman and members of the Presidential Special Oversight Board.
The purpose of my briefing this morning is to provide you with an update to my November testimony of where the services stand on implementing their depleted uranium training programs. This follows our report to Congress which was in accordance with the Defense Authorization Act of FY99.
The Department's overriding intent has always been to prepare our service members to operate safely and effectively in a DU contaminated environment. Service initiatives and programs together with Joint Staff actions in the doctrine arena have clearly met this requirement.
These are the topics that I'll be going over during the briefing.
Military training has to respond to two critical requirements. The first is the need for source force protection, and the second, the need to carry out the mission. Some would reverse those.
That's what we mean by operating safely and effectively. It means that you have to reconcile two very distinctive priorities -- battlefield effectiveness on the one hand, and preventing or minimizing health and safety risks to the troops on the other. Getting it right in both of these areas has been a real challenge, but we feel confident that the training we're putting into the field answers both of these areas.
OSAGWI's investigation of DU use in the Gulf, as I reported in November, and subsequent DoD follow-up actions indicated that DU awareness training and guidance was inconsistent in terms of information and emphasis among the services. This resulted in mixed messages that detracted from the Department's intent of providing clear, consistent and accurate information and guidance.
To make a long story short, the appropriate staff representatives from the Joint Staff and each service's medical, safety, training and operational communities came together at the same place and time to form the Tri-Service DU Awareness Working Group sponsored by the Office of the Special Assistant.
While recognizing that each service has specific DU training requirements based on their operating environments, the working group agreed that their DU training would feature agreed-on essential elements of information, specifically those three listed on the slide.
Basically what we're saying here is that depleted uranium's primary hazard comes from its heavy metal toxicity, that troops can and must continue to operate and carry out the mission despite the presence of DU, and that MOPP IV is not required for protection from brief exposures to depleted uranium. However, it does offer good, on-hand protection.
A big question that many people ask us is okay, so why not MOPP IV? Most of the Gulf War era guidance did in fact tell people to wear MOPP IV. However, MOPP IV and even use of the protective or gas mask does provide some limitations. It also is associated with acute NBC hazards which tends to confuse the actual hazard associated with depleted uranium.
If you wear MOPP IV when it is not exactly necessary, it does in fact create some significant safety and performance concerns, and it does degrade situational awareness.
SENATOR RUDMAN: Is that last bullet, degraded situational awareness, speaking as an infantry officer, is that bureaucratic for you can't see what's around you?
MS. MORRIS: Pretty much, sir.
SENATOR RUDMAN: Why don't you just say that.
MS. MORRIS: Yes, sir.
Next slide, please.
Therefore in responding, the current guidance reflects the observations of the Gulf War as well as better knowledge of risk factors associated with depleted uranium from both a medical and an operational standpoint.
Specifically, the guidance which we are now promulgating in training materials and which we have sent to both our forces and the allied forces in Kosovo is that brief, life-saving or other mission-essential entries into DU-struck combat vehicles will not expose unprotected personnel to unsafe intakes of depleted uranium; that when everything calms down and people are decontaminating their vehicles that use of an approved respirator and covering exposed skin is appropriate protection; and that for those people whose jobs require them to go in and out of vehicles frequently that have been contaminated by depleted uranium, that special protective equipment is appropriate. Generally, this is just to make them more comfortable as they're operating.
Next slide, please.
This graphic shows a recent chronology of the significant events relating to DU training. While efforts to improve DU training have been underway since the early 1990s, the latest Hamre memo in December of 1998 which was the guidance that allowed us to form the Tri-Service DU Working Group, has in many ways been the catalyst for jump starting a comprehensive improvement in our training plan.
As Dr. Roster indicated, the Army is the executive agent for a number of things, and because they essentially have about half the problem here, they are the executive agent for DU training. They have played an instrumental role in developing and fielding improved DU training.
The Army is at the forefront of developing new doctrine and policies to respond to depleted uranium and similar battlefield toxicant issues. In addition, the Army is in the process of fielding a range of institutional -- which are schoolhouse -- and field training materials that reflect our best current knowledge of depleted uranium and ways to operate safely and effectively despite the use of DU weapons or the presence of DU contamination.
This slide depicts the schedule under which we're operating.
You'll note the first bullet there is that new tier one training support packages are due this month. They are on track. There is a film that's been produced and it's being expedited through command channels for release.
The Air Force, like the Army, has undertaken a comprehensive program to ensure that all of its personnel who could be exposed to depleted uranium receive appropriate DU training. Obviously their operational environment is different from that of the ground forces.
Air Force personnel are less likely than their Army or Marine counterparts to come into contact with DU contamination since most of their operating bases are in typically secure rear areas and because their main operating bases in forward operating locations would be flushed of personnel and equipment well before hostile ground units could come into contact with them. Therefore, they're not likely to be attacked by weapon systems with depleted uranium rounds.
We also don't believe there are any threat aircraft which currently are armed with depleted uranium rounds.
Next slide, please.
The sea services -- the Navy and the Marines
-- have, like the Army and the Air Force, also undertaken a thoughtful look at their DU training requirements and developed a comprehensive training approach that reflects their own operating environments.
I'd like to point out here that the Marine Corps is actually coming very close to the Army, whereas the Navy and the Air Force are somewhat selective in the people that they believe need to be trained. The Marine Corps, like the Army, believes this is a universal training requirement.
Where appropriate, the Navy and the Marines have adopted Army-developed training materials to suit their own requirements.
In addition, we have fielded specific training materials for use by medical personnel. One of the things you may have noticed in the Army's training plan was that there are three tiers. The first of those tiers was for general use; the second tier was battle damage, assessment, and repair personnel; the third tier was for chemical personnel, largely because they would be in an advisory capacity. However, those tiers didn't reflect medical training. This was recognized during the process and the medical community, which has been instrumental in helping us develop these materials, has been very proactive in coming out with their own materials and in fact requiring and documenting that their people have received it.
Next slide, please.
However, you can train all you want, but you have to make sure that it's effective. Training assessment provides a means of monitoring and evaluating this to ensure that the right people are getting the right information. That measures of effectiveness are established. That recurring DU training and awareness deficiencies are identified and addressed. And that any fixes are validated and the program adjusted.
We will be using the normal existing training management systems that the services use to assess and evaluate DU training, and we are therefore making leaders responsible for the training of their own personnel, just like every other thing that's out there.
Next slide, please.
We will therefore be assessing the command support for meeting these objectives. The services are responsible for ensuring that they do have measurements of effectiveness and success. And that they have a validation system.
For example, the Army has in fact added depleted uranium awareness training as a mandatory, tested, common task for FY99, and there's all indication that they continue to do so in the future.
Next slide, please.
To summarize, we have focused on making sure that we train our forces to respond safely and effectively. That we are basing our joint doctrine and the services' training on the essential elements of information, and that these essential elements of information are consistent and we eliminate the mixed messages problem.
As I said earlier, we are on track to finish the tier one training support package this month, and this is serving as the basis for all of our guidance. This was done with the help of the other service members, even though it was an Army product. Medical guidance and training initiatives are also in force. And we are assessing and validating the training as we go out.
One of the things that we're doing is when we go to installations we go out and ask about depleted uranium training. I have personally assessed training in progress at Fort Hood, and we're looking to also do that at Fort Knox.
Subject to your questions, that concludes my presentation.
SENATOR RUDMAN: Thank you very much.
Just one quick one from me, and I'll see if anyone else has one. I understand, Dr. Rostker, that there's a Freedom of Information request that's pending before you for furnishing to one of the VSOs I believe the training data on this, the materials themselves. Are you aware of that? Is that true?
MS. MORRIS: I believe that's the National Gulf War Resource Center has it.
SENATOR RUDMAN: I believe that's correct. Have they made a FOIA request?
MS. MORRIS: They have made a request for materials, and as soon as those materials are releasable to them, we intend to comply with that.
SENATOR RUDMAN: What determines whether or not they're releasable?
MS. MORRIS: They've got to be materials that are in fact in use as opposed to drafts.
SENATOR RUDMAN: You do have materials that you're using, correct? Are they classified?
MS. MORRIS: No, they're not classified.
SENATOR RUDMAN: Then shouldn't they be released?
MS. MORRIS: They will be when we can do that.
SENATOR RUDMAN: What does that mean, when we can do that?
MS. MORRIS: As I've said, I believe that the only one that's actually out there as an official product is the medical program. We are expecting the video for tier one to be available through the approval process relatively soon. And we're in the process of assembling the materials to comply with the request.
SENATOR RUDMAN: The soldiers and marines who are getting this training are given material or they see material. That's there now, correct? They're getting this training as we speak. Correct? There is training going on of Marines and Army, according to your charts, correct?
MS. MORRIS: There is training going on using old materials at this time.
SENATOR RUDMAN: Then shouldn't those materials be forthrightly turned over to these people?
MS. MORRIS: They're available to them already.
SENATOR RUDMAN: Well, they've asked them to be produced and evidently they claim they haven't been.
DR. ROSTKER: Let me look into it.
SENATOR RUDMAN: I just want to say something, Dr. Rostker. The problem is, it's really to some extent what some of these panel members have said, it's what the General said. You do a terrific job, but sometimes -- and they may be legitimate reasons. I'm not being critical. I'm just telling you hypothetically that if somebody makes a request like this and it's not forthrightly produced and it can be produced, all you do is buy yourself criticism, mistrust, and accusations which are wild and inaccurate, but some people listen to them. I just make that observation.
DR. ROSTKER: I agree. We certainly can make available materials. I think that has been in the public domain. New materials that have not yet been produced, it's hard to make available. As soon as the materials are ready for distribution to the troops, they're not classified, they effectively are in the public domain, but we will accommodate all of those requests.
SENATOR RUDMAN: I appreciate that.
Any other questions?
SENATOR RUDMAN: We're going to take a quick break. I know Mr. Walpole's on a schedule, but we're still going to take about ten and come back.
I want to thank you both very much for appearing here this morning.
DR. ROSTKER: Our pleasure.
SENATOR RUDMAN: Robert Walpole from the Central Intelligence Agency has a presentation for us. If you'd like to proceed, then we'll have questions.
MR. WALPOLE: Thank you.
We're happy to be here, myself and Larry Fox, to have an opportunity to provide you an update of the intelligence community studies on the issue of potential chemical, biological and radiological exposure to Gulf War veterans. The result of our lengthy efforts will be published soon, hopefully by year's end, in three separate reports covering all three topics. We believe these assessments will be useful to those charged with determining what role exposure to chemical, biological and radiological agents could have had related to the veterans' illnesses. By carefully examining Iraq's extensive programs or weapons of mass destruction to uncover releases and to evaluate potential troop exposure, our work supports and complements that of Dr. Rostker and his group.
Using information from the United Nations Special Commission (UNSCOM) and all other sources, we're near completion of a comprehensive analysis that provides important new details on exposure issues.
Of note, our analysis on this issue would not have been possible without the cooperation of UNSCOM whose understanding of Iraq's programs is substantial because of its long access and information to Iraq's programs.
Let me first turn to our latest assessments in each of the three exposure areas and provide you with our plans for the future.
Our research continues to indicate that Iraq did not use chemical agents against coalition troops. Furthermore, it is unlikely that Iraq used chemical agents against Shiite rebels in areas near coalition troops immediately following Desert Storm. We still assess that troop exposure to chemical agent occurred only as a result of the inadvertent destruction of nerve agent filled rockets in the Khamisiyah pit. That event resulted in low level exposure, specifically at or above general population limit dosage.
On the basis of new UNSCOM information and a subsequent reevaluation of the pit release, we now assess that the amount of agent released from the pit was less than that modeled in 1997.
Some might recall that during that modeling activity we had stated that in any area that we had uncertainty we would use the worst case assumption in order to provide the epidemiologists with the most useful information for their studies.
This is an overhead of that pit area. If you recall, I don't remember now, 13 stacks of rockets there.
Of note, however, last year UNSCOM performed a very thorough search and excavation of a one kilometer area around the pit, locating only one-fourth of the nearly 500 rockets we had estimated were damaged there in 1997.
In addition to the scarcity of rockets found, a revised assessment is supported by several other factors. Discussions with the 60th Explosive Ordnance Demolition Unit executive officer who oversaw the operations of the pit indicate that many of the explosive charges were placed less optimally than previously assumed.
If you recall at Dugway we did some testing of how the rockets would have been destroyed, and we had soldiers helping us place the charges there. But with all the public scrutiny, I'm not surprised they would have wanted to place the charges very well.
You would also remember that the soldiers discovered these rockets on the way out of Khamisiyah. They thought they were pretty well done with the demolition. They were pretty well out of destructive charges. In fact they had to use Czech detonation cord to perform this operation, so it certainly would have been less than optimum.
UNSCOM accounting and photography has indicated that a much smaller number of rockets were destroyed, and photographs by soldiers show a smaller percentage of damaged rockets. This smaller release, especially when coupled with environmental degradation that we had not been able to calculate before the 1997 modeling, would probably result in far fewer troops exposed compared to 1997 estimates.
But again, I ask that you remember that we provided that model under an extremely tight deadline and with the purpose of providing epidemiologists with an area for closer examination. Recall that we used the union, not the intersection, of five different modeling efforts. The intersection would have clearly been a smaller one. We wanted to provide the epidemiologists that area for research to see if they could find any increased incidents of illnesses reported.
Our new information would be of particular value if the epidemiologists found any correlation within the larger plume.
Let me turn now to Bunker 73. We visited previously assessed releases at other sites, often aided by UNSCOM information, to revise our estimates. We now estimate in most cases that less agent was released primarily because more precise data is now available. That is, instead of using worst case assumptions when confronted with uncertainties, we have been able to input more accurate information.
For example, we believe that the amount of agent released from Bunker 73 was less than half what we had estimated in 1996. That's based on subsequent UNSCOM confirmation that fewer damaged rockets were present in the bunker. Furthermore, we had previously assessed that the agent was 100 percent pure. We now know that it was only about 50 percent pure at the time of the destruction.
The smaller release leaves unchanged our assessment that the troops were not exposed from the release of nerve agent from Bunker 73.
Let me underscore that I'm talking about two separate things here. I'm talking about release and I'm talking about exposure.
We have evidence of a few releases, but the only place where we have evidence of exposure, not evidence, but where we judge exposure occurred, is in the Khamisiyah pit.
Now, reassessment of some other possible sites. We've also reassessed releases at Al Muthanna Bunker 2, Muhammadiyat, and Ukhaydir.
The Al Muthanna Bunker 2 release is much lower than previously assessed because UNSCOM indicates fewer nerve agent filled rockets were in the bunker and the agent was impure because they were from the Iran/Iraq war period.
Two releases have occurred at the Muhammadiyat depot, a nerve agent release from DB2 bombs that we now assess as smaller, and a mustard release from bombs whose analysis is incomplete, but involves more bombs than previously assessed. At this time we do not expect the release from mustard at Muhammadiyat to have been large enough to cause contamination to reach coalition troops.
For Ukhaydir, on the basis of a thorough UNSCOM inspection of the site last year, we now assess that there was not a release from the 155mm mustard shells. You might recall, and we have a paper on this, that the Ukhaydir site, we were concerned that a bomb had actually hit a stack of shells and had caused a release of mustard agent. We had modeled that it didn't reach coalition troops, but we thought we should publish that at that point.
UNSCOM was able to go back and look at it, and we don't think the mustard release occurred. So in this case we changed our judgment of a possible release, but it didn't change any judgment of exposure because we didn't think it occurred anyway.
Thus we assess that troops were not exposed to even lower levels of chemical agent contamination from these three locations.
We've also continued to look for additional possible releases from coalition bombing, and have found two additional potential release events -- one likely and one uncertain, at Al Muthanna and Al Walid respectively. In both cases the exposures were unlikely.
The Al Muthanna, we conducted a thorough review of the facility to test our previous assessment that there were no bombing-induced releases other than previously mentioned. We concentrated on the possibility of agent releases from the production and fill-in areas. After discussions with UNSCOM we have determined that there was likely a slow release of mustard agent from its production facility. We believe no troop exposure was involved due to the small size of the release and the fact that troops were over 400 kilometers away.
UNSCOM and other information does not support a release from the nerve agent production facilities, the fill-in area, or the bulk agent storage area.
It is unclear whether coalition bombing at Al Walid air base could have caused a CW agent release. Iraq had told UNSCOM that over 400 bombs filled with a binary nerve agent component -- alcohol in this case -- had been destroyed at Al Walid by a fire caused by coalition bombing. Alcohols are not considered highly toxic.
However, last year UNSCOM uncovered information indicating that some R-400 bombs could have been filled with another binary component needed to form their nerve agents. UNSCOM informed us that photos taken on a 1992 inspection showed several R-400 bombs that apparently burst from internal pressure, something UNSCOM considered unlikely if the bombs were only filled with alcohol.
In addition, UNSCOM had information indicating that 12 of the R-400 bombs were filled with GBGF agent at an unidentified deployment site. We have examined available photos and find them inconclusive. We will be unable to determine whether a release occurred at Al Walid unless new information becomes available.
Our previous modeling indicates exposure to coalition troops is unlikely, nevertheless, due to Al Walid's great distance from the troops.
SENATOR RUDMAN: How far was that distance roughly?
MR. WALPOLE: How far is Al Walid?
MR. FOX: It's about 400 kilometers.
MR. WALPOLE: About the same distance as the other ones.
SENATOR RUDMAN: Go ahead.
MR. WALPOLE: Combined with the low amount of agent that could have escaped from only a dozen burning bombs.
Iraq also destroyed chemical weapons after the end of the war, but we have insufficient data on these events to determine whether releases occurred. Again, all destruction areas were very distant from coalition troops, so troop exposure would have been unlikely.
Finally, we assess that inadvertent releases from leaking munitions or Iraqi accidents did not expose coalition troops to CW agent. Post-war UNSCOM inspections detected contamination from leaking of damaged munitions at six facilities ranging from a barely detectable release from [a] 155mm mustard round at Khamisiyah, to 100 155mm mustard rounds burning at an unknown location.
Our study of chemical weapons has also resulted in several other conclusions on chemical agent exposure. Additional large releases of chemical agents from coalition actions are unlikely. This is based on UNSCOM accounting of Iraq's chemical weapons, especially chemical artillery, and the assessed low likelihood that Iraq would try to hide damaged weapons.
Furthermore, we have been unable to identify any chemical agent releases that would account for reports by coalition troops through alarms or ground observations of chemical agent detection.
Let me turn briefly to biological agents and radiological contamination.
We can now say with high confidence that veterans were not exposed to Iraqi biological agents or radiological contamination as a result of either Iraqi weapons used or coalition military action. According to UNSCOM, Iraqi biological production facilities were not damaged by aerial bombing, and Iraq protected its biological munitions by burying them in the open or hiding them in a tunnel.
Of note, we cannot exclude the possibility that biological agent filled bombs were among the binary R-400 bombs destroyed at Al Walid. UNSCOM has established that the R-400 bomb was used for chemical and biological agent fill. However, we assess that UNSCOM information on the R-400 bombs declared destroyed by the coalition is insufficient to justify a release because there is no clear evidence of a black strike signifying a biological agent fill on these bombs.
On radiological weapons, we have uncovered no source of radioactive material or mechanism for spreading radiological contaminants to friendly troops. This is not surprising based on our understanding of Iraq's nuclear program. The location of the Iraqi nuclear facility is far from coalition ground forces, and the apparent localization of any contamination.
A comprehensive review of intelligence reporting and other information indicates Iraq did not use nuclear or radiological disbursal devices or deploy these weapons during the Gulf War.
In summary, we assess that the exposure of U.S. troops to chemical, biological or radiological agents is probably limited to the low level chemical agent exposure from the Khamisiyah pit release. As already stated, any future modeling of the contamination from the pit explosion is likely to indicate fewer potential troop exposures than in 1997 due to the smaller release and natural environmental decay.
The intelligence community will continue to refine its assessments by seeking and examining new information if it becomes available.
Our reports on exposures summarizing our years of research will be published as soon as they are completed, as I said earlier, hopefully by year's end.
OSAGWI will use this information to support its own efforts and conduct any modeling it deems necessary.
I appreciate your attention, and I'm sorry I ran a little over the ten minutes I promised.
SENATOR RUDMAN: I don't know if you were here earlier during our discussions with Dr. Rostker, but a fundamental issue that we are addressing is the future of this whole effort and how it will evolve and how emphasis will shift.
I get a strong sense from your briefing this morning and from our discussions going back over several years that you're now in a situation where unless there is new information that is brought to your attention, there's not a great deal left for you to do in your analysis either to exposure or to existence.
MR. WALPOLE: That's correct. In fact, two of these three papers I mentioned will be published I had drafts of over a year ago. The reason that we have been waiting until about now to get the things done is we were waiting to see if UNSCOM had any other information that could shed light on it. In both cases, the biological paper and the radiological paper, we had no indication of exposure. We could either have published a year and a half ago saying that, although we had said that in testimony, and then if UNSCOM uncovered something we'd have to change it. Or wait until we had that. So we are pretty close to closing the books.
SENATOR RUDMAN: And from a chain of evidence point of view, since the UNSCOM personnel have been in and out of Iraq and they are now out, if I'm not mistaken, you cannot present anything with any amount of precision because you don't know if anything was found. Let's assume they went back in there next month and they found something at Point X. You really don't know where that's been since 1990 or whatever. You have no idea because you have not had control of the evidence, correct?
MR. WALPOLE: That's correct, although in some cases if that were to happen we would be able to take that information and cross-check it with other sources of information we have that existed back then to see if we could track those things.
SENATOR RUDMAN: That's true, but let's do a hypothetical. Let's assume there was a cache of 100 bombs or rockets at a location that was unknown to U.S. intelligence, it was at Point A. In the last 60 days it's been moved to Point B. It's reported to you that they found these chemical weapons or biological weapons at Point B. There is no way for you to know as to where they were.
So the whole investigative process has been, to a large extent at this point in my view, invalidated by the fact that UNSCOM is no longer on the ground.
MR. WALPOLE: If it was supposedly at a location unknown to us by definition we wouldn't be able to tell you anything else about it.
SENATOR RUDMAN: Exactly. And I think no matter what you find today, there's no assurance of where it was a year ago or certainly nine years ago.
MR. WALPOLE: I would make one other point, and that's that UNSCOM's accounting of the biological, the chemical, we've been able to cross-check charts where it all seems to add up. So I would be more than a little mildly surprised if we found something else.
SENATOR RUDMAN: So you're pretty confident that what you've got now is pretty complete and your analysis is complete, and since there aren't any people on the ground doing any more gathering, any more collection, if you will, then it's pretty hard to do any analysis if you don't have new collection.
MR. WALPOLE: If you don't have new information, we've looked over all the old information multiple times.
SENATOR RUDMAN: So what you're telling us is that the CIA right now is kind of done with its work but will keep an eye open for anything new that comes along. But we shouldn't be expecting anything particularly different from what we've got today.
MR. WALPOLE: I think once we publish the three papers that would pretty well be it. We'll certainly, if people have questions, want us to look at things, we'll do that. But as far as actively generating work to produce, I don't see that we have anything else.
SENATOR RUDMAN: How soon can you get those papers published?
MR. WALPOLE: As I said, by year's end. In addition to modifying how we're approaching this, I now have another job on top of this one where I'm right in the middle of a missile report on --
SENATOR RUDMAN: I'm aware of that.
MR. WALPOLE: I expect that sometime in the September/October timeframe we would be able to --
SENATOR RUDMAN: That would be good. It would fit into some things that we're doing.
We're going to issue a report next month as required, but we're probably, if I get the concurrence of the panel, going to get something from Dr. Rostker which will give us kind of a probable cause analysis of the 33 remaining cases to see how many of those they really ought to go to completion on. He's going to try to get that to us.
In other words, we're not sure that it's a good use of resources to follow these all to the kind of studies that have been put out in terms of resources, in terms of probability of anything new.
If your information was in that timeframe then maybe in the fall we might be able to issue a supplemental report to the Secretary of Defense and to the President which might buttress what we're doing.
I'm not giving any promises here, we're not binding anything, but to the extent you get it to us this fall, early, that would be helpful.
MR. WALPOLE: That's what we'll shoot for. That is doable.
SENATOR RUDMAN: Mr. Vice chairman?
SECRETARY BROWN: Thank you very much for your remarks.
I just have one basic question. Can you describe the process by which you coordinated your research and your findings with DoD?
MR. WALPOLE: You're talking about with these three papers or through the whole process?
SECRETARY BROWN: Let's start off with the whole process, and then narrow it down with these three papers.
MR. WALPOLE: Okay. I'll start with the whole process then.
Once I got engaged I think Bernie and I were almost joined at the hip for over a year there, coordinating both of our efforts. I don't think you could have seen any more cooperation between the two for such a length period of time.
Since we went into what I would call a virtual task force, where I didn't have a full task force in place, people went back to their regular jobs, we communicated by e-mail, had periodic meetings, then the coordination has mostly been on substantive issues, specific issues, and Larry's been focusing that.
MR. FOX: It really depends on which topic you're talking about. With Khamisiyah where it was where our troops were, we had a lot more cooperation because we had to get the information on what the troops saw on the ground.
If you're talking about some of these other areas that are further north where the aerial bombing took place, it really comes into a lot of intelligence and a lot of working with the UN to try to get down to the bottom of these things. On these different trips that we've taken up to talk to the people in the UN, the DoD personnel from OSAGWI have always been on those trips to talk to and ask their questions to.
SECRETARY BROWN: Would you summarize your overall relationship and particularly the conclusions as being totally independent from those of OSAGWI?
MR. WALPOLE: I wouldn't call the relationship independent. I would call the relationship excellent. But the conclusions, our conclusions have been independent. Independent in terms of making our judgments.
In many cases we have had to get U.S. bombing information, U.S. troop location information. So it's not independent in that sense. We had to have the information. But every judgment the intelligence community has made has been an intelligence community judgment, and every judgment that DoD has made has been their judgment.
Now in most cases, probably all cases, we've ended up agreeing.
SECRETARY BROWN: Let me ask the question maybe in a little bit different way. When you reached a conclusion let's say on one of the three papers. While it was in its draft stage, early draft stage, and I recognize they have not been finalized at this point. But in their early draft stage did you run that by OSAGWI to get their reaction to it?
MR. WALPOLE: We have had OSAGWI people on our staff and intelligence people on their staff, so that would have happened as a matter of course.
In any intelligence product I work, and the Senator knows this, I follow the guideline that intelligence is intelligence, separate from policy. Policy can make judgments it wants after the intelligence is done.
So when we did, for example, our Khamisiyah paper, which was done two years ago, Defense came in with some things that they would like to see changed within the paper that from my perspective were policy issues and would have to be handled outside of the intelligence paper, so we didn't accept those. And Bernie remembers those. And he respected that particular approach.
I have always kept a thick wall between an intelligence judgment and a policy judgment so we don't end up tainting either.
MR. FOX: Let me just add something.
From the analytical standpoint, we've had analytical differences. We try to work those out. I can't point to any specifics of times where we've just chosen to disagree, and there are still some analytical differences I know in some of the things I say in the CW paper that we've got in draft so far. So it is a process where we try to work together to come to a consensus, but if we have analytical differences, and I've told the OSAGWI people in meetings, if you have something that you disagree with, you bring it up, please. That's the scientific method. That's how you get down to the bottom of things. You don't try to squelch any analytical disagreement.
SECRETARY BROWN: You mentioned, and I guess it's in part what I was getting at. You mentioned that you have some analytical disagreements.
I have two remaining questions. One is, can you tell us overall, from a big picture perspective, what areas you disagreed with OSAGWI on. Then I would like for you to follow up to tell us specifically what you were referring to when you said that you had some disagreement on some specific analytical issues.
MR. FOX: Let me give you an example. The pit. And I could put up a picture there. There are 13 stacks there. They have, meaning OSAGWI, has interviewed some of the troops that were in that pit, and I've been there at the times of the interviews. These interviews contradict each other. It gets very difficult to see, it looks like there's two sets of people that were there but don't remember seeing each other in the pit and exactly what happened there. From that standpoint, our conclusions on exactly who blew up what stack and who was actually in charge there have differed. Again, we have not come to closure on some of those things, and I hope to come to closure before the publishing of this paper.
They don't really impact on our overall conclusions as far as the number of rockets in the pit. They're on some of the sub-points of what supports what happened in that pit.
Right now I don't think we have any big analytical differences that would impact on whether troops were exposed from any of these other sites or anything like that. We're still trying to iron out Muhammadiyat and how much was released there and some of these things, but in the process we've --
SENATOR RUDMAN: Let me follow up. I think the reason the Vice Chairman is boring in on this is I don't think you're stating it correctly. I don't think you're using the word analytical the way I understand this has been done, and I have spent a lot of time, as Mr. Walpole knows, at the Agency.
Let me just make a statement and tell me if it's true or false. OSAGWI has had nothing to do with the analysis that leads to your conclusions, but has a great deal to do with aiding you in collection.
MR. WALPOLE: That's a better way to explain it.
SENATOR RUDMAN: Is that true?
MR. WALPOLE: Yes. DoD information has been used and it's been essential to get that DoD information.
The soldiers' descriptions of what may or may not have happened in the pit is DoD information. We might disagree on which soldiers we're going to end up agreeing with in the end, but that doesn't affect the overall conclusions that we make.
SENATOR RUDMAN: Secretary Brown's question is a very valid question. What he's really boring in on here, and I didn't think we heard clear answers here. I think I know the answer, but I want to hear it from you. Your intelligence conclusions are community-based conclusions vetted in the community. And you have disagreements within the intelligence community. Then you finally decide what they're going to be and that's what you present to policymakers. But the OSAGWI has no role in that. Am I correct?
MR. WALPOLE: That's correct. That's what I'm trying to say in terms of this --
SENATOR RUDMAN: That's important.
MR. WALPOLE: -- wall between policy --
I view OSAGWI as part of the policy community, part of the Defense community. The intelligence community is separate from that. They don't have a part in forming intelligence community judgments.
SENATOR RUDMAN: As a matter of fact they don't have the capacity for analysis. That's not their job.
MR. WALPOLE: Well, there are some pretty smart people there --
SENATOR RUDMAN: That's beside the point. Could they do it? Probably.
MR. WALPOLE: Yes.
SENATOR RUDMAN: Do they do it? That's not what they do.
MR. WALPOLE: It's not their role.
SENATOR RUDMAN: It's not their role. That ought to be very clear here, or else you get a headline that says that the CIA was influenced by OSAGWI in reaching its intelligence conclusions, and that's totally false. I've been over there. I've seen what you've done.
MR. WALPOLE: That's correct.
SENATOR RUDMAN: But the Secretary asked a very valid question and I think you ought to try to give a much clearer answer lest we get the wrong answer.
Do you want to restate it?
MR. WALPOLE: That's what I tried to say with the wall. We have intelligence community judgments and OSAGWI doesn't make those judgments. We make those judgments. They help with getting information to feed into those judgments, but they're not part of the intelligence community.
SENATOR RUDMAN: All right. I think that's the answer, the accurate answer.
LIEUTENANT GENERAL CISNEROS: The opposite of that, Mr. Walpole.
In reading your paper about the influence, and you indicated that you based your assessments on intelligence not on politics, and so forth. Yet in your paper here you start off saying, "We now assess that the amount of agent was less than modeled in 1997."
Were you joined at the hip in '97 when you made that first initial assessment?
MR. WALPOLE: Oh, yeah.
LIEUTENANT GENERAL CISNEROS: Then you say some, "some might recall that during the modeling activity we had stated that for any area of uncertainty we used the worst case scenario."
So your paper seems, now you're trying to put the genie back in the bottle. You let a genie out that was bigger than what you thought it was because you worst-cased it. Now that you have more adequate information, you now know that as much was not released, and it's also 50 percent less pure than before.
My question is that in the information you're getting from OSAGWI that was giving you that, did that, were you more comfortable in going to worst case than the intelligence you had available? In other words, did you have intelligence that caused you to worst case?
MR. WALPOLE: We were not comfortable doing the modeling when we did it. Anybody that remembers that period of time, we were basically told by the Presidential Advisory Committee either you model this by X date or you draw a circle around Khamisiyah.
Now as far as I was concerned a circle would have been completely useless. Anybody could have drawn a circle around Khamisiyah, but that wouldn't have done anything for the epidemiologists, it wouldn't have done anything for anybody.
You can go back over the transcripts, we had some rather stiff debates with the PAC, with the Presidential Advisory Committee over that. They were pushing us to get a model done, and to get a model done by X date.
We were able to get them to allow us to do the testing at Dugway that would give us some feel. We had already got information on the purity, so we didn't use 100 percent purity in the '97 model, it was used in the '96 model at Bunker 73. But we still didn't have all the information that we could have got from UNSCOM if UNSCOM had been able to go back in, which they did, and sort some of these other issues out.
We were forced to do a model at that particular time. When Dr. Rostker and I sat down and talked about it, we decided a circle is useless. Let's put together what we've got with the information we have. We'll still have to use worst case assumption where there's uncertainty, but at least we'll give a vectored area that epidemiologists can focus their attention.
LIEUTENANT GENERAL CISNEROS: But taking your own words, "We were forced to do a model and we were not comfortable with it." Is that not the same as saying we were forced to accept OSAGWI's input or we were forced to do this?
MR. WALPOLE: No. No. It wasn't OSAGWI that was forcing us at all.
LIEUTENANT GENERAL CISNEROS: No, I understand, I understand. I'm talking about the issue of pressure and the issue of intelligence to do a model.
What happens now is that this was not as bad as we modeled it. The problem is that when your model came out it was accepted as fact by all the communities. All the conspiracy theorists were out there, and the essence of that revelation was to completely debunk the DoD. Great distrust came out after you announced this, that what DoD was saying was not correct because this modeling covered a larger area.
Now your paper says well, it wasn't as bad. So in essence we're feeding the conspiracy theories, that you're here today after being forced politically to accept the lesser view, is what you're not publicizing. And to the conspiracy theory, it even adds more fuel to the fire is the point I'm trying to make here.
MR. WALPOLE: And we debated that at the time, sir. We debated, do we just --
One option was to draw the circle, or let PAC draw the circle and be done with it. We were trying to do something that was going to be helpful to the research. In 1997 Dr. Rostker's and my approach was let's do something that's helpful to the research.
We may not, we didn't know for sure if UNSCOM was going to be able to go back in. We may not get more information. This may be the best that we've got. And to tell the veterans they have to wait on the hope that we might get more information didn't seem like something that would fly well. So we did it. I might have used too strong a word in saying forced, but I do remember at the time we were not happy with how fast we had to move with that, but we moved with it anyway.
The way we convinced ourselves that it was the right way to go was that the people doing the research, the epidemiologists, needed more information than a circle, and we felt a circle was going to be disruptive to the whole process.
LIEUTENANT GENERAL CISNEROS: When this thing came out with that uncomfort that you had, was there a public statement by you all saying this is a worst case scenario, be cautious about using it? Or when you use the word some may recall, the word some concerns me. What is the some may recall?
MR. WALPOLE: I meant some of you that had been involved at the time.
If you go back over the modeling paper, you go back over the briefings, we published all this and you should have copies of it. The briefing slides that we used as we modeled the paper, we pointed out where we were still using uncertain judgments, where we still had to use worst case. We pointed out that we don't have to use 100 percent purity because we have a better handle on that. We're still not certain of the number of rockets that were destroyed. We did some testing at Dugway, but we didn't test large stacks, we tested small stacks. So we took the worst case end of that type of effort to sort this out.
We pointed all those things out of where we were, and we said this plume is not indicative of where the actual agent went. It's a plume that gives the epidemiologists an area to look in to try to see if there's any causality between what happened here and the illnesses.
We pointed out by choosing the union we had done that. An intersection would have done a smaller area. It would have been common where all five modeling plans showed us to have been. We decided that, given uncertainties in modeling, that could miss it completely. Even though it's an intersection, there's five involved. We chose the union, knowing that it was bigger than the real area, but laying it out so the epidemiologists had an area to focus in. That was all laid out clearly in the paper. It was all laid out in the briefing, the presentation to the press.
LIEUTENANT GENERAL CISNEROS: Thank you.
SENATOR RUDMAN: Admiral?
ADMIRAL STEINMAN: Just a comment on your last comment. I understand what you did in your techniques, and the difference between the union and the intersection.
What happened politically though was rather than the public and the veterans understanding the point of maximum worst case exposure, this was presented as anybody under this plume was exposed, and that's not the way it was intended, but in statements I've heard discussed, people assume if they were under that plume they were exposed rather than you might have been exposed to very low levels of agent if you were in this area because of the worst case assumptions.
SENATOR RUDMAN: Do you want to comment on the letter, Bernie?
They sent a letter out to all the troops and I think it's important to get what phrase was used in that letter.
DR. ROSTKER: I understand the perception, and you're exactly right. In fact, at testimony before Senator Specter's group I made the definitive statement and he reacted and I corrected.
What is in the letter says that you may have been exposed to low levels of Sarin.
Let me clarify one thing. In the division of labor in doing the Khamisiyah analysis there were certain things that we had primacy over, there were certain things that the CIA had primacy over, and there were things that we worked together.
The "source term," the number of rockets, the purity of the rockets, those that were all derived from intelligence information were solely the purview of the CIA. My people may have an opinion, but I work off of the CIA's published information. They have both the expertise, and more importantly, the source of the information.
When it came to location of troops, the Department of Defense, my office initiated efforts by calling in the S-3s and G-3s from all of the units in the Gulf to create a database that never existed which was a definitive statement of where units were located down to the company level. We have the primacy in that regard.
We shared opinions as it pertained to the modeling of the weather and dispersion. We built off of some early work of the CIA that was done for them by SAIC. We substantially changed those models under direction from the Institute for Defense Analysis Senior Review Group, and we agreed on this.
Mr. Walpole referred to a disagreement, if its the one I'm thinking of, it was the issue of whether or not we needed to go back and reassess the CIA's modeling of the bombing releases. That modeling had indicated that no agent would have reached friendly forces. I alluded to it in my testimony by saying I could not independently make that determination. I couldn't do it then, I can't do it now.
The veterans have asked us to apply the new sets of models to that. We have agreed to do that. I doubt that it will show anything different than what the CIA has concluded and did, but I cannot tell you that until we do the analysis, and we've agreed to do the analysis.
SENATOR RUDMAN: I'm going to move this along. I know that you are roughly 15 minutes late.
MR. WALPOLE: I have five more minutes.
SENATOR RUDMAN: We're going to see if there are any other questions.
ADMIRAL ZUMWALT: One loose end with regard to Dr. Haley's work. As you may know, he finds that some of the neurological symptoms of people he's studied are consistent with Sarin gas having been either used or exploded accidentally in the southern part of Iraq and drifted, if the wind was right, he says into Saudi Arabia to expose these people.
Did you have any substantive evidence whatsoever to support that?
MR. WALPOLE: That's what was in the rockets in Khamisiyah was Sarin.
ADMIRAL ZUMWALT: Yeah, but that's quite a distance away, isn't it?
MR. WALPOLE: Al Jubayl.
MR. FOX: The plume that we modeled before did not make it to Al Jubayl.
One other note, there was a mention of Soman before, and that is not in the Iraqi inventory. Although they had researched it it was not something that they ever filled into any significant number of munitions.
ADMIRAL ZUMWALT: Thank you.
DR. CAM: Mr. Walpole, I just have one question for you.
In December 1997 the CIA published a lessons learned report about intelligence support on chemical and biological warfare during the Gulf War. I would like to know what progress has the intelligence community made in implementing the lessons learned that you identify in this report. And can you provide the Board with some examples, please?
MR. WALPOLE: We wrote the report as a task force for what we had learned and turned it over to the intelligence community. We did not establish a mechanism for following up to see if they implemented any of the recommendations that we had. So I can't give you the kind of answer I think you would be looking for. I wish I could.
I have had multiple engagements at times with the Office of Military Support when issues have come up where they've needed to look at what should have been done differently, could have been done differently, and I've referred them back to that report.
I know that many offices are aware of that. They are looking at some of the issues. The harmonization of database issue, which is one that we focused heavily there. I have personally been engaged in individual issues, and I can't go into them in an open forum, where we've been working on sites that have two different names to make sure we get it harmonized and get that straightened out in the database. Those end up being more case by case than an across the board procedure.
DR. CAM: Thank you.
SENATOR RUDMAN: Thank you very much. I appreciate it.
We're now going to hear from six veterans who've asked to be heard for five minutes each. We're going to try to stay on schedule.
The first gentleman, Mr. Edward Bryan. Is Mr. Bryan here?
MR. BRYAN: I'm here.
SENATOR RUDMAN: Take your seat, identify yourself, any organization that you --
MR. BRYAN: My name is Edward Bryan, Persian Gulf veteran, retired firefighter because of illnesses from Desert Storm.
Good morning Mr. Rudman, Department of Defense, Veterans Administration, general officers, enlisted soldiers, fellow veterans, ladies and gentlemen.
Mrs. Hillary Clinton [sic] left four stones unturned. They are carbon monoxide exposure, oil well fires, pesticide exposure, and nerve agents.
The oil well fires knocked out our senses while we were in the theater of operations. Brain damage. Dr. Heller's hypothesis is wrong. We needed respirators while we were in Operation Desert Storm/Desert Shield while those oil fires were burning. We have to come clean. We have to air out our dirty laundry for this.
Our lungs have to be washed. The BU study and the VA study up in Boston, this is being unnoticed.
Spec scans also are being denied for every Gulf War veteran.
Nerve agents. The enemy bunkers were blown up and a toxic cloud blew downwind over the troops -- a fog of war for months on end. Khamisiyah, that you people were talking about today, this was after the war. This was in March. You're not talking about the baby bottle factory that had Sarin nerve agent in it.
Pesticide exposure, another nerve agent. We had to put that on our uniform every day. I was at OSAGWI yesterday and they said we should have put it on our uniform every six weeks or every five to six washings or something like that. We had to put it on our things every day.
Carbon monoxide exposure. This is the hidden secret. The blacker the smoke the more carbon monoxide. That's a scientific fact under the National Fire Protection Association. What, it's different because we went to combat? We have different chemicals that are healthy for us?
Diesel fuel. This was the start of my investigations as a firefighter in 1992. In general health in 1986, they were going to tie Vietnam veterans and Gulf War veterans almost in the same exposures.
A visit to 801st, whatever it is in Washington, the VA Executive Office building, here I encountered VA officials scared and shaking of a bomb in my package. This is taken too seriously. I don't have to be insulted about bringing a bomb to Washington. Please. Don't insult veterans this way.
Quote, "If the U.S. government, the FDA, and the U.S. government continues to keep hazardous chemicals in the food chain -- Red 40, Blue 1, et cetera -- a pesticide, a nerve agent, we're going to have horrific diseases."
I urge this committee not to listen to the Gulf War investigation team, Office of Special Assistant to Gulf War Illnesses, Dr. Rostker, Dr. Kilpatrick, or the Surgeon General Ronald Blank who have fallen asleep since we have returned home from the Persian Gulf war. As today's testimony, the CIA doesn't even know what's going on. This is an insult to the community, intelligence if you would.
Dr. Rostker today reported 5,000 deaths due to car accidents. What about the total amount of veterans that have died? 11,734. That leaves 6,734 deaths. Is that neurological problems? Confusion? Multiple health conditions?
I spoke with the Chemical Conference in Atlanta on 27 February. If I were on a jury I would have to believe Mrs. Claudia Miller rather than Dr. Joseph's statement, while in today's conference I would have to say that the U.S. government's interaction is hostile and very disturbing.
I would like this to go to a grand jury. This is a lot of abuse of government funds. The DoD and the IG and the VAIG continuously, as we're speaking today, overlook the Gulf War illnesses of today.
My current health conditions are failing, and the VA puts me out on their own letterhead and refuses to compensate me. They are brain damage, multiple chemical sensitive, chronic fatigue, sample hay fever, diarrhea, vision problems. No response, professional or otherwise, have I got a response as of today. Neither.
SENATOR RUDMAN: That's your five minutes. I'll give you another minute.
MR. BRYAN: The current problems with VA and health benefits is a don't test, don't find policy exists. There were VA regional offices that did VA Gulf War claims. Now all VA regional offices treat Gulf War veterans like World War II veterans. This is wrong.
The time is now for the Presidential Special Oversight Board to request additional time on Persian Gulf illnesses and to keep the OSAGWI team in place until the job is done.
There's proliferation of weapons of mass destruction or terrorism, why is the national response team in this nation so interested in Gulf War illnesses that the national response team is following our illnesses, just as John Deutch, Director of the CIA, or myself on terrorism or chemical or biological attacks. As a firefighter, I'm disgraced that the national response is trying to force down on the firefighters issue on responding to chemical agents or nerve agents, without the proper treatment such as you did to us in Desert Storm.
SENATOR RUDMAN: I guess that's your time, sir.
MR. BRYAN: Thank you very much. The rest is in writing.
SENATOR RUDMAN: What unit did you serve in?
MR. BRYAN: The 173rd Transportation Terminal Unit. It's a stevedore terminal unit. There's only 15 of them in the U.S. and they're downsized to 10 currently as of today.
SENATOR RUDMAN: And when you served, was that a regular unit? Was that a Reserve unit? National Guard unit?
MR. BRYAN: Reserve unit, sir.
SENATOR RUDMAN: Out of Massachusetts?
MR. BRYAN: Out of Boston, sir.
SENATOR RUDMAN: Thank you very much, sir.
MR. BRYAN: One thing. I'm currently going through the CCEP program up here at Walter Reed. They give us a book, Chronic Illness and Uncertainty. I want that to be really looked at, this medical problem, because the doctors are really confused on how to treat a Gulf War veteran.
Thank you very much for the testimony.
SENATOR RUDMAN: Thank you for being here.
I'll call on Paul Sullivan next. You have five minutes, Mr. Sullivan.
MR. SULLIVAN: Thank you, Chairman Rudman and members of the Board for allowing me to speak with you today about my personal experiences during the Gulf War until the present.
Although I'm a member of various veterans organizations, the views I'm expressing here are my personal opinions because that's what the Board is soliciting.
I look at my presentation here today, Senator, in the following manner. If I was to spend five minutes with the President of the United States to share my thoughts about Gulf War toxic exposures and what could be done about it, what would I share with the President?
I would share with the President that tens of thousands of Gulf War veterans are ill. There really isn't any dispute about that. And Gulf War illnesses is not an academic exercise.
We need answers as to why we are ill so we may then receive appropriate medical care for specific toxic exposures. We also need to make sure lessons learned from the Gulf War are implemented so mistakes may be avoided or reduced in the future. That's a very common goal that we all share.
When I volunteered for the Army I knew the risks. My father was an Air Force pilot, my grandfather was in the Marines. However, what I did not anticipate was that my own country and the military, the very institutions I defended and trusted, lied and betrayed Gulf War veterans.
The military may have won the battle, but the military is losing the trust it shared with veterans by failing to train us, by failing to medically evaluate us, and by failing to tell us all of the facts about entering radioactive and toxic battlefields.
Mr. Chairman, here's my personal story. I was a cavalry scout, that's an armored reconnaissance specialist, on active duty. I entered basic training in 1989 at Fort Knox, the U.S. Armor School.
During my time at Fort Knox I was never informed or trained about the fact that some of our tank munitions are made from depleted uranium radioactive toxic waste.
I then served with the U.S. Army's 1st Armored Division during the Gulf War on active duty. I participated in the invasion of Iraq and Kuwait along with more than 400,000 other U.S. troops. During the period of February '91 until April '91, I climbed upon, sat upon, and drove around destroyed Iraqi tanks, many destroyed by M1 series tanks and A-10 attack aircraft. Some Iraqi tanks had been hit several times and were on fire as we drove by during the massive armor attack. Again, at no time did anyone inform me or train me regarding depleted uranium radioactive toxic waste contamination.
Upon my return to Germany I began experiencing health problems documented in my medical record. Much of the medical problems I believe may be related to the tremendous amounts of oil well fire from the nearly 700 burning oil wells.
My health problems continue today.
From my start to my finish of military duty, at no time was I ever trained or briefed regarding exposures to depleted uranium radioactive toxic waste. By 1994, after I'd been honorably discharged from the Army, I learned that the Army had used depleted uranium as an ammunition.
In 1994 I requested to be tested for depleted uranium at the Department of Veterans Affairs Medical Center in Atlanta, Georgia. No testing was provided.
I again requested DU testing in writing in 1999, once my VA medical record was found after being missing for four years. The VA has not yet responded to two separate letters dating back two months.
When I met with the Acting Chief of Staff at the VA Medical Center last week, he said he knew nothing about depleted uranium, knew nothing about a VA protocol for evaluating DU exposures, and he appeared very surprised when I informed him that the ammunition was made out of radioactive toxic waste.
Therefore it's my conclusion as an individual veteran, that AR 40-5, AR 40-14, and TB-91300278 were ignored by the military during the Gulf War. I'd like to read the specific portions of the regulations.
SENATOR RUDMAN: You have one minute left, Mr. Sullivan.
MR. SULLIVAN: All right. I'll do that as quickly as I can, Senator.
"Personnel potentially exposed to ionizing radiation in their occupational environment will receive medical evaluations are required by AR 40-14."
Again, "Bioassay procedures will be performed when radioactive materials are used in such a manner that they can be inhaled, ingested or absorbed into the body." Please note that the words say "will receive." These are not guidelines.
To date I still have not been tested. As a person, I'm not alleging any conspiracy theory by the government to cover up anything. I never have. I never will.
However, the rules say that we should have been trained, we weren't. The rules required that we should have had our medical records noted and been tested, and that wasn't done. Therefore leaving this huge void of information.
What I'm trying to do is make sure that veterans that follow in my footsteps, make sure that they're trained and make sure that their medical records are noted and make sure that bioassays are performed to make sure that we know what's going on.
SENATOR RUDMAN: Thank you, Mr. Sullivan.
Were you medically discharged or otherwise?
MR. SULLIVAN: My tour completed at the end of my regular enlistment. At the end of my regular enlistment as part of the program they have, it's an eight year, two active, six in the Reserve or Guard, I went into the National Guard and was discharged for respiratory problems.
SENATOR RUDMAN: All right. I think it's interesting, Mr. Sullivan, to be here, as our first witness after lunch we've got Dr. Naomi Harley from the Rand Corporation presenting a review of scientific literature pertaining to depleted uranium. We're very anxious to hear her testimony, and I would assume you would like to hear it, so I'd just like to remind you she will be here at 1:00 o'clock.
MR. SULLIVAN: That's important to note. What I wanted to do is right here, to make sure it was on the record if I could, Senator, Mr. Rostker here said depleted uranium saves lives.
Well, I was an armored recon soldier on the front lines, and clearly depleted uranium was effective. However, we have the memo from Los Alamos that says "write reports about how great it is, otherwise they might take it away."
We've asked Dr. Rostker to supply us with any evidence that he has that DU actually in fact saves lives. Otherwise what he's doing is he's making a statement. We were asking him to support his conclusion with evidence.
SENATOR RUDMAN: Mr. Sullivan, I can assure you when you read our report in August, that this Board is assuring that everyone in this government does everything it can so we know the answer to DU before we're done, and we will know the answer to DU.
SECRETARY BROWN: Mr. Sullivan, have you filed a claim with the VA for disabilities incurred while you were serving in the Persian Gulf?
MR. SULLIVAN: Yes, Mr. Secretary, I did. That claim was lost in the paper shuffle. This is a VA issue, not a DoD issue, but the VA tried to find out what was going on with Gulf War veterans illnesses, and my claim was filed in Atlanta. Then it went to a regional office X outside of Atlanta to look at Gulf War illnesses, then back to Atlanta, then to a second Gulf War illness review stage, then back to Atlanta, then it simply disappeared for more than four years until a lawyer I retained tracked it down after considerable effort. That claim is still pending. It hasn't been adjudicated after seven years.
SENATOR RUDMAN: Any other questions before our next witness?
SENATOR RUDMAN: All right, thank you very much, Mr. Sullivan.
MR. SULLIVAN: Thank you.
SENATOR RUDMAN: Charles Sheehan-Miles?
Mr. William Frasure.
MR. FRASURE: Thank you, Mr. Rudman.
My name is Bill Frasure; I'm on the government relations staff at Vietnam Veterans of America, and I would just like to read you a quick prepared statement.
SENATOR RUDMAN: Fine.
MR. FRASURE: Mr. Chairman and members of the Board, Vietnam Veterans of America appreciates this opportunity to voice our concerns in regards to Gulf War undiagnosed illnesses and in particular OSAGWI.
The concerns expressed here are the official views of VVA, and as a Gulf War combat veteran I personally share these views.
After reflecting upon yesterday's update by OSAGWI, it clearly seems that office's tenure is about to expire. The VVA believes it is premature for the Department of Defense to close the books on Gulf War undiagnosed illnesses. OSAGWI seems to be making the argument for closure on the basis that it's not turned up any "smoking gun."
VVA is making the argument that OSAGWI should stay open in some capacity for precisely the same reason. OSAGWI, with a staff of approximately 200, and after spending close to $60 million in taxpayers' money, has indeed answered very few of the many questions that persist in regards to Gulf War undiagnosed illnesses. With over 20,000 sick and undiagnosed Gulf War veterans, the VVA finds this to be a failure on behalf of OSAGWI.
We strongly believe that these sick and undiagnosed veterans are the primary reason why this office should remain open. The VVA asks for Dr. Rostker's resignation and suggests that he be replaced with someone who will sincerely seek answers and will not concentrate the office's abundant resources on simply debunking sick veterans' claims and eye witness accounts.
While not harboring a personal vendetta towards Dr. Rostker, we do question the efficacy of OSAGWI under his leadership. VVA believes this query is indeed in the interest of veterans.
VVA does hold OSAGWI accountable for producing no answers as to why these veterans are sick.
The VVA is at odds with OSAGWI's blanket refusal to further investigate DU and its effects. With ample evidence stemming from a variety of sources that contradicts OSAGWI's official position that DU is harmless, we find this refusal irresponsible and puzzling.
Furthermore, DoD's failure to implement DU safety is a clear sign of inefficacy on the part of OSAGWI.
Again, VVA strongly suggests that OSAGWI remain open in some capacity under new and vigorous leadership until these veterans are diagnosed, each and every one.
Secondly, we urge that DU continue to be thoroughly researched.
Thank you, Mr. Rudman.
SENATOR RUDMAN: Thank you very much.
The next witness, Mr. Dan Fahey.
MR. FAHEY: I'd like to thank you for having me come once again to talk.
Yesterday when we were at the Pentagon, the meeting with the VSOs, Dr. Rostker stated, and this is a quote, that depleted uranium, he said, "I don't think it's an issue of concern."
I'm here today because I believe it's an issue of concern. I work with many veterans, people who are out of the military as well as those still in the military who also believe this is an issue of concern.
I've done a lot of research on this and Paul brought up the Los Alamos memo. I understand that this morning Admiral Zumwalt said there's been no paperwork that surfaced that indicates that the government is trying to avoid responsibility. I think that Los Alamos memo, I really encourage all of you to obtain and read some of the documents that we've been able to get that we've provided to your staff about this, because there's a real change in what was written about depleted uranium prior to 1990 and after 1991. There's a significant change in the presentation of the issue.
That Los Alamos memo basically said there's concern about the environment, the impact of DU on the environment. So we need to write after-action reports to downplay the negative effects and play up the effectiveness. The date of that memo was 1 March 1991.
I want to read to you another quote from the Army Environmental Policy Institute report on Depleted Uranium from June of 1995. This is from page four in the introduction. It states, "When DU is indicted as a causative agent for Desert Storm illness the Army must have sufficient data to separate fiction from reality. Without forethought and data the financial implications of long term disability payments an health care costs would be excessive."
This report was leaked, I have to add. Even the Presidential Advisory Committee couldn't obtain this report, and it was actually the Military Toxics Project which obtained it and provided it to the PAC. It was not the Department of Defense.
But what we have now, here we are in 1999 and OSAGWI has helped gather the data that's needed to deny that depleted uranium could cause illness among even one veteran. They've used the Rand Corporation to help gather that data.
A couple of weeks ago I met with your staff and I provided them with an analysis, DoD analysis, too. I would encourage each of you, please, get this from your staff and read it. I go over some of the problems with the Rand report. One is that as you brought up earlier with the CIA, involvement of OSAGWI with the CIA, well there was a member of the OSAGWI staff on the Rand review team, and on page 120 of that report it states that that OSAGWI staff member helped in selecting research for review and in writing the report. It appears that there would be a conflict of interest.
Would you trust the tobacco industry to accurately report on the health effects of smoking and to task one of its own research institutes that it funds to do a literature review on the health effects?
I've identified many reports, scores of reports, some of them directly on the health effects of depleted uranium that were not reviewed by Rand. I'd like to know why, and I hope you'll ask Dr. Harley, and I'd be happy to provide you with a copy of this where I've listed these reports. Many of these reports I took right out of the bibliographies of the Army's own reports on depleted uranium. Some of them about the health effects of workers at a plant in Tennessee who went out on strike in 1981 on a health and safety strike because they were being exposed to depleted uranium dust in the course of making rounds.
SENATOR RUDMAN: You have one minute, Mr. Fahey [sic].
MR. FAHEY: Thank you, sir.
Yesterday also I asked Dr. Rostker if he believed that his environmental exposure report on depleted uranium accurately reflected the information that his investigation had obtained. Unfortunately I don't have time to read through some of the lead sheets that I printed out that are in the footnotes of his report, but there's some very significant things that people reported to his investigative team, such as trying to inform generals about the dangers of DU and being told to shut up. About the NBC officer at Doha saying that the Fox vehicles that they were sending out to look for alpha contamination weren't good, and then being pulled aside by the XO an being told to shut up.
Why isn't that in their report? There are some serious issues, and people reporting health effects not only for themselves but others in their unit.
I'll just close with a photo that I'm going to give one of each of these to you. This is from U.S. News and World Report last week. The caption says, "Kosovar Albanian children play on a Serbian tank destroyed by NATO." There are 11 children on this tank. I don't know if this tank is contaminated by depleted uranium if it was hit, and I doubt these children know.
Are there other tanks in Kosovo that are contaminated where there are children playing? I'd like to know.
When you watch the Army training videos from '95 with soldiers wearing MOPP IV climbing on the same type of vehicles, it's an outrage to see this happening in 1999 with all that we've known, that this hasn't been prevented. Have we learned any lessons from 1991? It appears not. I think that we've been ill served under Dr. Rostker's leadership. I think I would like to see the work of OSAGWI continue, but we have to get away from proponency policy. Everything is driven to promote --
SENATOR RUDMAN: Times up.
MR. FAHEY: Thank you very much.
SENATOR RUDMAN: Let me ask you a question, Mr. Fahey.
MR. FAHEY: Yes, sir.
SENATOR RUDMAN: Are you familiar with the National Institutes of Health?
MR. FAHEY: Yes, sir.
SENATOR RUDMAN: Do you have an opinion about the National Institutes of Health?
MR. FAHEY: Not necessarily, sir.
SENATOR RUDMAN: You don't have an opinion.
MR. FAHEY: No, sir.
SENATOR RUDMAN: So you don't know that much about them.
MR. FAHEY: No.
SENATOR RUDMAN: You don't know that, for instance, they have a reputation in this country of being absolutely independent, doing the most extraordinary research in health areas probably of anywhere in the world. You're not aware of that?
MR. FAHEY: No, sir.
SENATOR RUDMAN: Uh huh. Well, it might interest you to know that one of the recommendations I'm going to try to get this panel to adopt is to have this particular issue taken totally out of where it is because it's so controversial, and have it done by NIH with a major grant and settle it once and for all. Because with all due respect, Mr. Fahey, I think you've made some statements this morning for which there is no support.
I also believe that the issue has not been studied completely. And one of the things that I'm going to be very sure of before I fold up this commission is that that question is answered by a totally independent group with a reputation of world class research. And once that's done, Mr. Fahey, then some of the statements that are made we can reflect upon.
MR. FAHEY: I think that's a good recommendation, sir.
SENATOR RUDMAN: Questions?
SENATOR RUDMAN: Thank you.
MR. FAHEY: Thank you.
SENATOR RUDMAN: Last witness, Mr. Kirt Love.
I understand, Mr. Love, that you asked to be heard today and you've given us a document which you have prepared. You're from Dallas, are you?
MR. LOVE: Yes, sir.
SENATOR RUDMAN: This is your document that you prepared?
MR. LOVE: Yes, sir.
SENATOR RUDMAN: It's called "The Desert Storm Battle Registry," something you put together.
MR. LOVE: This is a survey that I run on the Internet to reach other veterans, specifically Army E-5 and below, and to find out what information they have pertaining to the Gulf War.
SENATOR RUDMAN: All right. You've got five minutes. I won't count my time on yours, so go ahead.
MR. LOVE: Yes, sir.
My name is Kirtpatrick Love. I was an Army combat soldier during the Gulf War. I bring a packet of material including media flyer outlining my point.
You should hear about VA failings that pertain to disruption and Cabinet department interactions.
I came under duress from the Dallas, Texas area with grievances, the Defense Department's so-called investigation of our mutual concerns. Specifically I'm perturbed by OSAGWI suggesting resolving some of these difficulties and wrapping up. Either the Oversight Board is part of the problem or part of the solution.
This is a multi-faceted dilemma. It involves other -- to be quite honest with you, I really can't follow a script here.
SENATOR RUDMAN: Let me help you out a little bit. We have your statement here, Mr. Love, and we are going to read your statement. It will be part of the record of this hearing. But in your own words, without looking at any paper, just tell us in the next three or four minutes why you came all the way up here today, what your concerns are, and what you'd like us to look at.
MR. LOVE: I've been atrociously handled by the VA. My health concerns have been totally unaddressed. I've still only received ten percent, even though my appeal was filed six years ago, I'm in the process of filing my fourth appeal.
I can't get -- I was supposed to do a CCEP in order to get information to include to my CNP to be of value. The Persian Gulf coordinator in Dallas, he hadn't even sent anybody to the Houston facility for the specscan in over a year and I had to fight and fight with them until I finally got an appointment -- January 3rd, year 2000.
I have 24 days in which to close my current CNP and send the information in for submittal. This is one of a series of problems just in that area.
SENATOR RUDMAN: Do you belong to any veterans organization that might be able to give you assistance?
MR. LOVE: My claim was being handled by the DAV, but I will be handing it back over to the VVA at this time. I'll change power of attorney once the material's closed in the CNP currently. But this is not my primary concern. This was one of many, many problems I'm having currently.
My indigence, my appearance and everything is courtesy of other organizations that have chipped in, but I literally live in a rotted old RV on the back of someone's property and I had to move to the Dallas area to get this medical treatment. I nearly died six years ago, I spent two years in a deathbed state of which I have another person that can corroborate that. I've little by little, bit by bit got back to a condition right now where I can at least partially, partial mobility and partial movement. So I tried to find out what happened to my unit.
My unit, 141 Signal Battalion, witnessed a bunker demolition in Kuwait which for a long time I mistook for Khamisiyah, but we were nowhere near Khamisiyah. We were much further south. This one was a multi-colored explosion, all kinds of colored plume and fire. And what I understand in an HE explosion, it's just a little gray cloud and some materials destroyed. This one had a lot of volatile material rolling up in it, secondary cook-offs, and there were rounds flying and smoke out of this thing for two days next to our unit. But this is only one of many, many things that happened to my unit.
I've been trying to go to the OSAGWI team for three years now with this information and trying to get it addressed, and I was only debriefed just last month, even though I've been on the Net for two years releasing this information.
I've been trying to get it addressed, even though it's being addressed as anecdotal, meaning that I am submitting information that I observed. I have other people from my unit that witnessed this. The OSAGWI team has not approached them. I have all the names of the people that served in my unit and the social security numbers of these people.
SENATOR RUDMAN: Fine, will you furnish that to us, please?
MR. LOVE: Yes, sir.
SENATOR RUDMAN: Let me ask you this question. Your unit was which unit again?
MR. LOVE: 141 Signal Battalion, 1st Armored Division, attached to 7th Corps which did the central spearhead through south Iraq into northern Kuwait, into the Republican Guard units.
SENATOR RUDMAN: And you were enlisted in the regular Army, I take it?
MR. LOVE: Yes, sir.
SENATOR RUDMAN: How long did you serve?
MR. LOVE: Three years, sir.
SENATOR RUDMAN: All right.
MR. LOVE: I was facing originally a medical discharge. I ended up getting a, I forgot the term.
SECRETARY BROWN: Severance pay?
MR. LOVE: No. I received basically an honorable discharge, but it was for not being able to maintain body fat standards. Basically, I wasn't able to maintain physical standards from an injury I had suffered earlier in the military and simply was not able to keep up. Plus there were ten other people in my unit with the same exact condition. We were all given the same chapter, which is the word I'm looking for, we all received it the same damn time. We were all having the same symptom, and our captain was going to chapter all ten of us at the same time from our unit. We all exhibited the same problem. And we weren't sure of this.
I came back to Texas, I was treated badly. The VA system has treated me even worse --
SENATOR RUDMAN: Your major problem then is, in your view, you've got a major problem with the VA. That's number one.
MR. LOVE: The medical care and the way that other veterans E-5 and below -- the people that I interact with, Fort Hood area and the other cities throughout Texas, most of them have given up on the idea of getting anywhere with this and don't even try. And when they do show up, a lot of these individuals I interact with have had so much difficulty that they just simply decided it's not worth pursuing.
SENATOR RUDMAN: Well, we appreciate you coming up. Any questions at all?
MR. LOVE: Well, I would like to address the fact that there's material that I have given the Oversight Board that I hope you'll pay special attention to.
SENATOR RUDMAN: We will.
MR. LOVE: Thank you, sir.
SENATOR RUDMAN: We thank you for coming up today.
DR. CAM: Senator?
I just have one question for you.
With regards to your difficulty in dealing with the VA, do you have any sense of how many veterans have such problems?
MR. LOVE: The survey that I have at this time is over a thousand-some-odd individuals that I'm interacting with. But of the 4,000 I've talked with and the surveys that I've got, roughly about 42 to 44 percent. It's a large number, and most of the people I'm interacting with have been always turned down on the first claim. So generally it takes a second or a third claim. But for instance a response that I received from the Waco administration says you cannot list chemical exposure as a disability. You must state that it's undiagnosed illness due to service in the Persian Gulf. That's how they addressed most of this in my case, as undiagnosed illness, unable to pinpoint, don't test, don't find, which I've requested specific testing in my CNP which is in my C file for two years now asking for PET spec and other specific neurological testing and other things that they have not done. There was even one occasion where they set me up for a psychiatric consult. I said this is not what I asked for. They put me down as a no-show, even though I had canceled the appointment, and later I had to get this shown as a cancellation, which I was concerned.
SENATOR RUDMAN: We'll look at all the material you've sent up to us, and we thank you for being here.
We're going to now adjourn for a quick lunch. We were supposed to start at 1:00. We'll never make it at 1:00. We'll try to make it at about 1:15, 1:20.
(A luncheon recess was taken.)
A F T E R N O O N S E S S I O N
SENATOR RUDMAN: I'm going to introduce Mr. Ross Anthony from RAND Corporation, who would like to make a few opening comments, brief, I hope --
MR. ANTHONY: Very brief.
SENATOR RUDMAN: -- and introduce our next witness.
We're going to try to move things right on schedule today because we are starting a bit late because we went over this morning.
MR. ANTHONY: Yes, I am one of the principle investigators of RAND's effort to review the scientific literature as it relates to the Gulf War, and have participated also in the DU study, primarily helping to bring together the information that three of the primary authors had provided to us who are experts in their own field.
This morning you're going to hear from Dr. Naomi Harley, and I'm going to let her kind of tell you a bit about her credentials, and you have in front of you her rather long and extensive resume which would take an hour to go through.
I did want to say one thing quickly. I had a chance to talk to Mr. Fahey at the break to indicate that one of the authors was really a research assistant, and that's Arlene Hudson. I think some issues have been raised about her role. I would just say that she was a research assistant who was not at all responsible for the primary scientific content of the project, and RAND stands by the independence of its work and we believe that this represents good science.
I look forward to you asking questions to Dr. Harley of any scientific nature. We hope that we're able to provide literature and information for the public, and to the degree that we can further and improve that, we certainly look forward to doing so.
With that I'm going to turn it over to Dr. Harley who is an expert in radiology, has many many years of experience in the field, and I think will speak briefly to you about her credentials.
SENATOR RUDMAN: Dr. Harley, welcome. I have had a chance to look over this resume, and it's an extraordinary resume considering the subject that we're interested in.
I would just point out to anyone who wants to make loose, unsupported statements about this issue, that I would tell you that this resume is available for your observation.
Dr. Harley is doing an independent look at this issue, has no ax to grind except to find the truth as the truth exists. We're glad that you were willing to undertake this project.
DR. HARLEY: Thank you. Thank you, Dr. Anthony and Senator Rudman.
I've been working at New York University Medical School for about 30 years, and for that time plus a little before my career has been involved with natural radioactivity from the point of view of exposure assessment, the biological modeling, dosimetry and risk. That is cancer risk, because that's really the only risk from radiation.
I am a council member of the National Council on Radiation Protection and Measurements, and that is the group that really provides guidance on radiation for the U.S.
I'm an advisor to UNSCEAR, the United Nations Scientific Committee on the Effects of Atomic Radiation. This organization produces a document of about three inches thick every five years that contains essentially all the known information about radiation. The base data and the human health effects.
I am on four national research council committees. Two of them, the most recent one is just about to have a report put out. It's on the background effects of radon in drinking water. EPA will use this as their background document.
The other research council committee I'm on is dealing with the A-bomb data and the health effects in the Hiroshima/Nagasaki A-bombing.
I have over 100 refereed journal publications, have six book chapters. I teach four courses in radiation. I have three patents on monitoring equipment. And I'd like to do a little PR, because I'm about to get a fourth patent on a device that measures both radon and thoron, the other isotope of radon. This will be for occupational exposure assessment in DOE facilities that are working with radon and thoron.
With that, I guess we should proceed to the technical part of this. If we could just have our logo.
I've already said enough about the logo.
The background information is that radiation is known to cause cancer, but only at high doses. The base data that people use to project health effects is mainly the A-bomb data. But also underground uranium miners; the ankylosing spondylitics who were irradiated with X-rays for their disease; the radium dial painters; and a few other smaller studies. So there's a great deal of information about what radiation does in the way of causing cancer. There is no other effect known from radiation exposure other than cancer.
The Army used, as you well know, depleted uranium as defensive equipment and offensive equipment, so this is radioactive. But because of the very long half life of uranium, 4.5 billion years, its radioactivity is really very, very low. It is almost a stable compound.
Now depleted uranium is even more so because two of the isotopes have been decreased. That is U235 and U234 are less abundant than in natural uranium, and they've been removed for use in a reactor, weapons, et cetera. So it's less radioactive -- DU is less radioactive than natural uranium.
Now how do you get exposed? You must be exposed in order to have any health effects.
Well, they have external radiation because they're near it. They could inhale aerosol particles, if anything is hit by ammunition. Or if you have shrapnel you can have embedded DU in wounds.
So the question posed to me when RAND approached and asked for a background document was, does DU play a role in illness in Gulf War vets? Could we have another overhead, please?
So the purpose of the report was to review the scientific literature related to depleted uranium. And of course my strength also, coming from a research background, is to make recommendations about future research. We were to look at the toxicological effects and the radiological effects.
Now my strength is the radiological effects, and Dr. Faulks, the toxicological effects. But working in the field for 30 years I also feel a good relationship with the tox effects as well, although that's not my chosen field.
You have to be exposed in order to have any health effects, so how do you get exposed?
The decay products of uranium are thorium and protactinium. Uranium is a radioactive substance so it decays to two elements and then to U234. So the decay products emit beta and gamma radiation. So if you are inside of a tank, you have shielding around you as well as the munitions around you.
The measurements that have been made inside of tanks show that your external radiation exposure is about 10, a maximum of 20 times what you receive just normally from background radiation. You have to realize that all of us sitting in this room are breathing radon, being exposed to cosmic rays, and to gamma rays from earthbound materials. The uranium chain, the thorium chain, et cetera. So each year you receive about 100 units of this. The unit is the millirem. So each year you have about 100 millirem is your exposure.
Now the external radiation inside of a tank is 10 to 20 times that of natural background radiation, just standing here in this room. So this means that in order to get the same amount of radiation by being in a tank as you would get normally every year, you would have to spend about five percent of your life in a tank. So this is about 20 days.
This would give you, 20 days in a tank, fully shielded, with munitions, would give you the same exposure you get normally just living on the planet earth.
This external exposure is all from the radiation. There's nothing of the toxicological properties here.
Now internally, you can inhale aerosol particles. You can ingest material if it gets in your month, or if you're shot, you have an embedded fragment that is slowly dissolving and putting depleted uranium into your bloodstream.
So once in the body in the blood, you can then have a radiation problem or you can have a chemical problem, and that really is related to the kidney. That's the target organ for most heavy metals, and uranium is no exception.
Can we have the next please?
How does your uranium distribute once it's in the blood? It's really a calcium analog, so much of it goes to the skeleton, about 60 percent. A little bit of it distributes to the lungs, the lung tissue; 20 percent goes to muscle; .4 percent goes to kidney; 4 percent goes to blood, fat, liver, et cetera.
Now these data are from a very large database that's developed by my colleague at the Department of Energy who is a radio chemist and has been publishing and doing measurements of uranium in the environment for many, many years. She's a well recognized radio-chemist.
Can we have the next please?
If you inhale particles, and one of the properties of depleted uranium is of course it's very good as a weapon and it can go through material. Its density is almost twice that of lead. It's about 19 grams per cubic centimeter, so it's a remarkable penetrator. Then you have the weapon. And uranium itself is pyroforic that is it burns. So you create aerosol particles. If they're small enough, you can inhale them. Bigger than about 10 microns, you really can't inhale. Material does not get through the nose. one to two microns is readily inhalable.
Some of my research currently, I digress, I take my teacher's prerogative and digress. I do aerosol work currently. So my main interest is very small aerosol particles because this may be involved in some of the respiratory illness we see currently that's on the increase.
Anyway, as these particles are formed by the explosion, some of them can be inhaled. You breathe in, you breathe out. Most of them are exhaled, just like say cigarette smoke. Otherwise you would die much sooner from cigarettes.
Twenty-five percent approximately is retained in the lung, depending on particle size. Of that 25 percent, the lung is just a marvelous organ. It has a wonderful mucociliary escalator where when particles deposit on the tree or in the lower lung, material is brought up to this mucociliary escalator, and it's like little sheaves of wheat waving in the wind. So particles are carried up to the mouth where they are swallowed.
Lung clearance is just a marvelous thing. It's very efficient. Especially, for example, those of us who live in cities, we'd have terrible respiratory problems if we didn't have this marvelous bronchial escalator clearing material that deposits when we breathe it.
So then of the 25 percent, you clear 80 percent. Some stays in the lymph nodes, some gets into the body and gets excreted, mostly through the kidney.
Once uranium is in the bloodstream, essentially all of it, about 90 percent, is excreted via urine every day. So once in blood, you really don't deposit much in organs. You excrete most of it. This is why urinalysis is a wonderful way to detect uranium in the body, or additional uranium over that which is normal.
You've all had about a microgram of uranium when you went out to Burger King or some other fine dining spot out there, and had your lunch.
Can we have the next, please?
What happens to the uranium that's really left in the body that doesn't get excreted? Again, this is my colleague Dr. Ficenne and Dr. Wolford at the Department of Energy. They have taken New York city autopsy specimens. And each point here represents many people, up to like 20 cases that have been pooled to give a single age point.
So in your bone, and this would go for Washington or most any place in the U.S. With age, going up from about 15 to 80, the bone accumulates a little bit of uranium. This is micrograms of uranium per kilogram wet vertebra. So this is bone, here is lung. This increase from about .2 to .8 represents what gets hung up in lymph nodes, because the lymph nodes are like scavengers in the lung and they retain particulates over a very long time.
So the lymph nodes account for this factor of about four or so.
If you've ever had the opportunity to see smokers' lungs at autopsy, they look like little black pebbles all over the lung surface. Those are the lymph nodes that have collected all the garbage from the smoking.
Non-smokers you see a little bit of that, just from the normal dirt you breathe, but a smoker's lung is something that if you see I think you'd really stop smoking.
Here's liver, kidney.
The reason I wanted to show this graph is very important. This is because in this case, the reason this is important is because you know the input. The diet has been measured, the air has been measured, urinary excretion has been measured in New York City population. So if you know the input, then you know exactly what the organ content is in the body. There is no mystery.
So if you, for example, measure urinary excretion in a veteran who has an embedded fragment and you say oh look, the value is 10 or 100 times what you would see in a patient or a person not exposed. That means that the body content will be that ratio, that many times, 10 times or 100 times what you see in this normal background population. So this is a really powerful tool.
You measure urinary excretion, you know exactly what the steady state body burden will be in this person organ by organ. That's why it is important say on these fragment cases where the embedded fragments are known to exist, to follow their urinary excretion and look over time, and you know then what will happen in the body. It's not a mystery.
Can we have the next overhead, please?
Now you can have either chemical or radiological effects, and I've been more or less emphasizing the radiological effects. But there's a lot of information on chemical effects. Early on in the atomic energy programs the University of Rochester started right away, in the early '50s, to do the biggest toxicological experiment known to man. It's still the biggest. They looked at what happens with a really very, very high level exposure in rats and dogs and mice and other experimental animal species -- guinea pigs, rabbits, et cetera. Because they knew that in the atomic energy program people were being exposed as they processed uranium ore to the final product which was uranium metal and the separated U235.
So in all of these animal experiments you will see some deaths because they're giving exposures that are just way outside of anything that would be even credible in an exposure situation, say in a war, the Gulf War, or whatever.
Now in the epidemiology of these uranium workers there's been no statistically significant increase in deaths, and they have really looked. Oak Ridge has studied these populations, I hate to say to death, a bad pun, but nothing has been seen in these exposed workers.
The kidney is really the target organ and this should show any effect if it's present. There's a transuranium registry that Ron Katherine runs out of the University of Washington. He has, when people donate their bodies when they have been occupationally exposed, they look at organ concentrations, they look at tissue histology, they look at any effect for uranium, plutonium, whatever, any of the transuranics. He has never seen, to date, anything unusual, even though he has autopsy cases where the exposures were really incredible due to say an explosion in a hood and things like this.
So in 19,000 Oak Ridge workers, no excess cancer or any other health problem noted.
Can we have the next, please?
Regarding the ingested or embedded depleted uranium, this covers a little more than I really have time to go into, but for example if you have a more soluble form, it's more toxic because it gets into the blood more readily. This is kind of obvious. But mostly, and really in the Gulf War when you've had a fire, an explosion, and a weapon, you're talking about an insoluble compound. That's a high-fired compound and generally it's U3O8, uranium oxide. So it's really less soluble and then less toxic.
EPA is now concentrating, their latest effort now is uranium in drinking water, so they are going to set a limit. Their existing limit is 20 micrograms per liter. This bottled water here on the table may very well have more than that. Some of the other bottled waters definitely do, like when you go to Italy and drink some of that nice stuff, it's really right up there in a lot of things -- radium, uranium.
One sort of fascinating thing is in the local water around Beijing is up over 100 micrograms per liter. And of course EPA would never allow that. And I often think to myself, gee, if the Chinese want uranium, all they have to do is take it out of the drinking water.
So there's no adverse effects from ingested DU. Less is known about the effects of embedded DU.
This is a RAND slide. I really don't care for that remark because DU is U. The mass is U238, and the mass of DU is U238. So we're really talking the same element. It's not really different from uranium. So you say we studied natural uranium, that is the same as studying depleted uranium.
Then these veterans are being followed at the Baltimore VA hospital. There's no evidence of kidney disease or any radiological effects to date.
The external I really covered. The uranium itself is an alpha emitter, but the decay products have the gamma rays. Externally alpha rays can't get through your skin really, so there's not really an external hazard. It's the gamma rays. So you can, if you lived in a tank for a full year, you could get up to occupational exposures. You could then be an occupationally exposed person. But who's going to live in a tank for a year? I don't think this is a credible exposure.
People in the uranium mines and animal studies, again no skin cancer from exposure to uranium.
Can we have the next, please?
So the conclusions were that no studies showed negative health effects from inhaled or ingested uranium at levels far greater than those likely in the Gulf. This is from the extensive studies in the contractor facilities that the Atomic Energy Commission and the Department of Energy have, and are still studying.
Alpha radiation, no external threat. Beta and gamma inside a tank are below even environmental guidelines. As a person moving around say from place to place, the radiation authorities say you have changes in background. Like if I move from here to Denver, et cetera, you easily can shift that 100 millirem to 200 millirem. So for continuous exposure, lifetime exposure, they say an additional 100 millirem is nothing significant.
So even in a tank under normal conditions, not living there forever, you don't reach these environmental guidelines.
Now sort of lastly, I don't really have an overhead, but RAND was asked to make some recommendations. And I, as a researcher, I really love this. I love to do research. So what should be done in the event that these weapons are going to be used in the future? And considering the fact that they are so marvelous, apparently, in war, they probably will be. Even if not by us, by others.
So what should be done? Well, first of all the exposure assessment is really poor. Nobody ran out on the battlefield with an air sampler and said gee, let's take some particulate samples. As soldiers were breathing material, say, there wasn't a whole bunch of people to run out and say, "Pardon me, but would you mind giving a urine sample?"
So what is needed is some background information on a broad spectrum of military people showing what background uranium is. Because this is variable.
I have some additional, more technical overheads here to show, for example, if you go from country to country the uranium in bone, for example, varies by factors of easily ten. China, of course, being the very highest point because their everyday exposure is probably highest on the planet earth. So you need some background information because if a veteran walks into a physician's office and says I think I've been exposed to depleted uranium, all right, you take a urine sample, but then how do you know that that's not just normal for him because of his diet? His or her diet I should add.
So there's a need for this background information. Then there's a need for some actual exposure estimates to be done. And as a researcher and studying aerosols, I know that exposure to humongous amounts of depleted uranium are just impossible.
If you have nuisance dust in the air, that's permitted, it's five milligrams per cubic meter. If you had that much uranium in the air you couldn't see through this to the back seats there. So nobody was breathing this kind of depleted uranium in any war.
Yet if you work out the dosimetry and you breathe say that kind of atmosphere for two hours, you would not approach the dose you get normally every year from natural background.
So there are things you can do about these exposures that you know are credible in the war situations. But there's a need for real data, so that you say well, we now have it in hand. We really know what it is. And we know what the aerosols are like and we know the particle size and we know this and we know that.
So when you have facts at your fingertips then you can make a good case about what real exposure was.
Also I would certainly like to see these veterans followed because it's a new experience. You have people with embedded stuff, and it's very good research as well as being useful for the veterans to see what will happen in the future. Presumably, like other metals where there's data, this material dissolves and slowly gets into the bloodstream. And again, you can predict body burdens from this.
I guess I've taken up a little more time than I should have, but thank you very much for your indulgence.
SENATOR RUDMAN: Thank you, Dr. Harley. If there are any questions from the panel before we proceed? Admiral Steinman?
REAR ADMIRAL STEINMAN: Thank you, Dr. Harley. I have a question that concerns your last statement.
Did I understand you correctly when you said that you had a cloud of respirable particles of DU that was opaque enough that you couldn't see the back of the room, and you would have to breathe that for two hours and then you would end up with one year's worth of background radiation?
DR. HARLEY: Less than.
REAR ADMIRAL STEINMAN: There has been some concern expressed by a number of veterans about less severe exposures of respirable particles. For example, walking through the desert where vehicles have been hit with depleted uranium rounds, produced smoke from DU oxides, and perhaps littering the ground or being blown across the surface of the ground. What's your assessment of the amount of respirable particles that come from tromping through that environment, and how much dose would that give a soldier?
DR. HARLEY: See, this is where good exposure assessment really is needed.
If you take any situation where there's some dust, typically you will find you have something like 50 to 100 micrograms per cubic meter. This is the kind of -- You just tromp around in a dusty situation. This is what you get.
Then how long are you exposed? An hour? Ten minutes? Two hours? So you're in the less than a milligram range generally for any kind of predictable situation.
When things get very bad, people can't take milligrams per cubic meter. You start to choke and cough and you get away from a situation like that.
Now occupationally you're allowed, your permitted by ACGIH, the Government Industrial Hygienists, you're permitted to two milligrams per day. That's a permissible occupational exposure.
So it's incredible that a veteran could be exposed even to something like this. This would be very unusual. Maybe if there was a fire and they were around a fire for a long time. But see, aerosol particles, the big ones, you can't breathe, and then mostly they tend to settle rapidly and be very disbursed by the wind. So that's why exposure is just, you're protected. It's a very good thing that nature handles situations like this. Dilution or deposition on the ground.
REAR ADMIRAL STEINMAN: A follow-up question. Your comments about the exposure to dust. Were you talking about average dust on the ground or sand? If not, can you comment about the weight of a depleted uranium or uranium particle and whether it would disburse in the same way that sand or dust would? By virtue of its weight but it be less than, more --
DR. HARLEY: It depends on the aerosol size that's formed. So I'm always acting like most of it is respirable, around one to two microns, but you don't know.
This kind of particle settles slowly. You could breathe it for say some hours after say a weapon exploded. But again, normal winds dilute aerosols dramatically. Average wind speeds are things like five miles an hour. Amazingly enough. You watch any sort of aerosol that you can see and it disburses very rapidly. So it's very difficult to imagine a situation where you are able to inhale milligrams of material. And remember, two milligrams is occupationally acceptable.
SENATOR RUDMAN: I have a question for you, Doctor. This morning during testimony one of the veterans who has no scientific background but I'm sure is well intentioned held up a photograph. The photograph that's being presented to you is a photograph taken in Kosovo after the hostilities ended. It obviously showed a Russian-manufactured Serbian armored vehicle, probably pretty well riddled, probably with DU rounds, we'll assume. It was disabled by probably DU rounds fired from an A-10 aircraft in all likelihood. There it sits with those DU rounds having long since penetrated and probably inside there.
He made the point that he thought it was awful that those poor children were sitting on top of that armored vehicle and could possibly get radiation damage from it.
From what I've seen from your charts, I don't think you'd agree with that.
DR. HARLEY: You know, I don't care if there are children playing on tanks that have weapons in them or exploded weapons, just as a person. But as far as a health hazard --
SENATOR RUDMAN: We're talking radiation hazard, rounds that are in the tank.
DR. HARLEY: Rounds that are in the tank. Again, the kind of exposure you would expect has been measured. Several studies were done at Battelle to measure the exposure internal in the tank from a fully-loaded tank with shielding and rounds. That was varying from 10 to 20 times normal background, depending on where you were. If you get close to the munitions it's higher, or if you're in the middle it's a little lower.
So these children could be exposed to say -- now they're outside the tank, not inside. So say the same thing, be generous. Ten to 20 times normal background.
Are they going to play in that tank for 20 days? That would be equivalent to their natural exposure from normal background each year.
SENATOR RUDMAN: Twenty days, 24 hours a day.
DR. HARLEY: Twenty days, 24 hours a day. That equals your natural background.
SENATOR RUDMAN: So your answer is, it seems to me, that what we're looking at does not present a health hazard to those children under normal circumstances.
DR. HARLEY: That's right. And they may be in a group that have a few percent more radiation from the tank than another group of children. But see, this all goes into the normal variability of background.
This area of Kosovo probably has 20 percent less than another area of Kosovo, just all naturally, due to what's in the soil in the first place.
SENATOR RUDMAN: But in any event that is not a health hazard.
DR. HARLEY: Right.
SENATOR RUDMAN: I want to make one other point here. When you talk about the aerosol effect that you have of the dust, that of course is well, that is at the moment normally that these rounds hit, and deform. What you're looking at in most cases, and I have seen DU rounds fired on practice ranges by aircraft and tanks, and my sense is that once the initial hit and a few minutes goes by, you then have an inert round embedded in armor giving off radiation, but not giving off aerosol at that point, am I correct?
DR. HARLEY: That's right, yes.
SENATOR RUDMAN: Good. Just so we all understand what we're talking about here.
LIEUTENANT GENERAL CISNEROS: Dr. Harley, I'm not a doctor, so I'm going to ask some layman questions.
Your response to the Senator's question on the hazards had to do with radiation hazard, is that correct?
DR. HARLEY: Mostly.
LIEUTENANT GENERAL CISNEROS: My question has to do with what's also in the Rand report here, review, about the most dangerous aspect is not the radiation on DU, but it's the heavy metal toxicity.
DR. HARLEY: That's correct.
LIEUTENANT GENERAL CISNEROS: So looking at the chemical toxicity of it, you earlier talked about urine, that you can measure urine. When you're measuring urine are you looking for the radiation aspects of it or can you also measure the chemical aspects of heavy metal through the urine?
DR. HARLEY: When you do urinalysis what you do is you measure the mass of uranium. So you actually do a flourometric measurement. So you're measuring micrograms of metal. You're not really doing much with the radiation. Now you could do measure it that way, but most people use the mass aspect. So you're measuring the metal.
LIEUTENANT GENERAL CISNEROS: Okay, that answers that one. So you can in essence pick up the chemical aspect by how much metal you have in there from that.
DR. HARLEY: Right. It's the same thing. Once you know how much metal say you're excreting, then you know what the chemical problem is because then you know the organ burden.
These graphs are actually in micrograms of uranium. See, that's talking metal.
So the four graphs with bone, liver, et cetera, were as weight of metal. I didn't bring in the radioactivity part of it although you can by multiplying by a factor.
LIEUTENANT GENERAL CISNEROS: I just had in my mind that uranium was just radiological, but it's a metal, so that answers that one.
Let me ask you also one final question.
If this heavy metal is twice as dense as lead, and if I recall lead was a danger to not only your kidneys but it also had some neurological effect on you, like when the children were digesting lead from paint and causing a neurological --
DR. HARLEY: Right. I'm familiar with that.
LIEUTENANT GENERAL CISNEROS: Does this
also -- This is twice as dense as lead. How does that then, have we measured -- Is it twice as dangerous as lead per milligram or whatever your unit of measure is?
DR. HARLEY: I'm glad this came up, for two reasons. One, my department studies lead a lot. We have a few persons with a lot of credentials in lead exposure. But the Oak Ridge group has really been studied for neurological effects because of this tie-in with lead.
Early on in the atomic energy programs they set the toxicity not on radiation, because they knew gee, the stuff isn't hardly radioactive. They set it based on the lead values. So the lead air concentrations which were permitted were then brought directly to what you could inhale for uranium, using that historic context.
Then they started the University of Rochester studies to try to understand more about uranium. But apparently uranium is not as good as lead in crossing the blood/brain barrier. So you do not appear to get any neurological effects from uranium, and they really looked. And there are people that are really exposed in the contractor industries in the atomic energy programs. All of these places, you've got Frenauld in upstate New York and Oak Ridge and other places in Tennessee, places in Texas. So there are a lot of people really exposed occupationally, and they have not seen neurological problems.
LIEUTENANT GENERAL CISNEROS: So the density of DU, being twice as heavy as lead, has no link into the neurological aspects of it like lead does?
DR. HARLEY: I don't know if anybody knows why it doesn't cross the blood/brain barrier as well. That's research. But it doesn't. So you have not seen any neurological effects from uranium, whereas you have seen them, apparently, in children somewhat.
Now I'm fairly familiar with the lead data, and again that's controversial. Things like lowered IQs in children and so on who have been exposed to lead.
SENATOR RUDMAN: Mr. Vice Chairman, any questions?
SECRETARY BROWN: Thank you very much, Doctor, for sharing with us your expertise and helping us get some better insight into the relationship between various types of diseases, if any, and DU especially.
I want to kind of see if I understand your whole concept from the big picture.
In your conclusions, you say no studies found showing negative health effects from inhaled or ingested natural uranium at levels far greater than those likely in the Gulf. That's pretty clear.
My question is, is that statement equivalent to saying that there can be or there are no health effects from those exposures in the Gulf? Or even those that were subjects in the studies?
DR. HARLEY: Scientists always phrase things very cautiously because you always say, well, something might be. But I'm willing to go out on a limb with depleted uranium and say there should not be any health effects whatsoever. This is based on a knowledge of what possible exposures could have existed. And the background data, the large background data of people actually exposed in the uranium industry, atomic energy industry.
Now the transuranium registry has all of these autopsy cases, several hundreds, and nothing has ever been seen that is outside of normal. And they really look at kidney, they really look at liver, anything that is related to heavy metal damage and nobody has seen anything.
So even though that was cautiously phrased it would be, again here goes the scientist, highly unlikely. Essentially a zero possibility that there could be any health effects from depleted uranium as exposed in these wars.
SECRETARY BROWN: You mentioned the autopsy results falling from the examinations of the kidneys. I think someone said today, if not I read something, that the kidneys are the organs of target and they are probably the ones that are most sensitive in terms that we can measure the amount of uranium in the kidneys. So we get some type of laboratory confirmation of exposure.
DR. HARLEY: Only after you're dead.
SECRETARY BROWN: Let's talk about that. It was my understanding that the 16 veterans that have embedded uranium, that some of them, their kidney function levels are higher than normal with respect to DU. Is that correct?
DR. HARLEY: I've been trying to get that data, and this is Dr. McDiarmid, and she has not published, and nobody will release that data. And you see, at least to me.
Now if you are exposed to depleted uranium and as Dr. Anthony just said behind me, say the soldiers with embedded fragments. All right, their body burden, their blood burden is definitely higher than normal. Higher than normal by how much? I have not seen this data.
So if you get into very elevated excretion, you will see things like a little enhanced sugar excretion, a little enhanced protein excretion, a little enhanced beta microglobulin excretion.
Does this mean that it's bad? Is this a health detriment or is this just a change, or is this say within normal limits? I haven't seen her data to see whether or not this is within normal limits.
I'd just like to expand on that one more step. Take diabetes. You have people with somewhat high sugar levels in their blood. Does that mean they have diabetes? No.
So I don't know what kind of normal excretion these people would have of sugar and protein, et cetera.
A little historic comment. At one time around the turn of the century uranium was given by physicians because of the ability to have a little higher sugar excretion in diabetics, so they thought it was good for diabetics to help get rid of the sugar.
SECRETARY BROWN: Dr. Murphy, do we have any data on the urinalysis of the veterans who have embedded uranium?
DR. MURPHY: (Away from microphone) Secretary Brown, I don't have that data with me today, but it's been presented at meetings -- is on the record -- uranium levels are clearly elevated in those who've embedded -- uranium fragments. The beta microglobulin and other measurements in the urine are normal -- (away from microphone.)
DR. HARLEY: See, my colleague at the Department of Energy actually ran one of the urine samples for quality control, and I do sort of vaguely remember it was a few micrograms per liter which is a factor of 10 or so, 20, more than you would expect from a normal population. But it's nowhere near what you'd expect to be finding kidney changes like these protein excretion and so on.
SECRETARY BROWN: Just kind of bear with me because I really want to understand this.
So what we're basically saying, and I think we have this right, that veterans who have this embedded uranium, their kidney function tests are elevated with respect to DU. However, it has not at this point reached the point where there is some pathological change. I guess you could say this is a laboratory change. It's an abnormal change. It's elevated, but it's not to the point that you can say that there is a disease process present. Is that correct?
DR. HARLEY: Yes. But as a scientist I always feel they should follow this person for a long time.
SECRETARY BROWN: Absolutely. Because it's an indication that something may happen --
DR. HARLEY: No, no, no. It's not an indication that something may happen. It's that you want to know the whole story, that's all. Because an embedded fragment is most likely, again, an insoluble oxide. The solubility is fairly predictable. It's going to be just slowly dissolving at about the same rate over time, and maybe it will even go down, because the body has a habit of encapsulating things like this, and that would inhibit this entrance into the bloodstream. So you'd like to know the biology and the science of what's going on.
But in all probability you have essentially this more or less constant release from solubility into the bloodstream. So therefore nothing is going to be percolating or cooking in the future by way of these other tests like protein urea.
SECRETARY BROWN: Isn't that a statement that only time will tell on whether or not there is or ever will be a relationship between these elevated urinalysis and any subsequent development of a disease process? Isn't that one reason you would want to study these veterans?
DR. HARLEY: Yes. However, you don't expect anything unusual or dramatic to happen in the future, like all of a sudden the whole thing dissolves. This is not within any kind of scientific framework.
SECRETARY BROWN: I think if I were a veteran and I had this stuff in me I wouldn't necessarily be looking at it from that standpoint. I would be looking at it on whether or not I'm going to come down with kidney disease or I'm going to have some other pathological impairment as a result of the DU in my body.
Let's just hold that thought. I want to go back to something the Chairman talked about.
This photograph that you have here, and I clearly understand about the 20 days, the 24 hour, 20 days and all of that.
Let us say that if it were my child or your child and we now know that at least with respect to embedded uranium that it can bring about a change in kidney elevation.
My question is --
DR. HARLEY: But it hasn't. I don't follow. What do you mean it's brought about a change in kidney elevations?
SECRETARY BROWN: I'm talking about the urinalysis --
DR. HARLEY: Okay.
SECRETARY BROWN: -- in those veterans who have embedded --
DR. HARLEY: Yes, that's clear. That's true.
SECRETARY BROWN: These kids playing in this tank, and I'm trying to understand the process here. A tank that has been hit by DU with maybe jagged fragments from the penetration of the rounds. At the same time the heavy metal has, is now on the floor and the kids get cut, possibly they get some of this metal in their bodies, and under a scenario like that, as unlikely as it may seem, is it possible that they too could end up having increased levels of DU in their urine?
DR. HARLEY: Generally in a case like this with say children playing. Suppose there was aerosol powder on a tank floor or something and the kid wipes his hand and then actually ingests it. A small fraction of this kind of uranium is absorbed into the blood, and then it rapidly is excreted.
So even occupationally when someone has been exposed to rather high levels of uranium, you have to do urinalysis really fast in order to catch that there's been an exposure.
So the body is really very protective. In the case of uranium especially, you're getting rid of this material. Your GI uptake is very low. Then what does get into the blood is gone rapidly. You've got 90 percent approximately is gone in one day and the rest in a matter of days.
SECRETARY BROWN: I just got a note here, Doctor, pointing out that they have elevated levels in their urine, uranium, and not abnormal kidney function. I clearly understand that. What I'm just saying, to me as a lay person, something is abnormal in my body and that suggests that it's not normal. I want to know is that going to lead to something else.
Let me get back to these children, and then I'll be finished.
What I'm trying to get at is if we had the jagged edges with loose fragments, is it possible that some of these fragments can become embedded in these children, and as a result they too will have increased uranium in their urine?
DR. HARLEY: Yes.
SECRETARY BROWN: Thank you very much, Doctor.
DR. HARLEY: However, I have to qualify that because you can't get an embedded fragment by cutting yourself on some sharp edge and having something in your skin that will last very long. And even if it did, you get a fragment of some milligrams, and this lasted their whole life, you still couldn't make a case out of it from either a toxicologic or a radiation point of view.
SECRETARY BROWN: Thank you.
SENATOR RUDMAN: I just want to follow up, though, because I don't want to leave any misimpressions here, so we have a clear understanding of the testimony.
We have some veterans that have unquestionably embedded uranium. They're being studied.
My understanding of the study is, and I have read what is available, and I'm not sure why you don't have it, is that what has been determined is that certain changes have taken place, but those changes are not abnormal to cause illness, to cause kidney disease. And they are predictable in that they are the same, they are constant, because whatever is being given off from that uranium that is embedded is being given off at a constant rate.
DR. HARLEY: Right.
SENATOR RUDMAN: And there is nothing that would change that from giving it off at a constant rate. It's a material which deteriorates at a known rate, is that correct?
DR. HARLEY: That's correct.
SENATOR RUDMAN: So the Vice Chairman was following up on a question. I don't want the impression given that somehow, unless we see over -- These people have been studied now for quite some time. If there is a certain rate of deterioration of that uranium, that depleted uranium, causing a certain known change in the chemistry of the kidney, and that is measurable, which it is. It's being measured now on a regular basis. And that appears to be within normal ranges. Then the likelihood of anybody getting kidney disease from that depleted uranium is very low if not zero.
DR. HARLEY: Correct.
SENATOR RUDMAN: Is that correct?
DR. HARLEY: Yes, absolutely correct.
DR. CAM: Dr. Harley, you mentioned earlier that there is a need for background information as well as actual exposure. That's the ideal situation. This is something maybe DoD can get for existing and future deployments.
But in this case we're talking about a case where there is deficiency of data, and yet it is perceived out there there is some health risk, and there is uncertainty, to some degree there is some uncertainty in the scientific evidence.
How can we come up with some kind of explanation or statement to reconcile these things? I was wondering whether to use the concept of acceptable risk, if that would be helpful.
DR. HARLEY: I do a lot of risk modeling, and you can't get any risk from these exposures. I cannot calculate a cancer risk, for example, from the radiation that would be even considered anything but trivial by all the radiation bodies. They say it's a negligible, individual risk. So this is the kind of risk we're talking about.
Still, you're dealing with people. These people want to know was I exposed? If so, what is my risk? That's why you want data. You always want data, data, data, and facts. So if you have -- I'm sure they do a urinalysis program in the military. So if you had just one extra test on urine samples, one every 100 or whatever, you develop a database of background information of what normal military people excrete in the way of uranium every day from their diet, from different water. Everybody drinks a different content in the water. If you drink Poland Spring it's probably different from Deer Park, et cetera.
Then you would see this distribution of what's called normal.
Then when somebody comes in and says I think I have an exposure, maybe some sort of fragment or something that somehow got undetected, and it's ten times above what you consider normal for distribution, then you say yes, that's an exposure. Then yes, you can go all the way to risk.
You tell me the urine of these military people with embedded fragments, and I can go to cancer risk. That's easy. There's a lot of radiation data.
SENATOR RUDMAN: I think unless there's something urgent to ask we're going to wind it up there. We're an hour and ten minutes late.
I want to talk to the panel for a moment if I can. I want to suggest a change in our schedule here.
I happen to think that this issue that we're talking about now is the single most important issue for us to hear about today.
We've got another witness here from the Armed Forces Radiological Research Institute on DU studies, that's Dr. McLain. Is he in the room? Dr. McLain is in the room.
We also were supposed to hear today on something that has little to do with our primary objective but a lot to do with looking ahead, and that is the item that was supposed to appear at 1330, and that's the Health Affairs Joint Staff Update on Pre- and Post-Deployment Medical Surveillance. We're now talking about the present. We're not talking about the Gulf War, we're talking about the present and the future.
That's very important. We cut their time down anyway from what they wanted. They wanted more time than we gave them, and we're not going to have that much time.
I'm wondering if we might not, we've got to hear from the GAO, to reserve for our next hearing, General Claypool and Admiral Cowan, or whether you just want to keep going and run very, very late. I'll leave that up to the panel.
I don't know what their schedules are either. We're running well over.
DR. ANTHONY: Dr. Harley has a 3:00 o'clock training to make.
SENATOR RUDMAN: Dr. Harley we've heard from. But rather than bifurcating this, I would rather hear, we're talking about these depleted uranium studies, I'd rather hear from Dr. McLain, then the GAO. You're not going to have enough time for General Claypool. What's your pleasure?
SENATOR RUDMAN: General, Admiral, you've been here faithfully all day. This particular subject is of extraordinary importance to the Board. What you have to say is also, but in a very different light in terms of recommendations.
I'm going to suggest that we reserve that, and I'm sorry to do that, and I apologize very sincerely, but it's obvious from the last witness and her enormous credentials that the Board had a lot of questions for her, and it's extremely important. We also have to hear from Dr. McLain and the GAO.
So I would like to arrange, and we will arrange, to have another hearing for the express purpose of hearing your presentations. I again am very sorry it's worked out this way, but that's the way it happened.
MAJOR GENERAL CLAYPOOL: Maybe I can use that to bargain for a little more time next time.
SENATOR RUDMAN: Absolutely. General, you're right on target.
Because one of the things we have to do in our recommendations to the Secretary and the President is to talk about future deployments. What have we learned from this and what are you going to do differently? The staff told me you wanted more time than we gave you today, so I guarantee you we'll give you the original hour you asked for.
MAJOR GENERAL CLAYPOOL: Yes, sir, I would propose that force health protection is such an important new way that we assure the health of our deployed forces that perhaps that to weave in some of the question as to a larger overview of force health protection, and we'll be able to devote more time to it; I think that would be --
SENATOR RUDMAN: And maybe just have a hearing just on that and have it here in Washington.
We're going to do that. Thank you very, very much.
DR. McLAIN: Thank you.
SENATOR RUDMAN: Dr. McLain is the acting team leader of the depleted uranium team at the Armed Forces Radiological Research Unit [sic] in Bethesda. We welcome you.
Under our original plan you were going to have about 20 minutes for presentation and then questions. Will that do it?
DR. McLAIN: I think we should be able to cover it that way. I'll go through the slides fairly quickly.
SENATOR RUDMAN: Proceed.
DR. McLAIN: Good afternoon, Senator and members of the Board. We've been asked here to present or summarize the research being done by the Armed Forces RadioBiology Research Institute. I brought with me two of our principal investigators, Dr. Alexandra Miller who is going to be back in just one moment. Dr. Miller is investigating the carcinogenic potential of depleted uranium, of embedded fragments of depleted uranium. And Dr. Kim Benson is looking at the reproductive toxicology of depleted uranium fragments.
You can pass that. That's in your copy that you have. That's just the point of contact.
I just wanted to give you a little background of how our studies originated.
The Gulf War involved the first known combat use of munitions made of depleted uranium. In the Gulf War only the allied forces possessed this weapon. As a result of a number of unfortunate friendly fire incidents, there were friendly fire casualties.
The military was very interested in the surgical guidelines for metal fragment removal of the veterans, the individuals who survived these friendly fire incidents. Standard surgical guidelines at that time dictated that metal fragments should be left in place unless they have some greater potential for causing damage. The question, though, soon arose right after the Gulf War was are these guidelines really appropriate for a metal with the sort of unique chemical and radiological properties that DU possesses.
One of the primary driving things about this is not just the well being of just the relatively small number of veterans who were injured by these fragments. The biggest problem may come in future conflicts because a number of nations have already developed depleted uranium munitions, unfriendly to the United States. And I think that in the future we can expect that these weapons will be shot at us so we can expect a large number, an increase in the number of casualties in future conflicts.
Our AFRRI DU program, research program, is a relatively narrowly defined one. It's not looking at the general health effects of depleted uranium. We are looking specifically at trying to answer the question if there are short and long term risks that are associated with embedded DU fragments that warrant changes in the fragment removal policies currently in effect in the military.
I brought this picture just to show you why this is an issue. You say why not go on, if this stuff is possibly nasty, just go and take it out.
This is an X-ray of a veteran, a lower leg of a veteran who was wounded by DU shrapnel. I put all those little arrowheads just to point to what are DU fragments in this individual's limb. These are just the ones that you can see on the X-ray. There are smaller ones that are present there. So it's clear that you can't just go in there and chop out every little piece of fragment you have.
So you're facing the situation where these fragments are going to probably be left in place in the veterans.
I think I can probably bypass this one in the interest of time. That was just a history of the DU program at AFRRI and you have that on your handouts, so you're welcome to take a look at that.
Our research at AFRRI is done in laboratory animals. We're not working with humans or human subjects at all.
Our general experimental approach has been to do chemical toxicity and fetal effects studies using a rat model in which we have implanted small cylinders of depleted uranium. We then in these studies measure uranium distribution from the site of implantation to critical organ systems, and we've used male, female, and also looked at the fetal levels of depleted uranium redistribution.
As a part of these studies we've been looking at the carcinogenic potential. Can these DU fragments, the exposure to these DU fragments, lead to cancer in these animals?
We've also looked at the potential toxicity on the nervous system and immune function in these animals.
Now our whole purpose in this is to analyze the risk and develop treatment strategies that may impact upon the fragment removal policies in the military.
Today I'm just going to talk about three basic studies that we've done and I just want to give you a quick representation of some of the data we've gotten. I want to stress that all of the work we've done to date is published in the peer review literature. It's available. It's completely open and it's available to anyone who wants to read the articles.
One of the primary, or the initial study that AFRRI did was a study that began early in 1995 and was completed early in 1998. This was a DU toxicity and distribution study. This was basically just a study to look at a toxicity study of depleted uranium from these fragments.
We used a male rat model in these studies. In these animals we implanted in the leg muscle, we implanted four, ten, or 20 pellets of depleted uranium. The control animals had tantalum. It's a metal that's often used in human prostheses in surgeries and stuff. All of these animals received a total of 20 pellets. If an animal receive four pellets of depleted uranium he also received 16 pellets of tantalum, so all of them had the same number of pellets. That's a pretty hefty dose or a pretty heavy weight of metal carried around in these animals.
I want to say that these exposures, the amount of uranium in these animals, although an individual pellet, one by two millimeters, approximates some of the largest fragments that were found in the Gulf War veterans, the total number of pellets here is far in excess of exposures that took place in the Gulf War primarily because we're trying to push the system so that we do see some kind of effect.
At any rate, in these different animals, in these control and DU exposed animals, we then wanted to measure the DU distribution over time to various organ systems. We also paid a great deal of attention to the kidney and bone histology. Did they look different? Did these organs have any kind of apparent damage to them under the microscope?
We also did kidney behavioral and neuro-physiological, at least on the kidney we did biochemical testing of the kidney, looking for some of those parameters that you just talked about with Dr. Harley, about is there any evidence of damage to the kidney.
One of the simplest things you can do in a toxicity study is to look at the animals that are embedded with these depleted uranium fragments or not embedded with them, and to assess the rate at which they gain weight, their normal weight gain as these animals age.
It's a little bit difficult to separate the colors out here, but in general you can see that the animals with the 20 DU pellets, that's the bottom line actually on the graph, or the color you see up there. You see that these animals that had 20 DU pellets gained weight more slowly than animals that had no pellets or just 20 tantalum pellets present. So there's something going on with these animals. We don't know exactly what this is. This is just one level of indication that there's something that is different about these animals. It may be that they just don't eat as much. We don't know. This doesn't mean that they're sick or anything. This is just a first level indication of some kind of problem.
When you take these animals, we did at various time points after they were implanted with the depleted uranium pellets, we did at one month, three months, six months, 12 months, and 18 months. Eighteen months is about the limit of this experiment because that's when the animals really, that's their longevity.
What we did was we wanted to measure how did the uranium redistribute from the implanted pellet to some of the various organ systems. These are just some selected sites that we measured in these animals.
If you look on the left-hand panel first, you can see that on the Y or the vertical axis, this is the measure of uranium in nanograms of uranium per gram of wet weight of tissue that we looked at.
Across the bottom of the panel you can see the four different tissues, three different tissues -- kidney, tibia, muscle -- and also those are just urine level measurements.
The four bars in each one of the groups are the four, the tantalum control, the low DU which is the four, the medium, and then the high DU which is the 20 pellets. Notice that the tantalum levels which are the controls, you don't really see, there's nothing visible here using that access scale that you see on the left which runs up to 8,000 nanograms per gram at its maximum.
What you see with this data first of all is that you see that at 12 months after implantation, this uranium has migrated from the pellet to these various tissues, and you can see that it's migrated at a level to an extent based on the number of pellets that were present in these animals. So this is a demonstration that this redistribution is associated with that depleted uranium pellet.
You can see that if you look in the kidney, if you look at the 20 depleted uranium pellets, the blue bar on the kidney, you can see that it approaches, it's about 5500 nanograms per gram of tissue. This level of uranium in the kidney was the level that we were really seeking because the present guidelines for uranium exposure are 3,000 nanograms per gram of wet weight tissue. This is where the NCRP has decided as being a level to shoot for in terms of kidney damage. If you get above this, then you're probably seeing kidney damage after this.
But you notice, we've gotten fairly close to that in these animals, and the rats are roughly similar to the human in this regard in how they respond to metals like uranium. In just a second I'll tell you more about some of the physiological tests about that. But you can see that the kidney received uranium from that embedded pellet, the pellets. The tibia, that's the large bone in the lower leg, had a lot of uranium present in it.
Muscle that was distal or distant from the pellet implantation also received, it's a known site where uranium will collect. You can see that the urine levels that these animals were excreting in the blue bar is about 1,000 nanograms per gram, or that's about 1,000 nanograms per milliliter of urine. This is a level about 30 times, a little more than 30 times the level of uranium coming out in the urine of these animals that you saw in the Gulf War veteran who had the largest amount of depleted uranium. The question sort of came up about how much uranium was present. That veteran, the maximum levels they ever measured were about 20 nanograms per milliliter, or 20 micrograms per liter. So that's about the highest level that was measured in any of those veterans that were wounded by embedded fragments.
So here you can see that we're talking about much elevated levels here. We've got about 30 times what you saw in the wounded veterans. This is to our advantage because we're trying to push this system so if we're going to see any change at all, we may have to push the levels here just to try to generate a change.
On the right-hand panel, at the 18-month time point, this was the last point measured, we also did some additional organs that we did not do in the earlier test. One is the brain. We looked at the lymph nodes, testicles.
The brain, notice the scale there underneath in parentheses, it's times ten. So if you look on the vertical axis there that goes from 0 to 1,000, that's different than that first panel.
But in the brain we did measure a distribution of uranium into the brain. It's at a low level, but it's distinctly present and it's related to the number of pellets that you had implanted in the animal.
We also found it in the lymph nodes. This was not unexpected.
We also found it in the testicle, which was not necessarily unexpected, but at the levels we found it, it was somewhat unusual. Like other heavy metals, this can penetrate in the brain, in the case of the brain the blood/brain barrier. It can penetrate it. It also can penetrate the blood/testicular barrier which is very similar, analogous to the blood/brain barrier.
So just to summarize this data, you can see with the bullets there, we have shown that it redistributes from, uranium redistributes from the pellet to the various organs and tissues, especially bone and kidney. We also found it in the brain, the lymph nodes and the testes here.
But what is interesting about this is if you look at the kidney, the amount of uranium that is present, if you were to inject an amount of uranium in a single bolus injection into this animal that would reach this level of uranium in the kidney, and it would do it very rapidly if you injected it, the animal would be dead in an hour.
What apparently is happening here is these animals, because of the slow release of this from the pellet which as Senator Rudman pointed out, this sort of slow, steady state release that's occurring, the animal apparently adapts to the presence of this uranium.
What we found was, despite our extensive looking, we found no apparent changes in the histology of the kidney or the bone, and we found no changes in all of the biochemical tests that we could do that assessed kidney function. So despite the elevated levels of urine uranium here -- again, 30 times what you saw in those wounded vets, we still see no changes in the biochemistry that indicates kidney damage.
I just want to stress that all this work is supported by peer reviewed grants. It's externally refereed work. This is not just work that we're doing in-house.
As a part of that original toxicity study, though, we looked at some of the brain levels. We found that although at very low levels, uranium was crossing the blood/brain barrier. We intended to do a series of sort of basic neuro-physiological tests of these animals, and this was done by Dr. Pellmar who headed up this work. And it was a series of very complicated sort of results so I've attempted to summarize this with these two different groups of bars here.
If you look at the blue bar, which is the control, those are animals that only had tantalum. And you look at the pink bar which were animals that had the four pellets of DU in this particular study.
A series of measurements, you can summarize what we observed by seeing that with the presence of the depleted uranium, if you do some slices to the brain and look at the hippocampal region of the brain -- this is the part that deals with cognition and awareness in a human being -- that there were changes, physiological changes or measurable changes in the electrical qualities of these neurons such that the synaptic potential and the excitability threshold in the DU animals was elevated, meaning that you had to put more current in to make the nerve do what it would do normally. So it was sort of almost like a little bit depressed in its activity.
However, I do want to point out that just the measurement of this capability as we've already discussed with Dr. Harley, although there is an indication of a change here, there's no indication at this point of any kind of pathology that's associated with it. So there's no indication that this has caused any damage to the animal.
In this series of studies we did an extensive battery of behavioral tests. Not the most sensitive tests for these kinds of things because we didn't anticipate this result, but we observed on the tests we used there were no behavioral changes in the animals that had DU versus animals that didn't.
I want to stress that we saw no evidence of pathology in the brain.
This data is interesting enough that we have received a peer reviewed, a research grant from the United States Army Medical Research and Materiel Command to follow up on that.
To quickly go through this, the effect of DU on fetal development, I won't describe the model. It's very similar to the model we used before except we used female Sprague-Dawley rats. We used a different, at this time we didn't know how much DU we should be implanting in these animals, and we used a different range of DU pellets, so four to 32 pellets in these animals.
The animals were made pregnant after the implantation of the pellets. Then we looked at the redistribution of this uranium in the pregnant females.
Can we go to the next overhead?
Just to quickly summarize two aspects of the data. If you look on the left panel, we looked at the uranium levels in the fetus. First of all, we confirmed work that had been done earlier that uranium does indeed cross the placental barrier in these animals. And we did find that there are very slight levels of uranium that do appear in the fetus, in nanograms per gram. If you look on the vertical axis there.
If you look at those levels we're talking 1.5 nanograms per gram versus the kinds of levels that you saw in the kidney up in the thousands, but it's there, nonetheless.
And in the second panel you see litter size effects of uranium. What this study is, we implanted the animals, then at various times after surgery they were bred. So at two months, if you look at the bar, series of bars, two, four and six months. The first bar were animals that were bred two months after implantation; the second set of bars, four months; the last set of bars six months after implantation.
This is preliminary data, but what we did find was there was a decrease in the litter size in these animals if you waited longer for these animals to have that pellet in them before they were bred. Presumably related to the fact that there's more uranium going through their system.
May I have the next one please?
Just the last series of studies I just want to describe. This is a series of studies by Dr. Alexandra Miller who wanted to look at the transformation, mutagenicity and carcinogenic potential of depleted uranium fragments.
Our question was really do these embedded fragments pose a long term risk of cancer. This was based on the fact that other heavy metals have been shown to have carcinogenic potential.
We used both animals that were in this previous study I just described, the toxicity study. For some of those tissues, we did analysis of those. We also did a great deal of work in cell culture, so that's the in vitro work using standard methods.
Just to quickly describe the kind of things that we found. These series of data discusses [sic] work done in cell culture. These are human cultured bone cells. We found that if you expose these cultured cells to depleted uranium that these cells transform or change themselves to a cell that looks like a cancer cell. It doesn't mean that it's a cancer cell, but it has a cancer phenotype or a tumor phenotype so it looks like a cancer cell.
There's an example of that in the upper panel. You see the normal cells, these are cells that normally grow, growing on this particular culture, matrix here that it grows on, that's what they look like.
If you expose them to DU they do change their confirmation, so they do look different.
The question is are these cells -- How many of these cells are transformed? And how many of these cells look like cancer cells?
In the lower, in the table if you look at just the first row please, first, the transformation rate, that first number, 4.2 that's the number of cells that just spontaneously transform. So 4.2 out of 500,000 surviving cells if you look at the first asterisk underneath the table. 4.2 out of 500,000 cells will transform themselves.
This table has a lot more data than I really want to discuss here, but I wanted to bring your attention over to the soluble DU which is the third column from the right. You can see that 40.2 of those 500,000 cells were transformed to cells that looked like those transformed cells in the upper picture up there.
Also I want to point out that if you look over at nickel, nickel is a known mild carcinogen, so it's been recognized for many years as such. It has a transformation rate of about 29.9. So you can see that it's roughly comparable to soluble depleted uranium.
The question is just because a cell is transformed to a cell that looks like a cancer cell, is it a cancer cell? No, it's not.
Does it form a tumor in an animal, is sort of the next question you can ask about this. Sort of the next level of stringency of tests.
If you look at the bottom row on this table, if you look at the tumorogenicity, first let's look at the untreated cells. Even though 4.2 out of the 500,000 cells were transformed, when you took one million of those transformed cells, of the 4.2 cells, one million of those, and injected them into animals, in 82 experiments none of the animals developed a tumor at the site of that injection. So that transformed cell, the untreated cell, did not demonstrate any capability of forming a tumor in the animal.
Again, let's go over to the soluble depleted uranium. In this case 11 out of 25 experimental animals developed tumor when they were injected with the transformed cells. In the case of nickel, again, a recognized carcinogen, 7 out of 24 of those animals developed tumors.
I'll summarize this data in just one second a little bit more fully.
We wanted also to look at whether there was any indication that these cells are changed in other ways that may indicate some kind of carcinogenic potential.
In this graph what we did was we looked at liver, muscle and kidney from some of those animals in that original study that I described, that toxicity study. There were a large number of oncogenes that were looked at, and these oncogenes are genes that are often associated with cancer development or changes in cells that make them appear to be cancer-like.
If you look in both these two genes, the ras and the P-53 are both elevated in all of these cases here. If you look at the Y axis or the vertical axis, this is compared to the normal cell. You can see in the liver, four-fold in ras and a four-fold increase in the P-53 gene also.
So this is another level of astringency, so these things all are an indication of some kind of change in the cell.
May I have the next?
Just to summarize, we've shown that DU transforms cells, and soluble DU can form tumors in mice when these cells are injected, these transformed cells are injected.
In studies I didn't show you, DU, we've shown it's mutagenic. It can change using this Ames bacterial reversion test. It's a standard assay for mutagenicity.
Other studies have shown DU induces genetic instability.
One interesting point we should make is that we can suppress all of these effects by incubating those cultured cells with a compound phenyl acetate which is a compound currently under investigation by NIH for blocking cancer development.
In our in vivo studies, or studies with the animals using the tissue from those fragment embedded animals, we found that there's a time- and DU dose-dependent increase in oncogene expression. And we also found that the urine from these DU implanted animals is mutagenic, probably because there's uranium there. And we found that also oncogene proteins were detected in the blood of these animals.
Our conclusion is that there's fairly strong evidence to support a detailed study of the potential carcinogenicity of DU, but we have not, none of our animals, by the way, developed in this study, none of the animals were shown to develop cancer, so we don't know that this is actually going to happen. We need a full study to determine that.
Last slide please.
Well, I won't go into that. This is just some of the future direction of our studies, I'm sorry.
SENATOR RUDMAN: Let me just have one brief question for you. You started out by telling us that the purpose of this study, Dr. McLain, is to determine whether or not the policy of DoD towards fragment removal for battlefield casualties should be changed.
What I'm a little bit confused about, and I must say that for a non-scientific person some of these presentations were a little puzzling, maybe not to Dr. Steinman, but maybe to the rest of us. But obviously if you load somebody up with 30 pounds of DU, you took me up to the hospital and implanted me with 40 pounds of DU, I'm obviously going to have some problems.
But what I don't understand is how does that study help you in what you're trying to determine? There didn't seem to be a correlation between the relative weight of the fragments versus the weight of the laboratory rat to the weight of the fragments versus the weight and the body fluid count or volume of the average soldier. So how do you get to a conclusion here?
DR. McLAIN: The conclusion is, it's similar to most kinds of studies that are done this way by the National Institutes of Health and anyone investigating cancer development stuff. You want to try to push the system to the point where it can develop a problem.
We ran the low levels of DU, which are still appreciably larger than what you saw in the veterans. The low levels of DU, we didn't see any remarkable effects even at the low levels in terms of kidney toxicity and we didn't see any, in these particular studies we didn't see any cancer development in these animals. So we're trying to push the system. So even at the higher levels, except for this possibility, this potential of some carcinogenic risk that may be analogous to other heavy metals, we are saying that it appears that this stuff, at least at the lower levels, does not appear to be a problem.
SENATOR RUDMAN: But obviously at the higher levels it's a carcinogenic agent.
DR. McLAIN: No, no. One of the problems with presenting this data is when you say just because you find an oncogene or you find something that is tumorogenic, it does not mean that this thing is cancerous. That work has just not been done. We feel the work should be done. But just because, these are manifestations of cells --
SENATOR RUDMAN: The slide just before this one is the one that said at the bottom that you thought it indicated more work should be done.
DR. McLAIN: Really all of that data on the carcinogenic potential. As we understand it now, it's not normal for a cell to express like oncogenes. It doesn't normally express those kinds of levels of oncogenes. But an injured cell, not necessarily a cancerous cell, can also express oncogenes. A cell that expresses oncogenes can sometimes repair itself and not -- after it's been injured and then repaired and it doesn't express the oncogene.
So it's the kind of thing that there's a body of evidence that we feel is the primary purpose of this evidence and we feel justifies the need for further study. We are not saying that this stuff is carcinogenic.
SENATOR RUDMAN: Good.
SECRETARY BROWN: Dr. McLain, that was an outstanding presentation.
I'll tell you, before I heard you I was beginning to believe that there was no possibility of a relationship between some of the complaints of our veterans and DU. I'm not saying that you've made any statements directly to the contrary, but I have to tell you that to me it's very important that for the first time I've heard a scientists say that uranium was redistributed to the bones and the kidneys, the brain, the lymph nodes, the testes, the placenta, the fetuses. It's involved in reproductive activity. And I think that's very, very important to --
DR. McLAIN: One thing you want to remember, and you have to differentiate between the fact that the uranium is there and any kind of pathology that's been noted.
SECRETARY BROWN: I understand. Don't get me wrong. I understand what your basically saying we've been through with respect to the kidneys, that there is elevated urine results but no pathology. We clearly understand all of that. But this is the first evidence that I've heard which really shows that it is possible -- I'm not saying that it's probable. I'm saying that it is possible. I think it lends more support that we really need to take much, much more, have much more research and have some real smart folks like yourself, sir, to continue to look at this to make sure that no stone is unturned. And to simply dismiss high elevated uranium urine analysis by saying it causes no pathology risk to the patient, I don't think that's good enough because we don't know what the future has to offer there.
We need to have some folks come up, look at this stuff very, very closely and give us a sense that it raises no risk now and it will raise no risk 10 years, 15 years or 30 years out in the future. I think that's very important to the peace of mind of the veterans that have been exposed, and I also think that it will go a long way to bringing piece of mind to the veterans, our sons and daughters that we're going to ask to place themselves in harm's way in the future.
Thank you very much for those observations.
DR. CAM: Dr. McLain, I have a couple of questions.
Last year when I was in your lab in November you had mentioned you had started a study on some osteoblast cell lines. I just wonder whether the results are in here or the study has not been finished.
My second point is I understand there's some plan of reorganizing AFRRI. What do you feel will the impact be?
DR. McLAIN: In terms of the in vitro studies with the human osteoblast cells, those studies, most of them are complete. There is a paper in publication that will be published on that data. There's some additional work that's continuing to be done on that work. Dr. Miller, who is doing that work, could summarize that if you wanted more information, exactly where the status of those studies is, but it will be published.
The reorganization of AFRRI is of unknown consequence to us at this point. We don't know exactly what's going to happen. I don't think it's going to impact the depleted uranium work. I think a lot of this work is being done under peer reviewed grants from outside agencies. So I believe the work will go on.
As any researcher will tell you, we need more money to do this work effectively. More money and more personnel. But we don't feel this reorganization will necessarily impact AFRRI. It may slow us down, though, as we get reorganized.
DR. CAM: Is it possible you can give a quick summary of the findings of that human cell line study?
DR. McLAIN: Basically the findings that you have are what you saw there. The human osteoblast cells can be transformed by uranium, by incubating those cells in uranium. And again, transformed means they're changed to a cell that looks like a cancer cell. That doesn't mean it's a cancer cell.
Also, depleted uranium can cause these cells, or at least some of those cells, to actually have the capability to develop a tumor in an animal. That's a special experimental situation. It's not really analogous to anything that happens in the human, but it's just an experimental system that one uses to look for abnormalities in these cells. So those kinds of results, which have been summarized on numerous abstracts that have been presented outside, that have yet to appear in publication.
ADMIRAL STEINMAN: A couple of questions.
The three different levels of uranium pellets that you implanted in the animals. You used the figure, one of them was equivalent to 30 or 40 pounds in a human. What would the equivalent of each of those three levels be?
DR. McLAIN: I never really have calculated it, I'm sorry to say.
The best measure, it's sort of like what Dr. Harley said. The urine levels of uranium that you see are often an indication of the organ loads inside the body. Although we haven't correlated that directly in the rat. She was talking about humans and other studies. Various other studies.
I tried to point out, not very effectively, I guess, but point out that the animals in this study, at 12 months they were urinating about 1,000 nanograms per milliliter or 1,000 micrograms per liter of uranium. And just to correlate that with what was seen in the veteran study by Dr. McDermott up at Baltimore VA, I believe the highest levels they ever measured were about 20 micrograms per liter. So you can see that there's about a 50-fold increase. Therefore there's probably 50 times more uranium in these rats than there is in the human relatively.
ADMIRAL STEINMAN: The 1,000 level you spoke of, which level of rat was that? Was that the highest --
DR. McLAIN: That was in the high dose. The lower levels I think went down to about 400, I believe. I'm not sure about the exact data. You can probably estimate it from the handout I gave you there.
ADMIRAL STEINMAN: It has been suggested that as a heavy metal encasing for a penetrating weapon that tungsten might be safer than depleted uranium. I see there were some tungsten studies done on the tumorocity ratings, but you didn't do that on the pellet implantation. Is that an intended study in the future, to see if the --
DR. McLAIN: We have submitted a research proposal to the U.S. Army Heavy Metals Office in Picatinny Arsenal, New Jersey, to do exactly that study. It would basically be an analogous study using tungsten alloys, a pellet experiment just like we did here, but using tungsten alloys that are identical to alloys that have been proposed or that are currently being used for tungsten weapons.
This stuff, one interesting lesson here is that this stuff is apparently more toxic than uranium. So people that say let's just go to tungsten, it will be okay, this points out the need for studies of these kinds of situations before you go to the point of actually fielding a device like that.
ADMIRAL STEINMAN: Thank you.
SENATOR RUDMAN: Thank you very much. I'm sure we'll be talking to you again.
Mr. Gebicke is here.
MR. GEBICKE: Good afternoon.
SENATOR RUDMAN: Welcome.
I notice that on the original schedule we had you scheduled for about a 20 minute presentation. If you can do it in that or less, that will be fine.
MR. GEBICKE: I'll be glad to do it in lot less if it's okay with you.
I'd like to introduce to my right, Mr. Bill Cawood, and to my left, Mr. Steve Fox. They were instrumental in the work that we did at OSAGWI.
I'll summarize in about five minutes for you.
We looked at the operations of OSAGWI principally in late 1997 and 1998. We looked at them in two ways. We looked at OSAGWI on a broad front, and that is what resources did they bring to bear to the problem that confronted them and the objectives they had to meet.
On a broad front, we noticed that they had increased their staff level from 12 to about 200. They'd increased their budget from a little over $4 million a year to over $29 million a year. We noted that they had access to all of the information that they needed to conduct their work, both classified as well as unclassified. We know also that they made a lot of efforts and inroads to work with the veterans in terms of providing communication with the veterans and veterans groups, responding to inquiries that were made to them. They also worked with DoD to protect service members on contaminated battlefields by working in a number of areas, but just to mention a few to you, to ensuring that the detection equipment was less prone to false alarms, that implementation of training for dealing with depleted uranium which we heard about earlier was underway. And finally, improving the medical recordkeeping and the management.
In addition to looking at OSAGWI's operations in a broad sense, we looked at them in a very, very specific and in a very detailed sense as well. As you heard discussed earlier this morning, the principal output and the principal product from OSAGWI is its investigations and its cases.
At the time we began our review, eight cases had been completed, and we opted to select six of those cases and to look at those cases in great detail.
We found in looking at six cases that three of the cases had weaknesses -- weaknesses that I would probably consider to be significant. However, in the six cases that we reviewed -- and the other three, I should mention, had no such evidence of weaknesses. Of the six cases, however, we only had one where we found the evidence was such that we questioned the outcome or the conclusion that OSAGWI reached concerning that case. I'll give you an example.
I'll start with the one example of where we disagreed with OSAGWI's outcome at the time we reviewed the case. It involved the U.S. Marines during a minefield breaching operation.
OSAGWI concluded, if you recall, that the exposure in that particular case was "unlikely," but we found that the case narrative didn't include some key information that was available in its files. In other words, OSAGWI had this information in its files and it was not included in the write-up.
Specifically, they had information on the presence of artillery fire that contradicted one of the case narratives primary determinations, namely that no artillery fire or chemical mines were present. Therefore, since there was no means of delivery, chemical agents probably did not exist. We found that not to be correct.
OSAGWI also didn't mention in their write-up that the chemical detection paper, which was attached to a vehicle used in this particular operation, changed color. The changing of color could indicate the potential, the presence of a chemical agent.
In this case we concluded that OSAGWI's assessment was open to question and that they really needed to do a reassessment considering the new information that we brought to their attention.
There are two other cases where we identified weaknesses and possible exposure of service members to mustard agent and also possible exposure of service members to chemical agents in Al Jubayl, Saudi Arabia.
In the mustard agent case, OSAGWI, we found three shortcomings. One, they didn't adequately follow up to confirm whether or not an in-theater urinalysis was actually conducted. Two, they didn't firmly establish that the clothing that was tested by the individual who allegedly had been exposed to mustard agent, it was actually his clothing. And three, we also found that some key witnesses were not interviewed.
Despite the lack of this information or the lack of the evidence, we still came to the same conclusion after conducting our work that OSAGWI did. That was that the exposure to chemical agent in this case was likely.
In the Al Jubayl case, the available evidence generally supported OSAGWI's conclusions that two of the reported events did not occur and the presence of chemical agents was unlikely in the other reported event. But the case narrative didn't fully disclose that many of the individuals associated with this case had reported unusually high levels of health problems since they served in the Persian Gulf War. Moreover, many of the individuals associated with this incident were among the very first to report health problems, and their health problems had been the subject of various DoD investigations and studies.
But OSAGWI didn't include this information in the case study, and did not adequately identify and coordinate other information which we felt could help them determine whether or not some correlations could be found.
Our review also indicated for all of the six cases that we reviewed, that OSAGWI did not avail itself of the DoD or the VA clinical data base. Now these data bases contain information on the health of thousands of Gulf War veterans and it had been used by OSAGWI in some ways, but it was not used in these particular cases that we reviewed.
We also found some what I would call quality control weaknesses in the conduct of the cases themselves. As we brought these to the attention of OSAGWI officials they were quick to correct the shortcomings that we noted.
We made some recommendations in our report which we issued in February of this year. DoD generally concurred with our recommendations. They were very quick to agree that the information we brought to their attention should be included in the case studies and agreed to make modifications to the cases. As you heard Mr. Rostker say earlier this morning, they were always of the opinion that the case studies would be updated or modified as new information was brought to their attention, and they agreed to do that.
The one area where we did not reach agreement with DoD in terms of our recommendations is the use of the DoD and the VA clinical data bases. DoD's position and VA's position as well was that that information could be misused and should not be used to find whether or not a causal relationship might exist between the health as reported by veterans and the potential causes for Gulf War syndrome illness.
We continue to believe, however, that notwithstanding that issue, that there's a wealth of information there that can be used and certainly could shed some light on the individual cases in question. DoD has agreed to review that information for that purpose.
So that's a quick summary of what we did, Mr. Chairman and members of the Board, and we'd be glad to respond to any questions that you may have at this time.
SENATOR RUDMAN: I really only have one because we have been going over that material as well.
You cited a number of problems with the case narratives as your staff examined them, and in most cases DoD agreed with your conclusion and went back and made the necessary changes.
To what would you attribute the kind of mistakes that have been made such as not looking at information that is contained in files that were there for the looking, but it wasn't looked at; not interviewing a key group of people that obviously should have been interviewed, only when looked at by outside groups such as yours or us saying yeah, we ought to do that. What do you attribute that to?
MR. GEBICKE: I think it was just an oversight. I think it was a lack of quality controls in place at the time.
I'll be honest with you, Senator Rudman, we held them to a very, very strict criteria. We looked not only at the case narrative, but we went behind the case narrative to the supporting documents to ensure that the supporting documents were consistent with the write-up. We then looked at other information in their case file which was not included in the write-up to determine whether or not it was relevant. Then finally, we contacted some individuals on our own to verify that what was in OSAGWI's records was consistent with what that individual said he told the OSAGWI investigator when they spoke. So we held them to a very high standard.
SENATOR RUDMAN: Did you find anything at all in your discussions, both initially and then after disclosure and then re-write. Did you find anything at all in the course of your inquiry that would indicate to you that people were trying to deliberately conceal information, not produce information to put into the reports?
MR. GEBICKE: Quite to the contrary. From the very first day that we arrived I think we had what I would consider from an auditor's perspective a model relationship and rapport with OSAGWI in terms that they provided all files that we asked for in a very timely basis and provided all individuals that we needed to speak to.
SENATOR RUDMAN: Vice Chairman?
SECRETARY BROWN: Nothing.
SENATOR RUDMAN: Admiral? Doctor? General?
SENATOR RUDMAN: We thank you very much for coming down, and we'll be talking to you again, I'm sure.
MR. GEBICKE: Thank you very much.
SENATOR RUDMAN: It is the Board's intention to in the next month or so to indicate when our next public hearing will be and when it will be. I will withhold comment on that until we really come to a conclusion.
There is supposed to be a meeting in Seattle in October of '99, that's previously been published, and in Washington next year. We will just let you know about that, anyone who is interested, in the next four to six weeks.
Before I ask Ann McGuire from the White House to do her duties to close down this hearing, I will ask the members of the panel once more if they have anything to say at the conclusion of the hearing?
MS. McGUIRE: The meeting is adjourned.
(The meeting was adjourned at 3:30 p.m.)