I.  OVERVIEW

United States personnel deployed to the Kuwait theater of operations during Operations Desert Shield and Desert Storm were possibly subjected to numerous natural and man-made factors capable of causing adverse health effects. All environmental media were affected, however, of primary concern was the poor air quality in the region, the result of several factors, including blowing sand; emissions from petro-chemical industrial sites in Kuwait and Saudi Arabia; civilian and military vehicle traffic; oil fields and refineries; and oil well fires in Kuwait.

The Office of the Special Assistant investigated the events surrounding the Kuwait oil well fires and their potential impacts on human health. The findings and results of this investigation were originally published in November 1998, and revised in August 2000.[1] During the course of the oil wells fires investigation, analysts determined that the principal contaminants of concern to US military personnel were the soot and by-products of combusted crude oil. In addition, there was concern over the high levels of fine dust and sand particles present in this region. These particles, collectively called particulate matter, arise primarily from natural sources and were the subject of an intensive air-quality monitoring program that began in May 1991.

As a result of this monitoring program, the US Army Environmental Hygiene Agency (currently known as the US Army Center for Health Promotion and Preventive Medicine) gathered a substantial body of data that not only has assisted post-war efforts to assess the effects of the hydrocarbons contained in the oil well fire smoke on human health and the environment, but also revealed meaningful information on the particulate matter levels to which US military personnel were exposed during their deployment to Kuwait and Saudi Arabia.

These data indicate that while combustion by-products from burning crude oil (e.g., oxides of sulfur and nitrogen, carbon monoxide, carbon dioxide, non-combusted hydrocarbons, etc.) contributed to the poor ambient air quality immediately downwind of the burning oil fields, the principal contaminant of concern was particulate matter.[2] Particulate matter levels were often twice the safe levels established by the US Environmental Protection Agency in an ambient environment. All source monitoring data indicate that while the levels were among the highest in the world,[3] they were considered normal for the region and resulted primarily from sand, and, to a lesser extent, man-made sources. The possible health effects associated with exposures to particulate matter are discussed in Section V of this report.

The "Oil Well Fires" environmental exposure report, published by the Special Assistant for Gulf War Illnesses, identified several areas where additional information is required in order to better characterize the exposures received by some Gulf War veterans. One area identified was the possible health effect associated with exposure to particulate matter. Because of the uncertainties associated with the latent (diseases that develop months or years following exposure) or long-term (chronic – health effects that last a long period of time and are not easily resolved) effects from short-term exposures, analysts attached to the Assistant Secretary of Defense for Health Affairs, Deployment Health Support Directorate believed this issue warranted a separate investigation.

This report presents the results of an investigation into the possible health effects from such exposures and discusses what is currently known about US personnel exposures during the Gulf War. The report also presents the results of an analysis of the high levels of particulate matter observed in the region and assesses whether exposure to these levels could provide a plausible explanation for some of the unexplained illnesses reported by some Gulf War veterans.

In general, studies in the literature on the latent or chronic health effects of particulate matter exposure are inconclusive or inconsistent in their findings. As a result, the Special Assistant commissioned a medical literature search and health risk assessment on the effects of the two principal components of concern - silica and soot. The health risk assessment[4] estimates US personnel exposure levels to silica and soot and the potential chronic, or long-term, effects associated with these compounds. It was peer reviewed by leading scientists and subject matter experts from industry, academia, and the US Environmental Protection Agency.

This report also discusses: 1) background issues related to US personnel exposure to particulate matter; 2) the results of air monitoring studies conducted in Kuwait and Saudi Arabia in 1991; 3) US air quality standards governing particulate matter exposures; 4) general health effects associated with exposures to particulate matter; 5) an overview of the health risk assessment; and 6) areas requiring further investigation or research.

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