In addition to repellents, fly baits, pest strips, and area sprays, the general military population was exposed to pesticides applied in the field by professionally certified and trained applicators and field sanitation teams. Professional applicators applied pesticides as sprayed liquids, sprayed powders, or fogging pesticides. Each is discussed below.

• Sprayed liquids – Liquid pesticides (commonly known as emulsifiable concentrates or ECs) were sprayed on the outside base of walls or tents, the outside of garbage containers, and other places where pests congregated. They were also sprayed inside structures in cracks and crevices where walls met the floors. In small structures, like latrines, the spray may have covered much of the interior surface of the structure below waist level. Army applicators primarily used chlorpyrifos and diazinon. Navy and Marine applicators primarily used chlorpyrifos and malathion, while the Air Force used mostly diazinon. All the services also used propoxur and malathion to a lesser extent. The general population may have been exposed to vapor released and by skin contact with pesticide-contaminated surfaces in dining facilities and latrines.

• Sprayed powder – Bendiocarb powder was mixed with water (known as a wettable powder, or WP) and sprayed on the outside base of walls or tents, the outside of garbage containers, and other places where pests congregated. Bendiocarb was also sprayed inside structures around cracks and crevices where walls met the floors. In small structures, like latrines, the spray may have covered much of the interior surface of the structure below waist level. The general population may have been exposed by skin contact with pesticide-contaminated surfaces in dining facilities and latrines.

• Fogging pesticides – Pesticide products containing chlorpyrifos and malathion were applied outdoors as a fog to control filth flies, sand flies, and mosquitoes. Truck mounted and backpack sprayers discharged the fog outside living quarters, mess tents, and latrines. The Navy/Marine Corps and the Air Force primarily used fogs. The general population may have been exposed by inhalation.

1.  Certified Pesticides Applicators

The Army, Navy, and Air Force each had certified pesticide applicators. Army (specialty code 91S) and Navy (specialty code HM8432) applicators came from the PM community and performed other PM functions in addition to pesticide application. Air Force pest controllers (specialty code 566X0) came from the civil engineering community. All three services’ applicators went through similar training and certification processes.

The applicators’ experience varied largely by service. Because Air Force pest controllers were in an occupational specialty dedicated to pest control, they had the most actual application experience. For most Army and Navy PM personnel, the opportunity to participate in pest management operations only arose during deployments or field training. Navy PM technicians who previously served aboard ship or with a Fleet Marine unit generally had more pesticide application experience than Army PM personnel, due to shipboard duties or pest control requirements during deployments.

Certified applicators applied fly baits and pest strips, sprayed liquids and powders, and conducted area fogging. Fly baits and pest strips have been discussed previously. The pesticide sprays required mixing (usually with water) and were applied in various locations around camps. Sprayed liquids usually contained one of four active ingredients: chlorpyrifos, diazinon, malathion, or propoxur. The applicators sprayed a fifth chemical, bendiocarb, a powder that is also mixed with water. Applicators applied fogging pesticides using truck-mounted sprayers and motorized backpack foggers.^[41]

2.  Field Sanitation Teams

Among the services, only the Army employed field sanitation teams (FSTs). FSTs provided small Army units with limited PM resources to reduce the incidence of disease and nonbattle injury (DNBI). FSTs also assured that Army units established and maintained appropriate field sanitation facilities.^[42] An Army field sanitation team, by doctrine, consisted of at least two soldiers, one of which was a noncommissioned officer. When available, combat medics also were a part of the FST.^[43] PM personnel occasionally visited and monitored the FSTs, but were not necessarily always present when pesticides were applied.

The military trained FSTs in food service sanitation, field waste disposal, heat and cold injuries, and pest management. The recommended seven-hour pest management course for team members covered such topics as insects and disease, environmental and chemical control of insects (including 2 hours on pesticides and pesticide application equipment), and rodent control.^[44] Some teams received training before leaving the United States, but because the military did not designate some teams until after arrival in theater, the Army instituted in-theater FST training,^[45] which was frequently abbreviated.^[46]

The only pesticides the military authorized FSTs to use were chlorpyrifos and lindane. Chlorpyrifos was the only pesticide the teams had to mix and apply in a two-gallon sprayer (Figure 7).

Figure 7.  Two-gallon sprayer

D.  Delousing Pesticide

Coalition forces captured 86,743 enemy prisoners of war (EPWs) during Desert Storm. US-operated EPW facilities processed 69,822 prisoners. The Army’s 800^th Military Police Brigade was responsible for the EPWs and operated four camps; each was charged with escorting, processing, and interning EPWs in a safe and secure environment.^[47]

Given the large numbers of EPWs, US authorities were concerned about an outbreak of typhus, a disease transmitted by lice and known to occur in crowded human populations where personal hygiene conditions are poor. US forces selected lindane powder (one percent) for delousing.^[48]

The delousing procedure specified applying one or two ounces of lindane powder to clothed individuals,^[49] spraying beneath the clothing at the neck, sleeves, and waist; then whitening the head and hair with dust, and dusting the inside of the hat. The military police used two types of delousing equipment: the first, a plunger-type hand delouser with a six-inch extension tube, could treat approximately ten individuals before running out of lindane (Figure 8); the second, a gasoline-powered delouser, could treat up to six hundred personnel per hour (see Figure 9).

Figure 8.  Plunger-type delouser

Figure 9.  Power delouser

Lindane application procedures varied among camps. The instructions on the lindane label advised that a respirator and eye protection should be worn during delousing operations, and that lindane should be used only in open or well-ventilated areas.^[50] Because lindane is a powder, applicators could be exposed through skin contact and inhalation. Generally, PM personnel and military police personnel served as applicators, working shifts as long as twelve hours in around-the-clock delousing operations.^[51] Based on information received during veterans interviews, on at least two occasions, EPWs or military police applied lindane using their bare hands because power equipment or plunger-type delousers were unavailable.^[52] In three of the four camps, delousing operations generally took place inside a tent.^[53]

The availability of personal protective equipment (PPE) for applicators varied. Well-protected delousing personnel wore respirators and rubber or plastic gloves.^[54] Some veterans reported that only mission oriented protective posture (MOPP) gear-designed for chemical and biological warfare-was available.^[55] Other delousing personnel wore little or no PPE.

Investigators estimate that 20 to 25 individuals at each camp were directly involved with delousing and would have experienced the greatest exposure to lindane. Investigators interviewed a total of 60 personnel, 40 of whom had been actively involved in delousing activities, while the others simply witnessed the process.

In order to protect their service members from disease-carrying insects, coalition members implemented preventive medicine actions including pesticide application. As part of the investigation, analysts identified the specific pesticides used by troops from the United Kingdom and France. The British military supply system stocked malathion dust for delousing, bioallethrin for fogging, and fenitrothion, propoxur, and bendiocarb as residual pesticides. Residual pesticides are compounds that kill insects that may come into contact with the pesticides that may remain in or on a treated location for long time periods. The British also supplied their military personnel with DEET for skin application and permethrin for clothing and mosquito netting. The British used permethrin as an area spray, similar to US use of d-phenothrin. British preventive medicine personnel initiated local purchases of azamethiphos-based pesticides for fly control after observing the effectiveness of the products (see Tab C-5 for additional information on fly baits).^[56]

During the Gulf War deployment, French servicemembers applied K-orthrin (active ingredient deltamethrin) to mosquito netting, synthesized pyrethrins for disinfecting aircraft, and lindane (in both powder and solution forms) for laying on the ground and spraying on tent walls and building walls. In addition, French servicemembers applied insect repellents containing DEET.^[57]

During the Gulf War, the host nations’ support often included pest control services that were part of existing contracts connected to the facilities leased by US forces, or in the case of Saudi Arabia, by the public health departments of Saudi municipalities. In some instances, deployed US forces contracted with local pest control services. The US used these services primarily in more established camps and leased compounds. Pest control services tended to be available in or near urban areas, but were not prevalent in the temporary desert camps that some units moved to after they departed the ports and transient holding areas. These outlying camps tended to use only US military pesticide applicators.

Only limited data and information was available on the pesticides used by host nations, their training and certification requirements, and their application methods. Consequently, this section is based primarily on the information from interviews with US PM personnel.

An Air Force environmental health technician who served at the Tabuk, Saudi Arabia, Air Base obtained a list of pesticides used by Saudi Arabian contractors hired to apply pesticides at the base. He reported that contractors mixed the pesticides incorrectly, producing higher than recommended concentrations of the active ingredient. He also learned that the contractors’ pesticide selection depended on what was available.^[58] Two Navy entomologists who served with the Marines in the Al Jubayl area visited a pest control shop that conducted fogging operations for the Navy facilities. The entomologists learned that the shop used cypermethrin and deltamethrin in fogging operations.^[59] The senior Navy entomologist considered both of these products to be safe if applied as directed.^[60] Three interviewees reported that pest control personnel in Bahrain used DDT, which was available for purchase there.^[61] Table 3 lists some of the pesticides used by host nation pest control services. Except for the concerns mentioned by the Air Force environmental health technician about how the pesticides were mixed, the interviewees did not express reservations about the specific active ingredients. Table 3 reflects only the information collected or observed at two locations and therefore should not be considered a comprehensive list. Had other pest control operations been visited, additional pesticides would probably have been found.

Except for diazinon, malathion, and permethrin, the pesticides in Table 3 were not included in this investigation. Preventive medicine personnel provided the information that served as the basis for inclusion of pesticides in the group that was investigated. POPCs were selected based on their reported prevalence of use, toxicity, and manner of use. The known uses in the US for cypermethrin and pirimiphos-methyl are exclusively agricultural in nature.^[64] Deltamethrin has household, agricultural, and public health uses in the US.^[65] Warfarin and other rodenticides do not present a hazard to humans through dermal contact or inhalation. Ingestion is the only route by which these products normally pose a risk to humans. Temephos is an organophosphate that is supplied in various forms. Its toxicity is comparable to that of chlorpyrifos and malathion.

Many interviewees commented favorably on host nation pesticide activities: an Air Force pest controller assigned to a United Arab Emirates airbase felt the host nation applicators he observed appeared to follow standard application procedures;^[66] an Army entomologist commented that local pest control contractors were well trained;^[67] and the Navy entomologist who visited a Saudi Arabian pest control shop found that it was run by a trained entomologist, and that it was well equipped and used safe pesticide products.^[68]

On the other hand, some PM personnel expressed skepticism about some host nation products or procedures, including concerns regarding the training, knowledge, and experience of the host nation applicators.^[69] Some Air Force pest controllers in Saudi Arabia and the United Arab Emirates felt that the host nation applicators they observed were inadequately trained.^[70] An 82^nd Airborne Division PM specialist said that PM personnel at one facility stopped host nation pesticide applications because the applicators did not know what product they were using.^[71]

A Navy entomologist thought that host nation applicators observed less-stringent standards than US applicators.^[72] One Navy environmental health officer reported host nation applicators applied pesticides despite high wind conditions, and another questioned the standards to which host nation applicators adhered.^[73]

The host nation pesticides identified contain active ingredients that are registered in the US. Due to incomplete information on the precise specifications and the frequency of use, investigators did not include these pesticides in the health risk assessment (see the HRA discussion in Part B of this report). However, the HRA does include pesticides with similar or the same active ingredients.

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