Speech by Dr. Bernard Rostker
Special Assistant to the Deputy Secretary of Defense
For Gulf War Illnesses and Under Secretary of the Army
Before the DOD NBC Symposium and Exhibition
Aberdeen Proving Ground, Maryland
June 22, 1999
General Wooten, General Doesberg, members of the United States Army Chemical Corps, conference participants, ladies and gentleman.
It is my pleasure today to continue the dialogue that we started last year at the Worldwide Chemical Conference at Fort McClellan. At that time, I presented some important lessons that I think we had learned about the Gulf War. These lessons are so important that I want to reiterate them today. I will also review with you what we have been doing over this last year, and then raise another concern that comes out of the Gulf War, one that has recently caught the attention of Congress. Specifically, this is the issue of possible negative health effects from the exposure to low level concentrations of chemical warfare agents.
Last year we talked about the need to develop a new mind set and new doctrine. Any suspected chemical or biological warfare agent attack must be fully documented. This must include a detailed description of:
All this must go into unit logs, and all logs must be retained and archived. Most importantly - most importantly - this applies to all incidents, even those that turn out to be false alarms. The message from the Gulf War is check it out, squash the rumors and keep the tapes, regardless of whether or not they are positive.
Some of you may say, "we already do that." What the Gulf War taught us was that our existing procedures for documenting chemical or biological incidents needed to be expanded and what is really new in the above is the need to document false alarms. Why false alarms? Because unless we report back to those who observed the alarms, they don't know that it was false. They continue to harbor suspicions that they may have been exposed to a chemical or biological agents. If you think that they don't, consider the following survey of Marines taken right after the Gulf War: 14% of all Marines questioned believed they had been exposed to chemical agents and 28 % of the NBC specialists questioned believed that they "encountered chemical munitions or agent threats,"
Consider further the following stories from the New York Times:
On 11 December 1996, the Times headline was "Soldiers Say they Found Chemicals Weapons in Kuwait." Not only were those of us in Washington attacked, the Times charged, quote, "valid chemical detections had been dismissed, discounted, discredited or denied, by commanders eager to ignore that troops had been exposed to chemical weapons."
Three years and millions of dollars of investigation later we can conclude that it was unlikely that Marines, or any of our troops, were exposed to lethal doses of chemicals in Kuwait. UNSCOM, has told us, for example, that through their investigations, they have determined that no chemicals were ever shipped south of Khamisiyah. So no chemicals were in the country of Kuwait. However, we cannot be sure, and this is where doctrine comes in, because we don't have the tapes from the Fox vehicle mass spectrometer that took the readings throughout the theater. However, taking knowledge of the operating characteristics of the Fox vehicles, along with the evidence we have been able to develop (like UNSCOM reports), we believe there is enough information to make the call that it was "unlikely" that chemical agents were present.
This was not the only example where the fact that we did not document false alarms comes back to create problems for us. Last year I told you, and I'll review it quickly, the case of the Kuwaiti Girls' School; we believe this is instructive. In 1994, a Senate Committee concluded that mustard agent had been in the large metal tank found outside a Kuwaiti school in August 1991. As it turned out, this conclusion was premature. A more complete investigation by my office and the British Ministry of Defense turned up one of the two copies made of the full mass spectrometer and a report of the analysis performed on samples of the substance taken from the tank at the Girls' School. The second copy of the Fox tape that was sent here - to Edgewood - had never been found and was lost way before we began our investigation. The British copy of the tape, together with the sample analysis report, proves that the substance in the tank was red fuming nitric acid. In fact, the British knew this within 45 days of the sample being taken from Kuwait to Britain. Unfortunately, these results were not shared with the soldiers who took the samples. A subsequent report by the unit commander stating that mustard and phosgene were found in Kuwait was eventually obtained by the staff of the Senate Committee on Banking, Housing and Urban Affairs. They were investigating allegations of chemical warfare agent use in the Gulf War.
Was this a unique incident? Maybe! But over this last year we completed another case narrative that tells a similar story, but even more troubling.
On March 12, 1991, twelve days after the conclusion of the ground war, an industrial area outside Kuwait City was thought to be a possible Iraqi chemical weapon filling station. This site was inspected by a team of chemical defense and explosive ordnance disposal (EOD) specialists from the 2d Marine Division. Using a Fox vehicle, the Marines surveyed this area known as the "Cement Factory." The team found some chemical defensive equipment such as masks, and one of the EOD specialists pointed out land mines that he believed could have had either a conventional or chemical agent fill.
Within a half-mile of the cement factory's buildings, the Fox crew reported an alert for blister and nerve agents. The chemical defense commander on the scene ordered that soil samples be taken for further analysis and that a second Fox vehicle survey the area. The second Fox also alerted for chemical warfare agents. Again, samples were taken. The Fox operators printed records of both alerts. There were no other indications that chemical agents were present and there were no reported casualties.
The Fox operators turned over the samples to the US Army unit responsible for transporting them back to Edgewood, Maryland. The samples arrived approximately six days later. The analysis of these samples was negative for chemical warfare agents, but the analysts noted that the samples were improperly packaged and were not airtight. It also turns out the fox tapes were not assessed until several years later and they also showed that there were no chemical agents present. Approximately two weeks after the samples were taken, the laboratory communicated this information to the in-theater Joint Captured Materiel Exploitation Center (JCMEC), but the Marine chemical specialists were never informed of the results or the packaging problem. Attempts by the Marine chemical defense commander and another officer of the 2d Marine Division to ascertain the sample test results were unsuccessful. Here is the big problem and here's what happened.
Several days after the samples had been taken, the Marine group leader called the JCMEC office and inquired about the samples. The group leader is unsure but believes he talked to an Army major who told him that he did not have a "need to know" about the samples.
The group leader disagreed. He believed he needed to know if the Fox vehicles and crews were correct in suspecting chemical warfare agents at the cement factory. He recalls asking the division intelligence officer to call the Army major. The group leader recalls that the intelligence officer was told the same thing, "You don't have a need to know." The lst MEF NBC officer also recalls that he had a similar exchange with an officer at CENTCOM, in which the he was told he did not have a need to know.
Because these officers were told in 1991 that they did not have a need to know the results of the laboratory findings, the incident remained an open question in their minds. They also were denied the opportunity to correct their techniques in terms of packaging the samples. As a result of the incident being described in the highly classified draft report by MITRE on intelligence information flow during the war, the I MEF NBC Officer testified before the Presidential Advisory Committee in May 1997 that they had been exposed to chemical agents at the "Cement Factory." It was only with the publishing of our Case Narrative of the "Cement Factory" this year that we were able to put to rest the suspicions that Marines were exposed to chemical agents in Kuwait in 1991.
I think you can see by this example of how leaving these types of reports unanalyzed, and still open in the minds of soldiers, will result in the unfortunate situation we found ourselves in: the belief that chemicals were present and that commanders knew this and did not provide appropriate protection for our troops.
Since last year and with the added ability to talk from the prospective of the Under Secretary of the Army we have taken steps to move forward to review the lessons from the Gulf War and, where necessary change chemical doctrine and training. We now review and coordinate on all joint and multi-service NBC doctrinal publications as they are being updated to provide the insights we have gained from our investigations. Last fall we conducted an evaluation of initial entry NBC MOS and Fox ASI training at Fort McClellan to determine if documentation of all alerts and possible detections was being taught at the schoolhouse. We found that it was, but we had to take this approach because we had found that the relevant TMs and FMs hadn't been fully updated to reflect this lesson from the Gulf War. We also assessed whether NBC specialists were being adequately trained on the capabilities and limitations of their equipment to allow them to properly advise their commanders.
Let me stress the limitations of their equipment. One of the most important insights from our investigations was that contrary to the training that the NBC operators were given on the Fox vehicle - that the Fox vehicles weren't capable of false alarms - in fact, in the few cases where the tapes have survived and we're able to look at the alarm versus the mass spectrometer (those tapes are reproduced in our case narratives), we find that Fox alerted for phosgene and blister agents and the full mass spectrometer shows that it was a different substance. I'm very concerned that as we move into the realm of biological agents we'll find that the BIDS units may also false alarm under certain conditions. That doesn't mean that the system is no good, it means that we have to understand the characteristics of the system and that you don't have a positive indication of agents being present until full and complete mass spectrometer or laboratory tests for biological are completed. An alarm is just what it says: it is to alarm you to the possible presence so that you can take defensive actions, it is not a confirmation that the agents are there. We all know the trade-off between alarm and sensitivity. We want our alarms to be highly sensitive and we trade off the possibility of false alarms. But these are what our troops heard and that's the problem that we have to get over to them. The first part of understanding that is to understand the limitations of our equipment.
My Lessons Learned Implementation Directorate, that we stood up this year, organized the numerous observations and potential lessons learned from our investigation of over 40 separate reported chemical incidents and our review of the capabilities and limitations of NBC defense equipment used during the Gulf War to serve as the foundation of a comprehensive review of chemical and biological defense doctrine across all force development domains. TRADOC has committed to leading this review which will also need the support of the materiel development, environmental, medical and safety communities. Once the Chemical School has finished its move to Fort Leavenworth this fall, we expect to see significant progress along these lines.
Finally, I would like now to turn to another issue, Congress' concern for low level exposures to chemical agents. In Sec. 247 of the Defense Authorization Act for Fiscal Year 1999, Congress directed:
"The Secretary of Defense [to]review the policies and doctrines of the Department . . . on chemical warfare defense and [to] modify [them] . . . [t]o provide for adequate protection of personnel for any exposure to a chemical warfare agent (including chronic and low-level exposure to a chemical warfare agent) that would endanger the health of exposed personnel because of the deleterious effects of a single exposure to the agent; ... . . . [or] repeated exposures to the agent, or some combination of one or more exposures to the agent and other dangerous exposures" such as pesticides, environmental pollutants, low-grade radiation, preventive medications, fuels and other occupational hazards.
Given the Act's definition of low-level chemical agent exposure, we believe that in early March 1991, approximately 100 thousand American troops may have been exposed to low-levels of sarin and cyclosarin over a period of several days in combination with other potentially dangerous substances, particularly the smoke from the oil well fires.
The Department responded to Congress outlining the framework for a 5-year research plan which will provide the necessary information to support doctrinal and materiel development. My office has also been working on the issue, and I would like to tell you what we have been doing.
We have done three things: First, we are trying to understand the magnitude of the possible low-level exposures that resulted from the detonation of sarin rockets by American troops at the Khamisiyah Ammunition Depot in Southern Iraq in March 1991. Next we have commissioned a medical literature review to try to better understand what medical science has to say today about the danger of low level exposure. And, finally, we asked the Institute for Defense Analysis to suggest necessary changes to current doctrine.
The Congress has defined the area of interest for low level exposure as that between an upper limit of "immediate danger to life and health" and a lower limit of the "General Population Limit" as defined by OSHA. In our work on Khamisiyah over the last two years we have defined the range of low-level exposure as that between an upper limit of "first noticeable effects" by an unprotected soldier and the lower limit being the same general population level. We did this because we needed an empirical check to correlate with a health survey questionnaire we sent to all troops within fifty kilometers of Khamisiyah (about 20,000 troops). Our definition is not significantly different from Congress'. Based upon extensive computer simulations we notified 100,000 troops that during the three days of March 10-13, 1991 they might have been exposed to low levels of sarin. (See The Analysis of the Demolition at Khamisiyah, July 24, 1997
Sorry I didn't bring a map along to show you the area. It is available through the web at the GulfLINK site if you look through the Khamisiyah case narrative. But I'd like to characterize it, to use it as an example of what the problem is. On that map you would see an area of first noticeable effects, an area that would be consistent with where an M-8 alarm would sound or where you would feel that you've been exposed to something because of irritation to the eye. That area is approximately eight kilometers by six kilometers: a very small area. The area above the "population limit" is probably several thousand times larger and extends from Khamisiyah south to King Khalid Military City(KKMC), for those of you familiar with that map. That was from one release. Consider what would've happened if we had a number of small releases scattered throughout the battlefield. The spillover from these areas would come together over an extended period of time. It doesn't take much imagination to understand that if chemicals were used, even in a limited tactical sense, the area of low-level contamination could be very great with one release feeding sarin into areas. You could easily get a build-up. When we did the notification to 100,000 troops, this is how we explained to them what they might have been exposed to.
"Although little is known about the long-term effects from a brief, low level exposure to nerve agents, the current medical evidence indicates that long-term health problems are unlikely. Because the scientific evidence is limited, the Department of Defense and the Department of Veterans Affairs are committed to gaining a better understanding of the potential health effects of brief, low level nerve agent exposures, and they have funded several projects to learn more about them."
Since these notifications, we have asked the RAND Corporation to review the medical literature and advise us on how to proceed. As you may know, the prevailing view of a number of authors and review panels is that long-term effects from low-level exposures to nerve agents are not to be expected, and definitely not from unrecognized exposures. Exposures where you didn't feel, you didn't have enough instantaneous presence to have a reaction. The draft of the RAND study suggests otherwise and makes the case that a careful reading of the medical literature - here we're talking about literature on both exposures of chemical agents, chemical workers and workers who have been exposed to low levels of pesticides over a long period of time - the RAND study shows that adverse health effects are possible even without a "recognized exposures."
If low level exposure to chemical agents could be harmful, then what should be our protection doctrine? We asked the Institute for Defense Analysis to investigate the issue of low-level chemical protection. They recognized that "maintaining full-body protection for increased lengths of time would impose substantial greater performance losses and other costs on the force". They suggested a different paradigm from the complete full body protection needed for lethal doses of nerve agent. They postulate that it may be sufficient to reduce cumulative exposure to nerve agent and that "an oral-nasal mask alone could reduce ingestion of nerve agent vapors into the body by as such as a factor of 100-300." They noted that "oral-nasal masks are considerably less burdensome to wear, which is particularly important given the extended lengths of time that wearing such masks might be appropriate."
Frankly, I don't know if they are right or wrong. I don't know if a cumulative dose model is appropriate or if an oral-nasal mask would be sufficient to provide adequate protection. That is why the Congress charged the Secretary of Defense to develop a strategy to address low-level exposures to chemical warfare agents. My Gulf War Illnesses office is uniquely positioned to assist in that process.
Let me end by commending you and your colleagues in the occupational health and safety field. We really have come a long way since the Gulf War. Our equipment has improved and better equipment is under development. Several weeks ago, as we were getting ready to deploy troops to Kosovo an inter-agency group met to review information pertaining to the chemical, biological and environmental threat that our troops might face. From that meeting it was clear we are providing commanders with more and better information to make the right choices. The watchword is "force health protection." Part of that is to make sure that the lack of information about what happened during the Gulf war does not happen again. As I said last year, the final lesson of the Gulf War is that the honor of the Army is in the hands of Chemical Corps. Your job is not only to protect our troops from incapacitation or death, it also is to document what our troops might and might not have been exposed to in defense of our country. It may never be possible to provide a complete accounting to yesterday's veterans of what happened in the Gulf War, but we must work to provide a complete accounting to tomorrow's veterans as they deploy, and if necessary fight on future battlefields. The time to start to develop this capability is now!
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