Mr. Chairman, I welcome the opportunity to once again appear before the Subcommittee on Human Resources this morning. In previous testimonies, I have outlined the mission of my office, described the full extent of the commitment of the Department of Defense, and explained the case management system we use. In light of the recently released GAO Report: Improved Monitoring of Clinical Progress and Re-examination of Research Emphasis Needed, I feel it is appropriate to readdress my mission. We understand the shortcomings of the past and have owned up to them on many occasions. We have learned from our past and applied these lessons both to caring for our Gulf War veterans and to protecting our troops in the future. We will continue to be open and receptive to constructive criticism and oversight that contributes to our understanding and mission.
My mission as the DoD coordinator for all issues relating to Gulf War illnesses consists of three major elements. First, we must ensure that our Gulf War veterans receive appropriate care. Second, we must do everything possible to understand the events of the Gulf War in order to explain Gulf War illnesses. Finally, we must put into place changes to policy, procedures and doctrine as a result of lessons learned from the Gulf War.
To understand why people are sick, we are pursuing two lines of inquiry -- What does science say and what happened in the Gulf? To obtain answers to those questions, we have implemented a formal structure for our incident investigations. Based on an accepted United Nations methodology for chemical incident investigations, our process consists of five steps. First, substantiate the events by researching operational and intelligence logs/records for records of the event, corroborating evidence, and secondary or confirmatory detections. Next research the medical aspects of the event- deaths, injuries, symptoms, medical records and the science associated with the event. Step three is to interview appropriate people, witnesses, NBC personnel, commanders, medical personnel and subject matter experts in order to get a complete picture of the event. Coordination with appropriate external organizations is the next step. Finally, we publish a case narrative that reports all that we know about the event. After publication, if we receive new information from veterans or other sources, we will reenter the process at the appropriate point and update our narrative and findings accordingly.
We are aggressively investigating the events of the Gulf War. As I have previously testified, requests for proposals were published in the Commerce Business Daily soliciting proposals to investigate the causal relationships between illnesses and symptoms among Gulf War veterans and possible exposures to hazardous material; chemical warfare agents; stress; and combinations of inoculations and investigational new drugs during military service in the Gulf War. Proposals have been received and they are undergoing external scientific review.
To further assist our efforts, we have asked the RAND Corporation to conduct an extensive review of medical, epidemiological, occupational and environmental literature in several areas including: pesticides, immunizations, chemical warfare agents, pyridostigmine bromide, stress biological warfare agents, depleted uranium, infectious diseases, and environmental exposure to oil fires. Their process involves identifying the biologic relationship between possible exposures and reported symptoms, identifying new areas of research for further investigation such as the health effects of multiple chemical exposures, and conducting focused reviews of these new hypotheses. RAND plans to complete the literature review by the end of August and have their findings undergo peer review and publication. This effort by RAND will add to the previous investigations by the Institute of Medicine and the Presidential Advisory Committee and will give us a clear picture of the existing knowledge base, identify gaps in the knowledge base and identify future research needs.
Potential exposure to low levels of chemical agents continues to be a very important area for investigation. Currently, over $2.5 million has been allocated to research involving health effects of low-level chemical warfare nerve agents. Four projects are investigating the long-term neurological effects of organophosphate exposure and possible treatment strategies. Two others are investigating the long term effects and detection of nitrogen mustard exposure. All current projects will be completed in the year 2000. In January 1997, two additional calls for research proposals were made. Most of the $12.5 million set aside for this research is allocated for chemical warfare agent medical effects and the effects of combinations of exposures. The Research Working Group has reviewed specific proposals and has made recommendations for award of contracts. Details will be published upon award of the contracts.
I take seriously the concerns expressed by this committee and by our Gulf War veterans about the possible presence of low-level chemical warfare agents and their effects on our troops. In response to that concern, we have several efforts underway to investigate the possibility of that presence and to model the areas of potential contamination from our military operations.
One case that we are investigating deals with reports of chemical warfare agent detection by Czech and French chemical detection equipment. During the first several days of the air war, between January 19 and 24, 1991, Czech and French military units reported possible detections of the presence of nerve and blister agents in the vicinities of Hafar al Batin and King Khalid Military City (KKMC) in Saudi Arabia. After examining Czech procedures and equipment, U.S. technical experts described the principal detections claimed by the Czechs as credible, although the source of the chemicals is still unknown. The Czechs continued to use their sensitive equipment throughout the war, but no further detections were reported to United States Central Command (USCENTCOM) or are formally recognized by the Czech Government. We are currently pursuing more detailed information on the French equipment or procedures.
Although the concentrations of chemicals reported were far below the levels considered by U.S. military standards to be a hazard to troops, the detections do indicate the possible presence of low levels of chemical agents in these areas. We are continuing to investigate this case, and in fact, will be visiting both France and the Czech Republic this summer to discuss these and other issues with their experts.
A second area of concern for me has been the highly-publicized possibility that chemical warfare agents were released as a result of the coalition bombing campaign and may have subjected U.S. personnel to low-levels of contamination. The CIA published a study in September 1996 that examined the worst case possibility of contamination of US troops due to coalition bombing. It concluded "coalition bombing resulted in damage to filled chemical munitions at only two facilities - Muhammadiyat and Al Muthanna - both located in remote areas west of Baghdad." Muhammadiyat, the closer of the two, is 410km north of where troops were stationed at Rafha, Saudi Arabia and even further from the bulk of where troops were stationed. The CIA report also adds, "...analysis and computer modeling indicate chemical agents released by aerial bombing of chemical warfare facilities did not reach US troops in Saudi Arabia." While we continue to investigate reports of other chemical munitions facilities possibly bombed during the war, we have not been able to confirm any other chemical munitions facilities damage.
The United Nations Special Commission (UNSCOM) reported that Iraq declared 200 DB-2 GB Aerial Bombs, 200 LD-250 Mustard Bombs, and 20,000 CS Mortar shells at Muhammadiyat, and 2,500 122mm GB rockets at Al Muthanna. All were destroyed by coalition bombing. CIA's modeling of Muhammadiyat, the larger and closer release of the two, estimated that 2.9 metric tons of sarin and 15 metric tons of mustard were in that site on all possible bombing dates. Their model shows that, in the worst case, dispersion in the general southerly direction for sarin and mustard would fall below levels dangerous to the general population at about 300 and 130 km, respectively, still over 100km short of U.S. troops. Their model for Al Muthanna used 17 metric tons of sarin and determined that the most southerly dispersal for reaching the general population limit dosage is 160 km, again well short of US troops. To improve our confidence in the results of the original plume analysis, DoD is working to model the extent of potential exposure of our soldiers after the bombing of these facilities. DoD experts in meteorology and modeling will use multiple models. Within DoD, the Naval Research Laboratory, the Defense Special Weapons Agency and the Naval Surface Warfare Center will be contributing expertise to this effort.
After the war Iraq admitted to production of biological agents at four facilities, none of which showed damage from Coalition bombing when inspected by UNSCOM. UNSCOM has also reported that Iraq has never indicated that its population suffered any casualties from release of chemical or biological agents due to Coalition bombing of their facilities.
Another claim of a possible source of low-level contamination to U.S. troops of which I am concerned is through destruction of ammunition supply depots. Consequently, I have several case investigations underway to determine the facts related to such destructions. One such case is that of Khamisiyah, the destruction of which has been well publicized and for which we published an initial narrative in February. During and after the close of the Gulf War, captured munitions were destroyed throughout the theater of operations by Coalition forces. Included in this massive undertaking was the depot level ammunition supply point (ASP) at Tall al Lahm or Khamisiyah, as it was later known. The United Nations Special Commission (UNSCOM) reported that Iraq declared 2,160 122mm rockets containing a mixture of sarin and cyclosarin nerve agents, and 6,240 155mm mustard rounds were at Khamisiyah. In 1991, the UNSCOM inspectors were driven to Khamisiyah by the Iraqis and shown a destroyed bunker called Bunker 73 that they claimed was supposed to have contained 122mm chemical rockets. During this same inspection, they were also shown an area called "the Pit" where unfuzed 122mm chemical rockets were found in three bulldozed piles. Later in 1996, Iraq declared this area -- the Pit -- was also destroyed by Coalition forces. Research has confirmed that elements of the XVIII Airborne Corps destroyed the warehouses, bunkers and open storage areas in March and April of 1991. It is vital to point out that the engineer and explosive ordnance disposal units took all due caution in conducting their initial searches of the bunker complex prior to the beginning of demolition operations. Both the EOD teams and the engineer commanders were satisfied that there were no munitions in the bunkers, warehouses or in "the Pit" area that could be identified as chemical weapons. Following the first large demolition of 38 bunkers on March 4, which included Bunker 73, engineers and EOD specialists worked in the ASP and "Pit" area for a period of approximately 6 days preparing for the next demolition. During this time the soldiers were not in protective gear but did have active M-8 alarms deployed in the ASP. No chemical alarms sounded during this time with the exception of one M-8 alarm that occurred about 45 minutes after the first demolition on March 4. It proved to be false through documented, follow-up testing. Interviews of hundreds of soldiers who participated in the destruction of those bunkers as well as the soldiers providing security to the site revealed no instances of health reactions consistent with exposure to nerve agents. Photos of an EOD sergeant without protective gear who participated in "the Pit" demolition show him standing in "the Pit" area a day or two after the stacks of rockets were destroyed. Another photograph of a soldier, taken in the same area several days later by an engineer battalion commander, shows this soldier without protective gear. Recent interviews with most of these individuals indicate they did not have any physical reactions that could be associated with exposure to nerve agents when they were in the area.
The DoD and CIA recently completed a series of small-scale demolition tests designed to assist in developing a model of the detonation of chemical weapons by U.S. soldiers at Khamisiyah, Iraq in March 1991. The results of the tests are expected to produce data that will assist us in answering two fundamental questions: 1) who may have been exposed to chemical agents at Khamisiyah, and 2) to what extent they may have been exposed. The test used 32 foreign-made 122mm rockets and warheads filled with the simulant triethyl phosphate, a substance which replicates the characteristics of sarin gas. The tests fundamentally examined how the rockets explode and how much material vaporizes or spills onto the ground. The CIA and DOD to include the Naval Research Laboratory, the Defense Special Weapons Agency and the Naval Surface Warfare Center will apply information derived from the tests to multiple models. Additionally, evaporation tests to determine how nerve agent evaporates from soil and wood are now being conducted at Edgewood Research and Development Center, Maryland and Dugway Proving Grounds, Utah. We expect the findings to be published by 21 July1997.
Another major area of investigation is the Kuwaiti oil well fires. The setting on fire of the oil wells was first detected on 24 January 1991. The number of fires increased daily, peaking at 730 between 22-24 February. This coincided with the movement of Coalition forces into position for the ground war, which began on 24 February and ended 28 February. Our soldiers began redeploying in March and most had returned home by the end of April. The first American fire fighters arrived in Kuwait in April and were part of 10,000 workers from 37 countries ultimately involved in extinguishing the fires. By October 1991, all 730 fires had been extinguished.
Emissions from these fires have the potential to cause acute and chronic health effects. Our soldiers were exposed to heavy smoke and other by-products of the fires. During the early stages of the fires, the smoke was close to the ground and caused minor respiratory problems for some of our soldiers. Later, the smoke lifted and stayed at higher altitude, posing less risk. Sampling of the ambient air and soil began in May of 1991 when 558 oil wells were still burning and continued through December 1991. These samples were analyzed for particulates and metals (sulfates, nitrates, etc.), volatile organic compounds (benzine and toluene), polycyclic aromatic hydrocarbons, acidic gases and criteria pollutant gases and did not reveal any chemicals at levels of concern. Research thus far does not indicate that exposure to oil well fire smoke causes acute health impacts in healthy adults. In addition to other ongoing research, the RAND Corporation is conducting an extensive medical, epidemiological, occupational and environmental literature review to determine future research needs pertaining to the health effects of exposure to oil well fire smoke.
We have contacted several fire fighters that participated in extinguishing the oil well fires. Our conversations with them reveal an absence of any of the symptoms reported by our veterans; none have reported any adverse health effects. Larry Flack, former project manager for all fire fighters in Kuwait states that based on his first hand knowledge of firefighter health screening and his periodic contact with firefighters that "We are not ill." Dr. Gary Friedman, Director of Occupational Medicine in the Pulmonary Division, University of Texas, Houston conducted a health screening study of 40 American firefighters prior to and after their deployment to the Gulf. He found no apparent health problems or long term effects from exposure to oil well fires in Kuwait.
We are currently investigating the events surrounding troop exposure to oil well fire smoke and related by-products. The investigation is focusing on the events leading to the destruction of Kuwaiti oil fields. It will investigate the human health effects associated with exposure to oil well fire smoke, present the results of environmental sampling and monitoring studies conducted in the region, and present the results of human health, exposure and risk assessment studies conducted during this time period. We are also reviewing air quality and dispersion modeling data to determine units exposed. We are interviewing firefighters and members of oil companies to obtain information related to health screening studies and medical examinations of those individuals. And we are reviewing operational logs to identify the impact of oil well fire smoke on military operations. We expect to publish our findings by November 1997.
Depleted Uranium (DU) is another area we are investigating. There are many allegations from various individuals and groups that DU is an unconventional weapon equal to chemical and nuclear weapons; that DU causes genetic damage and childhood cancers; that DU is a greater danger to our soldiers than the enemy; and so on.
Uranium is a natural, chemically toxic and radioactive element. When the uranium isotope is extracted, depleted uranium is the byproduct. DU is approximately half as radioactive as natural uranium found in the soil and poses no significant external radiation risk to soldiers. The major toxicity from DU is from its chemical properties. As a heavy metal, it concentrates in the liver, bones and kidneys, as does mercury or lead, for example. The DU 'dust' generated when DU burns may be ingested and presents potential health risks.
The soldiers with the greatest potential for harmful effects of DU were those on board vehicles which were hit by friendly fire. Twenty-nine combat vehicles -- fifteen Bradley Fighting Vehicles and fourteen Abrams Tanks -- were contaminated in this manner. DU munitions from other Abrams tanks hit all of the Bradleys and eight of the Abrams. Five of the Abrams were contaminated when DU munitions burned in onboard fires. Its on-board DU munitions contaminated the final Abrams after being hit by a Hellfire missile.
On 11 July 1991 at Doha Ammunition Dump, as many as 3000 DU rounds burned. A fire started on an ammunition carrier and quickly spread to surrounding vehicles and ammunition stored nearby. Fifty soldiers were injured in this incident and it is unknown how many may have ingested DU dust. We are currently gathering information to attempt to determine the level of exposure to personnel in the vicinity of the fire.
The RAND Corporation is conducting an extensive review of existing literature that will evaluate the most current research on this issue. The Baltimore Veteran's Affairs Medical Center is conducting health surveillance of individuals who were in U.S. Army vehicles when they were struck by DU munitions. Currently, thirty-three individuals are being evaluated, including sixteen with DU shrapnel in their bodies. The health surveillance program has shown that "Those who have retained shrapnel identified radiographically are excreting increased amounts of uranium, indicating that these metal particles are not entirely inert. So far, analysis of the first round of examination participants have shown no evidence of adverse health effects associated with this absorption of uranium." Additionally, twenty-seven soldiers from the 144th Supply and Services Company, have been identified as having potentially inhaled or ingested DU dust while recovering contaminated vehicles. Twelve soldiers have been tested with no indications of radioactivity or renal toxicity.
We recognize that we were deficient in informing all soldiers of the risks associated with DU armor and munitions. Training on DU characteristics and risks was limited to Abrams tank personnel, munitions handlers and explosive ordnance disposal personnel. The Army has developed a three-tiered training program to meet the needs of crewmembers, maintenance, chemical, ordnance and medical personnel who may come into contact with DU materials. Training is scheduled to begin in July of this year.
There is an axiom that states "On the modern battlefield, what can be seen, can be hit. What can be hit, can be killed." Used by the U.S. Army in development of doctrine, tactics and acquisition programs, this axiom proved to be true for U.S. forces and totally false for the Iraqis, largely due to the use of depleted uranium (DU) munitions and armor. U.S. forces, using 105mm and 120mm DU sabot rounds routinely obtained first round kills of Iraqi T-72 tanks at ranges in excess of 3000 meters (approximately 2 miles). Clearly U.S. forces could hit and kill Iraqi targets with DU munitions well outside of the approximate 2000-meter range of the Iraqi T-72 tank, thus enhancing the survivability of our servicemembers. Conversely, the Iraqis could not harm our DU armor protected vehicles. Not one Abrams was destroyed by Iraqi tanks nor was the DU armor compromised. Dan Fahey describes in Metal of Dishonor a vignette of an Abrams that was stuck in the mud. He states "The unit (part of the 24th Infantry Division) had gone on, leaving this tank to wait for a recovery vehicle. Three T-72's appeared and attacked. The first fired from under 1,000 meters, scoring a hit with a shaped-charge (high explosive) round on the M1A1's frontal armor. The hit did no damage. The M1A1 fired a 120mm armor-piercing (DU) round that penetrated the T-72 turret, causing an explosion that blew the turret into the air. The second T-72 fired another shaped-charge round, hit the frontal armor, and did no damage. The T-72 turned to run, and took a 120mm round in the engine compartment (which) blew the engine into the air. The last T-72 fired a solid shot (sabot) round from 400 meters. This left a groove in the M1A1's frontal armor and bounced off. The T-72 then backed up behind a sand berm and was completely concealed from view. The M1A1 depressed its gun and put a (DU) sabot round through the berm, into the T-72, causing an explosion." Our first responsibility is to protect our soldiers and to provide them the best equipment possible. This is but one example of the effectiveness of DU armor and DU munitions in protecting our soldiers and in ensuring their combat success on the battlefield.
Interestingly, DU munitions were so effective that Iraq ran a disinformation campaign aimed at discrediting the U.S. and at potentially eliminating the munitions from future battlefields. U.S. intelligence assets intercepted several messages wherein Iraqi diplomats were directed to initiate publicity campaign to depict DU as posing a severe health and environmental threat to Iraq. Further, the campaign was to allege that the 40 tons of DU found in Southern Iraq came from radiation weapons used against the Iraqi military and that it was contributing to large increases in diseases such as leukemia. Iraqi diplomats were to relay articles containing this propaganda to parliaments, political parties and movements, peace and solidarity organizations, environmental protection organizations and friendly political VIPs. We plan to publish our case narrative on DU in September 1997.
I am taking a team of my investigators and staff to Europe to share information with the British, French and Czechs. I am hopeful that we can learn from their experiences with low level chemical detections, pesticide exposure and the health effects their Gulf War veterans are experiencing. In September, I am planning a similar trip to Kuwait, Saudi Arabia, Egypt and Israel.
The Department of Defense remains committed to providing appropriate care for our veterans, to understanding what occurred in the Gulf and to making necessary changes to policy, procedures and doctrine to protect our current and future soldiers. We have the right team in place to conduct the necessary investigations. We are open to oversight, have published all that we know and have a moral obligation to those who served to provide them answers. Clearly, DoD must play a central role in the investigation into Gulf War illnesses.
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