A bipartisan move to expand medical coverage for millions of Iraq and Afghanistan veterans exposed to toxic burn pits stalled Thursday after 25 Republican senators who backed the bill last month reversed their stance.
The move prevented the legislation from reaching President Biden’s desk. The bill has already passed the House of Representatives, and an earlier version passed the Senate last month before some changes were made. Supporters of the measure were surprised that the current version did not sail through again.
It’s about the way military bases in Iraq and Afghanistan disposed of garbage from around 2010 to 2015: by dumping it in a pit and burning it in the open air.
Many veterans attribute later health problems, such as cancer and respiratory diseases, to exposure to chemicals released into the air by these fires. The smoke contained a number of harmful substances including lead, mercury, benzene, hydrocarbons, dioxins and volatile organic compounds.
“Those deployed to bases where burn pits were used were clearly exposed to agents known to be harmful,” said David Savitz, professor of epidemiology at Brown University School of Public Health.
The legislation would have extended access to health care to more than 3.5 million veterans who were exposed to toxins during their military service after September 11, 2001. Also, 23 diseases, including several types of cancer, would have been added to the federal health insurance list of eligible diseases.
Sergeant First Class Heath Robinson honors our promise to address the Comprehensive Toxics Act of 2022 – or PACT Act, as it is known, was named after a US veteran who attributed his lung cancer to exposure to cremation pits. Robinson died from his illness in 2020.
Savitz and other experts said that burning waste like the military has done could certainly increase the risk of disease, but more research is needed to know if the conditions reported by veterans were directly caused by cremation pits. Regardless, they think veterans should be able to get the care they seek.
“The legislation was very important to provide health benefits and care for veterans who develop this type of lung disease and a suspected diagnosis of a rare cancer,” said Steven Coughlin, professor of epidemiology at Augusta University. “Hopefully they get back on track.”
Why cremation pits have proven to be so toxic
Savitz said that around 2010, cremation pits were gradually being replaced by incinerators. But before that, the military set fire to all sorts of waste in the open air.
“They burned everything they had — everything from the trash, the food waste, the medical waste, bottled water,” he said.
Coughlin said the list included plastics, cardboard, heavy metals and vehicle parts.
“They poured aviation fuel on it to ignite it and they burned these piles of garbage day and night,” he said.
Fire pits were often located near barracks, so fighters “often inhaled this filth on a daily basis with significant exposure,” Coughlin said.
Exposure to cremation pits during military service has since been linked to some Respiratory and cardiovascular diseases, including asthma, bronchitis and chronic obstructive pulmonary disease. A Small study from 2011 also identified cases of constrictive bronchiolitis – a rare but potentially fatal lung condition – in previously healthy soldiers serving in Iraq and Afghanistan.
A possible link to cancer is tenuous, both experts said, given that Iraqi and Afghan veterans have been exposed to burn pits over the past two decades and some cancers are diagnosed longer after exposure to a carcinogen.
“There have been widespread reports of veterans getting rare cancers,” Coughlin said. But “it can take decades — 30, 40, 50 years — before some chronic diseases manifest themselves.”
The PACT Act proposes that lung, brain, kidney, gastrointestinal and other cancers be included in the list of diseases eligible for expanded health care.
Department of Veterans Affairs Secretary Denis McDonough expressed support for the PACT bill in May.
“The bipartisan bill will help us advance one of the department’s top priorities: getting more veterans into VA care,” McDonough said said in a statement. “President Biden has also made it clear that he is committed to providing more VA health care to veterans affected by toxic exposures, which is why we need Congress to send the PACT Act to his desk.”
Biden’s son Beau died of a brain tumor in 2015 while serving in Iraq on military bases that used burn pits.
Coughlin said that of the various compounds soldiers have been exposed to, dioxins are a particular concern due to a link to respiratory cancer.
“Humans are not designed to deal with dioxins,” he said. “There is no safe limit.”
However, establishing a fortuitous link between burn pits and disease can be challenging, Savitz said, because exposures have not been well documented by the military. He is currently investigating whether people with respiratory or cardiovascular diseases were stationed at bases with fire pits in the past.
At the moment, Savitz said, “it has not been directly proven that those who were exposed to fire pits during their military service actually have increased rates of illness over the long term.”
But he and Coughlin said the government shouldn’t wait to offer health care to veterans until scientists fully understand all the risks of cremation pit exposure.
“It’s important to make sure these veterans get the proper care, not wait for epidemiology to catch up,” Coughlin said.
https://www.nbcnews.com/health/health-news/burn-pits-veterans-healthcare-risks-cancers-respiratory-illness-rcna40669 How cremation pits may have increased veterans’ risk of rare cancers and respiratory diseases