After an extensive investigation into the health effects of oil well fires during the Gulf War, the Office of the Special Assistant for Gulf War Illnesses has released its report. The special assistant for Gulf War illnesses also announced that RAND has released the first in a series of medical literature reviews they are conducting for the Defense Department.
Collectively, the results of the health effects and risk assessment studies suggest that, with the exception of particulate matter, the concentrations of contaminants were at levels below those that are known to cause short- or long-term health effects. And therefore, except for the possibility that some pre-existing respiratory conditions might have been exacerbated, one would not expect exposures to the levels of contaminants to result in the onset of disease in the long-term. However, a number of studies involving Gulf War veterans are underway to provide further information in this area.
Clearly the most visible source of possible contaminants to which US troops were exposed during the Gulf War was the smoke from more than 600 oil wells that were set ablaze by retreating Iraqi forces. These fires burned over a period of about nine months in 1991, and released numerous pollutants, some of which have been known, if in sufficient quantities, to cause adverse health effects or disease in humans.
The intensity of the fires made combustion relatively efficient, resulting in large quantities of coarse particles in the clouds that actually assisted in removing other pollutants from the smoke plumes. Because of the proximity of U.S. troops, concerns about the effects of the fires on them were high. Military personnel saw a dark sky at noon, inhaled sooty air and coughed black phlegm. But those highly visible, irritating effects of the oil well fires were caused by carbon particles and oil droplets too large to penetrate deeply into the soldiers' respiratory systems. The air-filtering system resident in human noses, throats and lungs is very efficient in keeping out or cleaning away those relatively large droplets. The black phlegm bears witness to that efficient filtering and cleaning action. What soldiers saw were primarily clouds of carbon particles too large to lodge in the lungs and cause long-term health effects.
The results of air quality monitoring programs conducted during this timeframe indicated that the concentrations of contaminants in the oil fire smoke, with the exception of particulate matter, were on par with US cities and did not exceed US ambient and occupational air quality standards (used for comparative purposes). Short-term health symptoms, however, were reported by some troops. Some of these problems involved an exacerbation of an existing respiratory condition (e.g., asthma, bronchitis), other reported symptoms included: coughing, black mucous in nasal discharge, eye and throat irritation, and the onset of skin rashes and shortness of breath.
RAND conducted a review of the scientific literature on the potential long-term health effects from exposure to oil fire smoke. Based on this information RAND concluded that, even under conditions of a very conservative exposure scenario, the concentrations of contaminants contained in the smoke (other than particulate matter) were much lower than the levels that are currently known to cause disease in the long-term.
The levels of particulate matter (particularly in the respirable size range) observed in the region were high and had the potential for causing short-term or acute symptoms. In addition, the high particulate matter levels were not merely the result of the oil fires, but largely the result of natural background conditions. RAND cites an absence of epidemiological studies on the indigenous population in the peer-reviewed literature for health effects due to particulate matter exposures. A determination of whether there could be long-term health impacts on US troops from short-term particulate matter exposure is the subject of a number of planned and ongoing health studies.
Finally, two health risk assessment studies, using modeled calculations for projecting excess cancers and non-cancers (i.e., damage to the cardio-pulmonary, renal, neurological, and reproductive systems), have been conducted by the U.S. Army Center for Health Promotion and Preventive Medicine and its predecessor organization the U.S. Army Environmental Hygiene Agency. In these studies, estimates were made of the likelihood that exposed troops would experience the onset of disease, including cancers, originating from their exposure to oil fires.
Risk levels were calculated for all U.S. troops. The calculated risk levels were then compared against levels determined to be safe by Environmental Protection Agency. The results of the assessment indicated that in all cases, model projected troop unit risk levels for cancer and non-cancer causing agents were below levels that the EPA considers safe for a normal population.
"It is important for the reader to recognize that further investigations are necessary to fully assess the long-term health effects associated with exposures to particulate matter in the respirable size range, as well as to examine the synergistic affect of multiple contaminants," said Bernard Rostker, special assistant to the deputy secretary of Defense for Gulf War Illnesses. Rostker also emphasized lessons learned for future operations. "In the future, any natural and man-made threats existing in a potential theater of operation should be identified and fully accounted for during the operational planning phase."
For more information on this or other Gulf War illnesses issues, see GulfLINK, an interactive Internet site, at http://www.gulflink.osd.mil.