In Afghanistan and Iraq, especially in the early years, soldiers burned their waste in big, open-air pits.
“A burn pit’s just a big hole in the ground. You push dirt up and just have trash there, and light it on fire and walk away,” says Army veteran Eric Mullins.
Mullins and I met up in Campus Martius Park in Detroit, near where he works.
He served in Iraq in 2003 and again in 2008. On his first tour, he was assigned to burn barrels of human waste.
“We didn’t have bathrooms there and we didn’t have electricity. So we had these, they were a type of an outhouse, to use the bathroom,” he says. “So every morning, being the private, being the lowest ranking guy there, (I) had to go out, take the barrels out, fill it with gas and burn the barrels of human waste.”
Mullins says he had to stand there, breathing in the fumes, and stir the waste until it turned into liquid.
He says they also burned confidential documents, plastic, and anything you’d normally throw into a trash can.
“There were some aerosol cans that’d popped after a bit, and we were like, ‘Oh crap,’” he says. “I know nothing was intentional but it got your heart beating.”
Sometimes, Mullins says, he'll smell something that reminds him of the burn pits in Iraq, and it takes him right back:
Mullins says no one wore respirators or eye protection in or near the burn pits.
"We never thought about it, we were 18, 19, 20 years old. We were young kids, we were in this country burning trash; we never thought there would be long-term effects," he says. "But after you get older, you become a dad, you realize maybe you shouldn't have been doing that."
Tires, batteries, chemicals and plastic
The Office of the Special Inspector General for Afghanistan Reconstruction released a report on burn pits this February. It notes that tires, batteries and plastics were routinely burned in open-air burn pits early on. Its investigation found these items were still being burned in some cases, even after they were banned from the burn pits.
The U.S. Department of Veterans Affairs says chemicals, munitions, paint and medical waste were also burned in the pits.
Jackie Maffucci is the research director for the Iraq and Afghanistan Veterans of America.
“Burn pits tend to be one of the major concerns of the post 9/11 generation,” Maffucci says.
She says veterans tell them they have concerns about respiratory problems that started after they got back to the States.
“Anecdotally, I’ve spoken to some veterans who used to be extremely active — running half marathons, marathons, those kinds of things — and now have trouble walking up the block to go to the store or to go get their mail from the mailbox," she says. "And they’re very concerned that this in part is a result of their exposures when they were deployed."
Research into health effects
There has been some research into long-term health effects, but it’s still early, she says. A study of soldiers published in the New England Journal of Medicine found links between prolonged exposure to burn pits and sulfur mine fires, and a severe respiratory illness called constrictive bronchiolitis.
A few years ago, the VA asked the Institute of Medicine to look into long-term health effects from burn pits.
Dr. Paul Ciminera directs the Post 9/11 Era Environmental Health Program with the Veterans Health Administration.
“The Institute of Medicine in their finding that was strongest in their 2011 report (was) that there could be reduced lung function,” he says. “So reduced lung function in itself doesn’t mean disease, but it could mean that individuals who deployed had some damage to their lungs."
Ciminera says at this point, they haven't identified any health outcomes at the population level that they can tie specifically to burn pits.
"So, individuals who have health problems and wish to receive compensation or service connection for that condition will need to go through our process and have their case looked at on a case-by-case basis," he says.
In other words, the VA has not yet identified what they call "presumptive diseases" related to exposure to burn pits. There are a number of presumptive diseases the VA has recognized in connection to exposure to Agent Orange during the Vietnam War. In an email, VA spokesperson Meagan Lutz explained how this process works:
How a presumptive is established:
The presumptive disability decision-making process involves numerous steps and several VA stakeholders. VA has a responsibility to review the latest evidence based science to understand if illnesses Veterans are encountering are connected to service, and might be associated with long-term adverse health effects. The VA often requests the help of organizations, like the IOM, to determine the long-term health effects of, in the case of Agent Orange, an environmental exposure.
What a presumption is:
The presumption of service connection relieves claimants of the need to submit evidence showing that their disabilities were incurred in or caused by their service. It relieves claimants of the burden of submitting medical evidence directly linking the onset of their condition to service, a burden that would be difficult to meet where the condition manifests at a time remote from service and the relevant medical principles may not be widely known. It also ensures that similar claims are given similar treatment, and enables VA to process claims more quickly by relying upon medical principles that need not be independently established in each case. Finally, it helps Veterans, who may not have been otherwise eligible, obtain prompt medical assistance for their service connected conditions.
The open burn pit registry
The VA is also doing its own studies. In 2013, Congress directed the VA to establish an open burn pit registry. Veterans can sign up on the registry and fill out a questionnaire about their health.
Ciminera says more than 40,000 veterans have signed up so far.
Jackie Maffucci with IAVA says this kind of research into health effects takes years. She encourages any veterans who think they were exposed to sign up for the registry.
“Because, particularly as we saw with Vietnam veterans and Agent Orange, the longer of a gap there is between the research and the outcomes, the harder it is to draw those parallels to be able to say, ‘I was here, I was exposed, here are my records, I need that care,’” she says.
She says she hopes the post 9/11 generation of veterans won’t have to wait as long for answers.