Letter to Secretary Eric Shinseki, U.S. Department of Veterans Affairs - Answers on Health Effects of Burn Pits

Letter

Today, Congresswoman Carol Shea-Porter sent a letter to Secretary of Veterans Affairs Eric Shinseki expressing her deep concern over allegations that the VA ignored data on the adverse health effects experienced by troops exposed to burn pits. This letter builds on Shea-Porter's work to provide veterans the access to medical treatment they deserve and raise awareness about the potential long-term health impacts of exposure to burn pits.

According to testimony by Dr. Steven S. Coughlin, a former senior epidemiologist at the Department of Veterans Affairs, the VA Office of Public Health ignored "data regarding adverse health consequences of environmental exposures, such as burn pits in Iraq and Afghanistan..." Coughlin added that VA supervisors instructed him "not to look at data regarding hospitalizations and doctors' visits" and "threatened" him when he disagreed.

To date, the full health impacts of burn pits has not been determined with certainty, and until such effects are known, Shea-Porter believes that exposure to burn pits be should be considered a presumptive condition by the VA. This designation would allow veterans to access the medical treatment they deserve.

In March 2009, Shea-Porter, along with a number of her House and Senate colleagues, wrote to Secretary of Defense Robert Gates to express concern that "veterans who have served in Iraq and Afghanistan may be ill, and some may have actually died as a result of exposure to dangerous toxins produced by burn pits used to destroy waste." Since then, she was the driving force behind passage of legislation to prohibit the use of open air burn pits in military theaters, and to mandate the establishment of a VA burn pit registry.

Full text of Shea-Porter's letter to Secretary Shinseki is below.

+++

April 22, 2013
Secretary Eric Shinseki
U.S. Department of Veterans Affairs
810 Vermont Ave. NW
Washington, DC 20420

Dear Secretary Shinseki:

I am writing to you because I am deeply concerned about the testimony that Dr. Steven S. Coughlin, a former senior epidemiologist in the Office of Public Health at the Department of Veterans Affairs (VA) from 2007 to December 2012, delivered at a House Committee on Veteran Affairs hearing on March 13, 2013 (testimony attached). I request that you investigate Dr. Coughlin's allegation that the Office of Public Health did not look at "data regarding adverse health consequences of environmental exposures, such as burn pits in Iraq and Afghanistan, and toxic exposures in the Gulf War." Until the health impacts of exposure to burn pit toxic smoke are finally resolved, I also request that exposure to burn pits be considered a presumptive condition by the VA.

As a member of the House Armed Services Committee (HASC), I have consistently worked to raise needed awareness about the potential long-term health impacts of exposure to burn pits and reduce the exposure of our service men and women to their potentially toxic emissions. In March 2009, I, along with a number of my House and Senate colleagues, wrote to Secretary of Defense Robert Gates to express concern that "veterans who have served in Iraq and Afghanistan may be ill, and some may have actually died as a result of exposure to dangerous toxins produced by burn pits used to destroy waste." I asked that he commit to full cooperation with the VA's proposed studies. Two months later, I and a number of my House and Senate colleagues wrote a letter to the GAO to request review of a study prepared by the U.S. Army Center for Health Promotion and Preventive Medicine (CHHPM) and the U.S. Air Force Institute for Operational Health on the health risks from burn pits at Balad Air Base, Iraq. Later that same year, as a member of the HASC, I succeeded in amending the FY10 National Defense Authorization Act (NDAA) to include my provision (now law) that prohibits the disposal of hazardous and medical wastes in open-air burn pits in war zones, and to prohibit, as policy, the open-air burning of waste (unless the Secretary of Defense certified that there was no other option). Rep. Tim Bishop (NY-1) and I also introduced bills to mandate the establishment of a burn pit registry, and in the FY11 House-passed NDAA, I included an amendment for report language to study establishing such a registry.

In order to determine the health impact of burn pit exposure on our veterans, thorough and careful scientific research and the establishment of a registry to track the impacts of exposure are critical to determining the health impact of burn pit exposure on our veterans. Among the many allegations in Dr. Coughlin's testimony, he stated that VA supervisors instructed him "not to look at data regarding hospitalizations and doctors' visits" and "threatened" him when he disagreed. We need an investigation to determine the facts.

The health impacts of burn pits on veterans have not yet been determined with certainty. For example, the VA public health website on burn pits (http://www.publichealth.va.gov/exposures/burnpits/health-effects-studies.asp), an Institute of Medicine (IOM) of the National Academy of Sciences report, Long-Term Health Consequences of Exposure to Burn Pits in Iraq and Afghanistan (October 31, 2011) "limited but suggestive evidence of a link between exposure to combustion products and reduced lung function in various groups thought to be similar to deployed Servicemembers, such as firefighters and incinerator workers" and noted that "further studies are required." But the report also found "inadequate or insufficient evidence of a relation between exposure to combustion products and cancer, respiratory diseases, circulatory diseases, neurological diseases, and adverse reproductive and developmental outcomes."

Until the current uncertainty of the research and the allegations of tampering with research results are definitively resolved, I ask that the VA presume that it is possible that exposure to burn pits in Iraq and Afghanistan has harmed the health of veterans. On April 26, 2010, the VA issued an environmental training letter (attached) that listed "environmental hazards…, which may result in adverse health effects" (p. 1) and included burn pit exposure. The letter indicated that a veteran's lay statement of service in Iraq, Afghanistan, or Djibouti was to be considered sufficient to establish occurrence of burn pit exposure (p. 4). The letter also states on p. 4, "Regional office personnel must also be aware that many Veterans suffering from illnesses such as, respiratory, cardiopulmonary, neurological, autoimmune, and/or skin disorders, may not associate such conditions with burn pit exposure," clearly implying that burn pit toxin exposure was considered a hazard to health. This presumption was and still is reasonable and necessary.

The VA has worked very hard to serve our veterans. It is critical that they now quickly address this controversy to preserve trust with our newest generation of veterans.

I know how dedicated you are to improving the quality of the VA's care for all of our veterans, and I thank you for your lifetime of service to our military, our veterans, and this great nation. I am confident that the VA and Congress, working together, can address this critical issue, and I look forward to your response.

Source