Health Hazards of Chemicals

Commonly Used on Military Bases

 

The chemical exposures of men, women, and children on military bases in the US are well-established. More than 100 military bases are federal "Superfund" sites, meaning that their hazardous contamination is documented and evidence is available to the public.  This webpage discusses some chemicals commonly found on military bases and health conditions they can cause.  This report was written as a voluntary effort by medical professionals in order to help inform Veterans about potential health effects they may experience due to chemical exposure during military service. We hope this will assist Veterans in obtaining early diagnosis, appropriate medical care, and a better quality of life.  We also hope that it will encourage federal policies that inform Veterans about their exposures and provide medical monitoring and care when warranted. 

 

Contents

 

            Introduction

            The Enemy You Know is Far Less Dangerous than the One You Don't Know

            Toxic Effects of Specific Chemicals

            Additional Sources of Information

            Medical Monitoring

 

Chemicals and material groups discussed in this report include the following:

 

            Solvents

            Petroleum fuels

            Pesticides

            Toxic heavy metals

            Radioactive materials

            Asbestos and other fibers

            Common engine maintenance products

 

Disclaimer:  This report does not providing medical advice.  It summarizes toxic effects of chemicals as reported in medical journals and related reports. Links to detailed studies and additional resources are provided at the end of this report.

 

 

 

I.  Introduction

 

Tim walked onto the El Toro tarmac, ready for another day's work on the aircraft he'd become so familiar with. Wearing standard issue work clothes, he handled the equipment with ease. The dirt, grime, and old paint would succumb to solvents he used to power-wash the fighter jet.  The smell was always pungent and often made it difficult to breathe.  On some days there was so much spray in the air that his clothes were damp by the end of the day, permeated with TCE and other strong chemicals.  But today the wind was stronger than usual, and he had couldn't avoid the spray.  Soaked to the skin, he quickly lost consciousness as the solvents were absorbed into his body and circulated to his brain.  The potent neurotoxins in the spray were too much, even for a Marine.

 

If this story were rare, or if the dangers of Tim's work were a necessary part of defending the health and welfare of US citizens, there would be no outrage over the chemical hazards and harm that Tim and other military men and women were subjected to.  But these hazards were avoidable, and the harm unnecessary.  Standard operations in many routine military jobs were not carried out safely, in spite of widely recognized safety practices outside of the military.   Ignoring established and relatively simple exposure control methods, the Department of Defense made a decision to allow enlisted personnel handle toxic chemicals without knowledge of the hazards or how to protect themselves. Tim could have been given protective gear, but he wasn't.  He could have been told that the power wash fluid was dangerous on contact or when he inhaled it, but he wasn't.

 

Decades later, Tim's health problems and those of his children led him to investigate the reality of his own military service and those he served with.  Those realities haven't changed much.  This isn't just history, and the harm isn't just in the past.

 

Cleanup efforts and water contamination problems continue at dozens of military sites across the US.  The legacy of chemical exposures continues to play out in the diseases, disability, and cross-generation damage to Veterans and their families.  This report provides basic information on some common chemical hazards at El Toro and other bases. Links to additional information is provided in the last section of this report.

 

 

II. The Enemy You Know is Far Less Dangerous Than the One You Don't Know

 

Imagine you are a firefighter in a typical US city.  Your team is expected to deal with heat, smoke, explosive materials and other hazards.  You probably imagine yourself equipped with the usual gear - fireproof jacket, heavy boots, a large helmet in case materials fall from above, and a respirator.  Pretty basic.  Essential to do the job and stay alive. 

 

Most fires produce smoke, heat, and other physical warning signs - a clear alert.  These signs  keep the firefighters from walking unknowingly into harms way. 

 

But what if the dangers were not visible.  What if  you couldn't see the smoke and you couldn't feel the heat?  Would you know enough to be cautious? 

 

That's the dilemma faced by workers who deal with toxic chemicals.  That's what many who served at El Toro and on other bases faced.  When people aren't told they are handling hazardous chemicals and aren't given essential gear, they face hazards with no protections and can suffer lifelong consequences.  Federal law requires workers be informed about many toxic chemicals, but those laws aren't always followed, and don't apply everywhere.

 

 

          Background

 

Who Knew What and When did They Know It?

As far back as the 1920s, factory managers knew that people exposed to toxic chemicals on the job got sick if they were too highly exposed.  The Ethyl Corporation had a notorious "butterfly factory" problem when they put lead in gasoline.  workers inhaling lead in the factory became disoriented and delusional that they couldn't do their jobs.  The company was forced to change it's practices in order to have functional workers.

 

By the mid-1940s, the hazards of working with ethers used in hospitals were widely known.  Women had miscarriages, men and women suffered from liver and kidney damage, and other health problems plagued nurses and doctors who merely inhaled small amounts of the chemicals intended for the patients.

 

By the 1950s, the health hazards of solvents like TCE, perchloroethylene, and benzene were widely known. Evidence about toxic metals like lead, cadmium, chromium, and mercury was well established.  And chemicals ingredients in jet fuel, diesel, and gasoline were known to be toxic - even lethal - at high doses.

 

Companies Protect Their Interests by Protecting their Workers

Industries and government agencies combined forces to set "standards" for chemicals - the maximum amount of a chemical that a worker should be subjected to. Protective equipment was part of the plan - specialized gear in some cases, ventilation of factories in other cases.  The goal was to keep the amount of the toxic chemicals in the air people breathed as low as possible.  Warning signs urged workers not to eat near their work stations, and wash stations were installed so any chemicals that got on the skin could be quickly removed. 

 

This didn't always prevent exposures and they often didn't reduce exposure enough to completely protect the workers from long-term health problems like cancer.  But most workplaces were forced to warn employees about what they were handling, provide protective gear, and insure there were ways to remove chemicals from people's skin, eyes, and clothing.  When highly toxic chemicals were used, regular "monitoring" - checking the health status or similar markers of harm - was required.

 

Companies that regularly ignored these rules suffered huge financial losses in legal actions that compensated women who were lied to about pregnancy risks and had badly deformed children. Families of men who died far too early of asbestos-induced lung cancer continue to seek justice in the courts.  Financial and legal consequences have compelled most companies to do the right thing, informing and protecting their employees about hazards.

 

The Department of Defense Stands Alone.

DoD was not affected by factors that led companies to treat their workers with care. Those in the service and Veterans have limited recourse when the onset of disease occurs after discharge.  Even hazards of well-known toxic chemicals such as Agent Orange were denied for decades, after Veterans had died of service-related diseases. 

 

Veterans have no recourse to sue for medical care or harm done. Coupled with that, many serve for a few years, so their direct benefit to the DOD is brief.  These factors limit the incentive for DoD to treat people as valued team members.  While those in and outside of military service working on routine operations at airbases and other military bases in the US perform many of the same jobs, they aren't protected equally. It would be straightforward, rational, and reasonable to provide training, and protective gear or use safer chemicals.  But those in the military who work with toxic materials often lack training and equipment to avoid health damage. 

 

Treating service members as expendable is neither ethical nor responsible.  Those who agree to place themselves in harms way for the good of the country should be protected to the degree possible.  Protection isn't always possible.  But when simple practices can protect the military's most valuable asset, the DOD should muster the will to make it happen.

 

Information on Specific Military Bases

Every base is unique, but most carry out many of the same operations. El Toro was an airbase, as are many military bases.  Most maintain a fleet of vehicles that involve similar or identical engine-related products and fuels as airbases.  And so the chemicals used at El Toro were and are commonly used at air bases and airports.  Their toxic properties  have been known for decades, and there are hundreds of medical scientific studies and federal documents that describe their harmful effects. 

 

In addition to chemicals used in base operations, many bases had burn pits.  These were large open pits in the ground where unwanted materials and chemicals were disposed of.  The pit contents were set on fire, and used to train fire fighters.  Burn pits created toxic clouds of chemicals created during incineration.  El Toro had two pits, one up wind of the base elementary school.

 

Other standard operations that can create high level exposures to toxic chemicals include pest control (insects and rodents), grounds maintenance, cleaning, repair, and remodeling activities, and other usual and customary activities you would expect at any commercial or industrial facility. 

 

It was not the simple fact of chemical use that created serious health problems, it was the failure to alert and protect those using and otherwise exposed to the chemicals.  Unsafe practices can be changed to avoid future harm.  But those who were harmed deserve medical care and other essentials to maintain a reasonable quality of life.

 

 

          Hazardous Chemicals on Bases

 

Some of the common chemicals and products commonly found on airbases are listed in Table 1 below.  These were present at El Toro and many are still used on military bases and other locations where vehicle fueling, maintenance, and airstrip maintenance are carried out.  Many are essential for standard operations, but are also toxic and require careful handling, personal protective gear, and other safety measures to minimize the exposure of workers and others in the area, and avoid health problems.  Federal regulations require many of the protective actions as a matter of law, but those regulations are not necessarily enforced.

 

The chemicals listed in Table 1 are organized into functional groups, often corresponding to the kinds of  health damage they can cause.  Each group is discussed below and links to more detailed information are provided in the last section.  There is extensive medical science on most of the chemical groups.  The fact of their occurrence at bases is provided by the soil and water testing that has been conducted at bases now designated as Superfund sites (hazardous waste sites) and corroborated by the verbal reports of those who worked directly with the chemicals. 

 

Table 1.  Some Hazardous Chemicals Commonly Used on Airbases

 

Solvents

    trichloroethylene (TCE)

    perchloroethylene (Perc)

Petroleum fuels

    jet fuel

    diesel

    gasoline

    benzene

    perchlorate

    combustion byproducts

Pesticides

    Agent Orange

    DDT

    chlordane

Toxic heavy metals

Radioactive materials

Asbestos & Other Fibers

Common engine maintenance products

 

For simplicity, chemicals and products are simply referred to as "chemicals" for the rest of this report.  In reality, products such as gasoline and chemicals such as chlordane are actually complex mixtures of dozens of individual chemical ingredients.

 

 

          Health Conditions Associated with Base Chemicals

 

Many health effects of toxic chemicals are discussed below.  They range from cancer to birth defects, many types of organ damage (liver, kidneys, heart) and even death.  The amount and timing of exposure, as well as individual variations in susceptibility to chemicals determine whether someone will be harmed, and the types of diseases or conditions that may occur.  The chemicals involved can damage every organ in the body, given sufficient exposure.  But even very small exposures can be harmful for some individuals, and exposures to carcinogens are able to initiate a chain of biological events that will be manifest as cancer many decades later. 

 

Who is Affected - Individual Responses to Toxic Chemicals

The amount of exposure that will cause a health effects varies from one person to the next.   Whether people have any noticeable health problems and the nature of those problems depends on a range of individual characteristics.  These include the amount and timing of exposure, whether exposure occurs through inhalation, ingestion, or skin exposure, and individual susceptibility.  Individual susceptibility is determined by genetic differences, previous and current health conditions, past and ongoing exposures to other chemicals and risk factors, diet, lifestyle, age, gender, and other personal variables. 

 

No one can predict the precise response of an individual to chemical exposure.  For example, the side effects of carefully manufactured drugs (also chemicals) that are prescribed based on medical knowledge of an individual aren't fully predictable.  Responses to exposures to unknown quantities of one or more toxic chemicals are far more difficult to estimate.

 

Medical Monitoring

The solution to this is to offer medical monitoring, such as screening for cancer, cardiovascular disease, or neurological damage, that can identify health conditions at the earliest possible stage of disease, when it is most treatable.  Medical monitoring can be  provided by an individual's usual medical care providers, if they are given sufficient guidance from a medical specialist.  Or it can be obtained at a specialty occupational medicine clinic, with results given to the patient and their primary care doctor. 

 

Drs. Brautbar and Wu, of the University of Southern California, are specialists whose journal article on medical monitoring outlines criteria for the monitoring and describes some types of monitoring.  Their article also lists guidance provided by the Centers for Disease Control on this topic.  Conclusions from that article and additional information on medical monitoring is provided at the end of this report, following Section IV.

 

Armed with the knowledge of the types of health problems that can be caused by chemicals they have encountered, a Veteran can best advocate for appropriate medical screening and best insure their future health.  The information provided here and in the more detailed scientific literature that is listed in the last section may be helpful for care providers who are working with people who have been exposed to toxic chemicals.  However, to obtain the most specifically targeted health care, Veterans can consult with a medical specialist in the subspecialty of occupational and environmental medicine.  These physicians are board certified in internal medicine, with further training in identification and treatment of chemically-induced medical conditions.  Those who were exposed to toxic chemicals in the past may require medical monitoring and care to identify health conditions at the earliest and most curable stages and insure the best possible outcome.       

 

While the VA should freely offer to Veterans:

1) information about their chemical exposures,

2) information on common medical conditions that can occur as a result of exposure,

3) appropriate medical monitoring for early diagnosis

4) appropriate medical care,

 

             they do not do so as yet. 

 

Instead, most Veterans remain ignorant of what they encountered, and if they are able to locate information that indicates their medical conditions may be related to their military  service, the burden of proof for chemical causation is on the Veteran.  They must document what they were exposed to and attempt to convince the VA that their medical conditions are related to their military service, often at a very high cost for "expert" documents.  This is the opposite of how the process should work from a protective public health perspective.  Failure to warn and screen ignores the usual medically sound approach used in preventive medicine.

 

Genetic Damage and Cancer - Latent Effects

Many of the toxic chemicals discussed below are genotoxic, meaning they can damage the genetic material in cells - aka, they cause mutations.  Cells genetic directions are carried on chromosomes (DNA) and dictate how our body will function, whether we will get cancer or many other diseases.  The genetic directions coordinate many actions essential for life, ranging from the production of new cardiac cells in the heart to the process of normal growth and development.  Cancer, which basically defined as the uncontrolled growth of cells, can be initiated by genetic damage - a mutation. 

 

Exposure to even a very small amount of a chemical that is genotoxic and carcinogenic poses some degree of cancer risk.  Individual factors and the amount of exposure determine whether someone will actually get cancer, and as discussed above, that can't be predicted on an individual basis.  But regardless of whether someone is more or less likely to get cancer, exposure to carcinogens usually occurs many years, and often decades, before a clinically-detectable cancer is identified.  This means that that cancer induced by chemicals used during service would usually occur after someone completes their military service.  That fact alone made it far easier for DoD to deny that Agent Orange was responsible for health problems. 

 

The time lag between chemical exposures and cancer, referred to as the latency period, complicates the situation for Veterans as well as any family members who were exposed to chemicals on bases (e.g., via drinking water).  However, the medical evidence is clear for many chemicals, so if a Veteran was exposed and related cancers occurred in coming years that were more than likely attributable to that exposure, Veterans theoretically have recourse to obtain services and disability.  This is not the same as medical monitoring, which could identify a cancer at the earliest and most treatable stages, but it is the nature of assistance currently available.

 

Genetic damage can result in birth defects.  In these cases, chemical exposure may be more easily tied to the harm because they occur during the same time period. But health damage to children, whether through exposure of parents or of the child directly, may also be recognized many years later.  Health problems such as learning disabilities and cancer are unlikely to be obvious in infancy.  Delayed identification of children's health conditions may make it very difficult to establish a connection between chemical exposure and harm.  Those families who lived on many bases may have an even greater challenge in sorting out any connections that exist.

 

Prevention

Protective actions, including the use of safety equipment, water testing, and other strategies could have prevented contamination and human exposure at military bases. Many toxic chemicals are still in use on bases, and standard protective measures will reduce exposure and harm.  OSHA, NIOSH, EPA, and other agencies and entities offer guidance on personal protective gear, safety measures, methods to prevent water, air, and soil contamination, and how to take other steps to insure people and critical land and water resources remain as safe as possible. 

 

 

III. Toxic Effects of Specific Chemicals

 

The information below is organized by chemical and chemical groups as listed in Table 1.  General information on a category of chemicals (e.g., solvents) is provided, if applicable, followed by information on individual chemicals within that category.  All information is based on medical scientific sources listed in the last section unless citations are contained in the text.

 

 

A.  Solvents

 

Background

 

Solvents are commonly used to degrease and clean mechanical equipment, as paint thinners, and for many other uses.  Solvents have the unique ability to quickly and easily cut through grease and oil.  While useful on worksites,  those same properties also allow it to move through human skin quickly. 

 

As with petroleum fuels, many solvents are "volatile" meaning they are able to change from a liquid to a gas at normal outdoor and indoor temperatures.  A puddle of TCE, perc, or other solvents can evaporate into the air, just as water does, only much more quickly.  Solvents in water can also evaporate, moving into the air in homes where the water is being used. 

 

Whether exposure occurs through inhaling solvents, drinking contaminated water, or skin exposure, once they are in the body they can circulate quickly.  Solvents can damage the outer protective layer of the skin, causing direct exposure, skin damage and also making it easier for other chemicals to move through the skin.  Underlying the skin is a vast network of capillaries that carry whatever is picked up from the skin into the circulation.  From there, the chemicals move throughout the body - to the brain, liver, kidneys, GI tract, and all other organs. 

 

Two common solvents are discussed below, but many more are commonly used in aviation and other activities carried out on military bases.  Each solvent has some unique properties, but those discussed below share many features, including their chemical structure and their ability to cause many specific types of health damage. These include damaging the skin, liver, kidneys, nervous system, lungs, reproductive system, lungs, and other organs in the body, as well as unborn babies of women exposed during pregnancy.  Many solvents can cause mutations and cancer. 

 

Some people are especially susceptible to solvents.  Very young children, especially infants, have skin that is not completely developed and so aren't as effectively at keeping chemicals outside of the body as the skin of older children or adults.  Consequently, chemicals that can penetrate through skin and move into the body, as solvents can do, create greater risks for infants.  The chemical can move inside the body more quickly and to a greater degree, potentially creating more serious health problems and delivering a higher chemical dose throughout the body.

 

Solvents can also irritate the skin, throat, lungs, and other areas they reach.  Consequently, people with respiratory problems, such as asthma, are at higher risk from exposure to many solvents.  They can trigger asthma attacks, and aggravate the symptoms of

 

Solvents and fuels (discussed below) that reach the lungs in high concentrations can remain in the lungs for some time and coat the lung surfaces necessary for effective breathing.  This can result in a condition called "chemical pneumonitis" - a chemically-induced type of pneumonia. Chemical pneumonitis can lead to respiratory distress and related serious health problems.

 

 

TCE

 

Basic Properties

Many Veterans who worked with equipment or did maintenance on aircraft or vehicles used TCE as a solvent, paint remover, and for other purposes. Tim King, the soldier described in the first paragraph of this report, worked with TCE, though he didn't know at the time it was highly toxic.  There is no way to know how many Veterans were exposed (or highly exposed as Tim was) to TCE.  But it was widely used, and so there were probably a great many servicemen and women exposed to TCE.

 

In addition to being exposed to TCE on the job, environmental contamination has led to more exposures from contaminated drinking water. TCE has been found in the water supplies on some bases (e.g., Camp Lejeune), and is suspected of being on many more.  Since TCE was used without adequate controls and so contaminated the soil at El Toro, it is very likely that it also contaminated the underlying water sources, leading to drinking water contamination.  TCE in water can contribute substantially to TCE in air.  Cooking, cleaning, showering, bathing, and other standard activities that involve heating or agitation of water can cause substantial TCE release into indoor air, resulting in additional TCE exposure.

 

 Due to the importance of TCE as a source of exposure to toxic chemicals, there is more information provided on TCE in this book than on the other chemicals. 

 

TCE is a colorless liquid that has been used as a degreaser, solvent, industrial cleaner, and for many other purposes.  On airbases it was used to clean machinery, remove paint and debris from areas to be painted on the aircraft, and to clean and prepare other machinery and weapons. 

 

TCE can mix with water and move through water supplies.  When it is dumped on the ground, it moved down through the soil and can enter underground water supplies (e.g.,. aquifers).  It is also "volatile" meaning that it can quickly evaporate into the air, where people can breathe it. 

 

People can be exposed to TCE by inhaling it, drinking it in their water, or absorbing it through their skin.  Because it is a solvent, it can quickly penetrate through the skin.  No matter how people are exposed to it, TCE can enter the blood stream and quickly circulate through the body. That is why it is possible for people to have serious health problems as a result of any type of TCE exposure.  The types of harm that are caused vary depending on individual susceptibility, but generally fall in to well-understood categories.  The health risks and severity of problems increases with increased exposure.

 

General Health Effects of TCE

TCE is capable of causing a wide range of health damage. It can damage the nervous system, causing headaches, nausea dizziness, disorientation and confusion.  Very high exposure causes unconsciousness, as happened with Tim, who was described at the beginning of this report. 

 

TCE has caused damage to other parts of the nervous system, including cranial nerves and the peripheral nervous system.  Chronic nerve disorders can also result from exposure.  These can impact motor skills such as walking, driving, and other daily activities because they damage the ability of people to control the way their body moves.

 

TCE damages skin cells, and can cause many different types of skin disorders which may be seen as redness, scaling,, chemical burns, blistering, inflammation, and dermatitis.  It makes the skin more susceptible to other types of chemicals, and can make skin more likely to be damaged by the sun (e.g., causing skin cancer). These are all obvious problems, but it can also cause damage that is much more difficult to identify quickly.

 

TCE is processed in the body by the liver and kidneys, which are target organs for TCE damage.  It damages both, and they are both essential for life.  Both liver and kidney damage are often not identified until substantial damage has been done.

 

TCE and also harm to the cardiovascular system.  Its effects may result in abnormal heartbeats (arrhythmias). TCE sensitizes the heart to naturally occurring chemicals such as epinephrine.   Exposure to TCE may be more dangerous for people who have heart problems, especially those that are related to heart rhythms abnormalities.

 

As noted above, solvents, including TCE, can cause lung irritation and damage, making it difficult to breathe.  The issue of chemical pneumonitis, mentioned above, was the focus of a statement about TCE by CDC, with a special focus on children: "Hydrocarbon pneumonitis may be a problem in children." (http://www.atsdr.cdc.gov/MMG/MMG.asp?id=168&tid=30). 

 

The effects of TCE on the nervous system can cause decrease in respiration, which is potentially dangerous.  And TCE is also a respiratory irritant.  All irritants pose risks to people with asthma, emphysema, and other respiratory diseases.  TCE can  potentially trigger asthma attacks and other respiratory episodes.

 

TCE reduces the ability of the immune system to function correctly.  This makes people more susceptible to infections and reduces the body's ability to identify and eliminate cancer cells.

 

These are all important health effects, but the types of harm that have received the most attention, and rightly so, are TCE's ability to cause cancer and birth defects.

 

Cancer and TCE

TCE is a "known human carcinogen".  That means that many cancer scientists have come together and determined that there is strong evidence that TCE can cause cancer in people.  There judgment is based on many scientific studies that found TCE exposure caused cancer  people.  That evidence is supported by dozens of additional studies that found cancer in animals, determined how it causes cancer, and provides other information that aids in the understanding of TCE's carcinogenic action in people. 

 

Concerns about TCE causing cancer are so substantial that the federal government has determined that only five parts per billion (ppb) is allowable in drinking water supplies.  It means that only 1 molecule of TCE can be present for every 200,000,000 molecules of water in a glass. That is one of the most stringent drinking water standards in the country. 

 

Birth Defects and TCE

An unborn child is exposed to TCE if their mother is exposed to it because it crosses the placenta.  It then enters the circulation of the fetus, circulating throughout their body.  Mothers exposed to TCE pass TCE along to their babies through breast milk.  Consequently, the prenatal and early life exposures of children to TCE are of very high concern.  Children are generally more susceptible to toxic chemicals than adults, and in addition, early life exposure to carcinogens imposes a cancer risk that is usually higher than an adult exposed to the same amount of the carcinogen.  For this reason, the federal government and public health officials are very concerned about the prenatal and childhood exposures of the public to toxic chemicals.  

 

Children's likelihood of exposure to airborne TCE

TCE is heavier than air, so tends to be at higher concentrations near the ground.  For that reason, ATSDR has said that children "may be exposed to higher levels than adults in the same location because of their short stature and the higher levels of trichloroethylene vapor found nearer to the ground."  (see:  http://www.atsdr.cdc.gov/MMG/MMG.asp?id=168&tid=30).  Overall, there is no question that exposure of children to TCE on military bases (or in any other situation) is a serious public health concern.

 

 

Perchloroethylene (perc, tetrachloroethylene)

 

Perc is very similar to TCE in both it chemical structure and the harm it can cause.  It was used as a cleaning fluid throughout most of the 20th century and has been phased out as a dry cleaning chemical in recent decades due to its hazardous properties.  It has contaminated drinking water in many areas, often near dry cleaning shops and manufacturing locations where it was used to clean machinery, parts, etc.  It is found at many Superfund sites across the US, including military bases.  As with TCE, it can rapidly penetrate the skin.  While used as a liquid, it can evaporate into their, causing exposure through inhalation.   Like TCE, it can move into groundwater and travel underground, contaminating areas in communities around the location where it was originally used.

 

According to the US EPA and the National Toxicology Program (part of the National Institutes of Health), perc can cause neurological, liver, and kidney effects following acute (short-term) and chronic (long-term) inhalation exposure. It causes irritation of the upper respiratory tract and eyes, kidney dysfunction, and at lower concentrations, neurological effects, such as reversible mood and behavioral changes, impairment of coordination, dizziness, headache, sleepiness, and unconciousness. Reproductive effects can include pregnancy loss, menstrual disorders, altered sperm structure, birth defects and reduced fertility.

 

Studies of dry-cleaners exposed to perc suggest increased risks for several types of cancer: throat, kidney, breast, bladder, lung, pancreas, skin, colon, cervix, lymphosarcoma, non-Hodgkin's lymphoma and leukemia. Childhood leukemia was reported in a study of perc contamination in drinking water.  In addition, animal studies have found many of the same cancers.  According to the NIH, perc " is reasonably anticipated to be a human carcinogen".

(citation: http://www.epa.gov/ttnatw01/hlthef/tet-ethy.html and  http://ntp.niehs.nih.gov/ntp/roc/eleventh/profiles/s169tetr.pdf )

 

 

B.  Petroleum Fuels

 

 

Basic Properties

 

Petroleum fuels are present at bases across the country because they are required for aircraft, trucks and other vehicles.  They are mixtures of chemicals, with toxic properties usually studied as a chemical group.  The amounts of specific ingredients in fuels vary, depending on location, use, weather conditions, and other factors.  But the chemical ingredients in a particular type of fuel (e.g., jet fuel, diesel, gasoline) are fairly consistent, and so are the toxic effects of the fuels.   Two ingredients of most petroleum fuels, benzene and perchlorate, are discussed separately below because they are particularly toxic and well studied.

 

Basic properties of most fuels for trucks, cars, and aircraft are similar because they share functional properties - a capacity to burn efficiently in a controlled manner at normal outdoor temperatures and derivation from crude oil.  Many chemical ingredients in the fuels evaporate into air quickly and so can be inhaled easily by anyone in the vicinity of fueling operations.  People can also be exposed through direct skin contact, which leads to rapid absorption through the skin of some fuel components.

 

To illustrate what is in a standard fuel, Table 2 below lists ingredients in jet fuel, as reported in the US Centers for Disease Control (CDC)'s CDC's Toxicological Profile for Jet Fuels #4 and #7 (http://www.atsdr.cdc.gov/ToxProfiles/tp76.pdf )  The table illustrates the complexity of the fuels.  Diesel, gasoline, kerosene, and other fuels also have a range of ingredients, and many are very toxic. 

 

As Table 2 shows, benzene and many other toxic chemicals are ingredients in jet fuel, and also are found in other car, truck, marine, and aircraft fuels.  While most people in the US have some exposure to these fuels at trace levels,  those who work with and around the fuels are often much more highly exposed and so incur much higher health risks. 

 

One of the greatest concerns, as previously mentioned, is benzene, and that is discussed in more detail below. Benzene is listed as a component of jet fuel and is in most other petroleum fuels.  Health hazards also result from the mixture of chemicals people are exposed to.  A combination of many chemicals can impose greater risks by virtue of the varied types of damage they can cause.  In addition, many of them attack the same parts of the human body, causing greater damage through the cumulative effects of multiple chemical exposures.

 

Table 2: Typical Hydrocarbon Composition Of Jp-4 Fuel

Compound

percent

N-alkanes

 

  Butane

0.12

  Pentane

1.06

  Hexane

2.21

  Heptane

3.67

  Octane

3.80

  Nonane

2.25

  Decane

2.16

  Undecane

2.32

  Dodecane

2.00

  Triecane

1.52

  Tetradecane

0.73

  Pentadecane

----

  Hexadecane

----

  Heptadecane

----

  Octadecane

----

Isoalkanes

 

  Isobutane

0.66

  2,2-Dimethylbutane

0.10

  2-Methylpentane

1.28

  3-Methylpentane

0.89

  2,2-Dimethylpentane

0.25

  2-Methylhexane

2.35

  3-Methylhexane

1.97

  2,2,3,3-Tetramethylbutane

0.24

  2,5-Dimethylhexane

0.37

  2,4-Dimethylhexane

0.58

  3,3-Dimethylhexane

0.26

  2,2- Dimethylhexane

0.71

  2-Methylheptane

2.70

  4-Methylheptane

0.92

  3-Methylheptane

3.04

Isoalkanes

 

  2,5-Dimethylheptane

0.52

  2,4-Dimethylheptane

0.43

  4-Ethylhepane

0.18

  4-Methyloctane

0.86

  2-Methyloctane

0.88

  3-Methyloctane

0.79

  2-Methylundecane

0.64

  2,6-Dimethylundecane

0.71

  2,4,6-Trimethylheptane

---

  4-Methyldecane

---

  2-Methyldecane

---

  2,6-Dimethyldecane

---

  2-Methylundecane

---

  2,6-Dimethylundecane

---

Cycloparaffins

 

  Methylcyclopentane

1.16

  Cyclohexane

1.24

  t-1,3-Dimethylcyclopentane

0.36

  c-1,3-Dimethylcyclopentane

0.34

  c-1,2-Dimethylcyclopentane

0.54

  Methylcyclohexane

2.27

  Ethylcyclopentane

0.26

  1,2,4-Trimethylcyclopentane

0.25

  1,2,3-Trimethylcyclopentane

0.25

  c-1,3-Dimethylcyclohexane

0.42

  1-Methyl-3-ethylcyclohexane

0.17

  1-Methyl-2-ethylcyclohexane

0.39

  Dimethylcyclohexane

0.43

  1,3,5-Trimethylcyclohexane

0.99

  1,1,3-Trimethylcyclohexane

0.48

  1-Methyl-4-ethylcyclohexane

0.48

  n-Butylcyclohexane

0.70

  Propylcyclohexane

---

  Hexylcyclohexane

---

  Heptylcyclohexane

---

Aromatic hydrocarbons

 

  Benzene

0.50

  Toluene

1.33

  Ethylbenzene

0.37

Aromatic hydrocarbons

 

  m-Xylene

0.96

  p-Xylene

0.35

  o-Xylene

1.01

  Isopropylbenzene

0.30

  n-Propylbenzene

0.71

  1-Methyl-3-ethylbenzene

0.49

  1-Methyl-4-ethylbenzene

0.43

  1,3,5-Trimethylbenzene

0.42

  1-Methyl-2-ethylbenzene

0.23

  1,2,4-Trimethylbenzene

1.01

  1,3-Diethylbenzene

0.46

  1,4-Diethylbenzene

---

  1-Methyl-4-propylbenzene

0.40

  1,3-Dimethyl-5-ethylbenzene

0.61

  1-Methyl-2-isopropylbenzene

0.29

  1,4-Dimethyl-2-ethylbenzene

0.70

  1,2-Dimethyl-4-ethylbenzene

0.77

  1,2,3,4-Triamethylbenzene

0.75

  1-Ethylpropylbenzene

---

  1,2,4-Triethylbenzene

---

  1,3,5-Triethylbenzene

---

  Phenylcyclohexane

---

  1-t-Butyl-3,4,5-trimethylbenzene

---

  n-Heptybenzene

---

  Naphthalene

0.50

  2-Methylnaphthalene

0.56

  1-Methylnaphthalene

0.78

  2,6-Dimethylnaphthalene

0.25

  Biphenyl

---

  1-Ethylnapthalene

---

  2,3-Dimethylnaphthalene

---

  n-Octybenzene

---

 

Adapted from Table 3-8 ATSDR's Toxicological Profile on Jet Fuels # 4 and #7.

 

 

Exposure - Skin Contact, Ingestion, or Inhalation Leads to Internal Exposure

 

Exposure to chemicals in petroleum fuels can result in rapid widespread internal exposure, reaching all organs in the body.  As noted above, many petroleum fuel ingredients are absorbed though the skin, which means that direct contact or contact with contaminated clothing leads is of concern.  As discussed for solvents above, chemicals that move through the skin can quickly circulate throughout the body. 

 

Some areas of the country have water contaminating as a result of fuel spills or fuel dumping directly onto the ground.  If drinking water supplies lie under or near the areas where fuels reach the soil, they can be contaminated.  These are often difficult to clean up, and can lead to exposures both on and off of bases where the initial contamination occurred.

 

There are many volatile chemicals (those that move from the fuel into air) in petroleum fuels.  When these are inhaled, they are absorbed through the lungs, which are conduits to the blood stream.  So inhaled petroleum fuel chemicals can move into the body's circulation and reach the brain and other important organs. 

 

 

Harm

 

Common rapid-onset effects of short-term exposure to chemicals in fuels include dizziness, confusion and disorientation, and headache - all related to depression of the central nervous system.  It is less common, but short-term exposure can also cause damage to the liver, kidneys, and other fundamental organs in the body.  In general, single short-term low level exposures are unlikely to cause obvious health problems, but damage could occur in people who are susceptible to chemicals, due to pre-existing health conditions or ongoing exposures to other toxic chemicals (e.g., if they are also exposed to other toxic chemicals routinely). 

 

Rapid-onset effects can be important in the short-term, but longer-term consequences are often more serious.  Repeated exposure to petroleum fuels can cause a range of health problems, even if the daily exposure levels are low.  These include damage to the reproductive system, liver and kidney damage, lung damage, mental health problems and other central nervous system damage, skin damage and susceptibility to skin disorders and skin cancer, stomach and gastrointestinal upset, cardiovascular damage, abnormal hormone level, difficult with controlling movements and feeling in the hands and feet (peripheral neuropathy), and some other health problems.  Some of these problems are due to the presence of the two chemicals discussed below, benzene and perchlorate. But there are many toxic chemicals in petroleum fuels, which make them particularly dangerous to handle and work around.

 

Petroleum fuels contain benzene and other cancer causing chemicals, as discussed below.  They  also contain many chemicals that can cross the placenta, and so pose special risks to unborn children when mothers are exposed to them.  Some ingredients can cause mutations,  meaning they can damage the genetic directions in a cell that direct normal development. Exposure to genotoxic carcinogens poses higher risks to the fetus and young children than to adults, according to extensive evidence in the medical literature.  Consequently, the exposure of mothers or fathers to these chemicals, which they can bring home on their clothing, or the direct exposure of pregnant women or children, pose unique and serious health risks. 

 

 

Benzene

 

Basic Properties

Benzene has been used since the 1800s for many purposes, so there is considerable evidence about its behavior and its ability to harm people.  It can evaporate quickly, changing from its liquid form in gasoline into a gaseous form. Benzene is an ingredient in fuels and other products, and was recognized decades ago as being very dangerous.  The fact that DOD

admitted it was a contaminant at Camp Lejeune is not surprising, nor is the fact that it has been found at military bases across the US where investigations have uncovered chemical contamination in soil and water. It is a fuel ingredient of great concern and the gas capture systems on most gas pumps are designed to prevent benzene (and other chemicals) from leaking out of the tank during pumping.  Air in the vicinity of gasoline is likely contaminated with benzene, due to its quick movement into the air.

 

Veterans, their families, and people who live around contaminated military bases need to know if they were exposed to benzene, and what kinds of health problems they should be on the alert for.  Their exposure levels will determine whether they are likely to have health problems, and what those problems may be, although people vary in their responses to toxic chemicals. 

 

Most people don't know their exposure levels, but some basic information can help them determine if it was likely to be high, moderate, or low.  The types and amounts of chemical contamination on military bases are documented for "Superfund" sites, as listed in "A Few Good Men" and on the federal site at www.epa.gov.  In addition, some states' departments of environmental protection or health departments  have information on bases that aren't on the federal list. 

 

Personnel who worked directly with benzene or fuels containing benzene were likely to have the highest exposures.  Benzene easily moves from gasoline into the air where it could be inhaled by people nearby.  It is also absorbed through the skin when there is direct contact. 

 

Benzene in tap water usually leads to lower exposures than working directly with it. But exposure may continue over many years, and can contaminate air inside homes and other buildings. Infants are at especially high risk if their formula was mixed with tap water containing benzene because all of their food was contaminated during a vulnerable time in their lives.

 

The health hazards of benzene are listed below.  People who think they were highly exposed can provide this information to their physicians, who will be on alert to catch and address problems at an early stage.

 

Health effects summary

 

During or shortly after exposure people have experienced headaches, dizziness, confusion, drowsiness, impaired memory or judgment, abnormal levels of blood cells, ventricular fibrillation, gastritis and other stomach problems, skin irritation and burns, swelling and edema, kidney damage, and damage to chromosomes, which can lead to cancer or birth defects in children.

 

After exposure and possibly delayed for years people have experienced abnormal blood cell profile (e.g., anemia, aplastic anemia, leukemia), cardiac stress due to lack of erythrocytes, infections due to a lack of leukocytes, peripheral nervous system damage with numbness, tingling and lack of sensation in hands and feet, difficulty sleeping, memory loss, chronic kidney disease, and reproductive problems. 

 

Benzene can cause cancer, and it is often referred to as a "leukemogen" because it is can cause leukemia in people.  Benzene attacks the blood-forming system in the body (the hematopoietic system) and can cause anemia and aplastic anemia - early steps towards leukemia.  There are no "prevention" treatments for leukemia, but many types of leukemia can be halted or even cured through early diagnosis and treatment. While most people exposed to benzene will not get leukemia, it is important to consider medical monitoring for people exposed to petroleum fuels, especially if they were exposed over many years to relatively high levels due to their work.

 

Benzene is also genotoxic and can cause birth defects and a range of other health problems if the genetic messages within cells are scrambled due to benzene exposure. 

 

 

Perchlorate

 

Perchlorate is a component of jet fuel.  Consequently, it is a common contaminant at airbases and in the water supplies near bases.  It can cause the health problems described above under petroleum fuels "basic properties", and also attacks the thyroid gland, which controls many of the hormones in the body directly or indirectly.  People with poor thyroid function are often tired, they may lose some of their ability to think clearly, and may also lose their hair or have other signs often confused with aging. 

 

When thyroid function is damaged in pregnant women, their children's nervous system can be damaged.  Studies have found cognitive damage in their babies, so it is important to be aware of perchlorate exposure during pregnancy.  This is probably an issue of most concern to base families.

 

Abnormal thyroid function can also impact other parts of the endocrine system, which are responsible for growth and development, sexual function and reproduction, levels of testosterone and estrogen and other normal aspects of physiology.  Because these effects can be subtle and attributed to many other causes (e.g., age, diet, other health conditions), it is easy to ignore or miss.  The identification and treatment of most thyroid diseases are simple and inexpensive.  It is important to be aware of the potential for thyroid disease if you have been exposed to perchlorate in fuels, particularly in jet fuel.

 

 

Combustion Byproducts & Burn Pits

 

"Combustion byproducts" is a common term for the chemical mixture that is caused by burning petroleum fuels (e.g., gasoline, heating oil, jet fuel, diesel).  The most familiar form of combustion byproducts is car exhaust, but there are many other sources. When a considerable amount of the chemicals produced by burning fuel are produced by either high use of fuels or accumulation over time, we often see it as "soot" deposited on surfaces where the fuels were burned.  Since exhaust and smokestack scrubbers and emissions reduction equipment has been installed on vehicles and equipment since the 1970s, the amount of soot in the US has been dramatically reduced in locations where the control technologies are used.

 

At military bases, combustion byproducts are generated by planes, trucks, cars, and other vehicles, by heating buildings with petroleum fuels, and from other sources.  As petroleum fuels burn, most of the chemical ingredients are changed and some elements that were tightly bound up in the fuel are also released.  The result is a mixture of old and new chemicals resulting from the combustion, and metals that have been released.

 

Some chemicals formed during burning aren't hazardous, but many are.  Most of the chemicals occur in groups of similar chemicals.  Burn pits create dioxins, which are in the same chemical family as Agent Orange.  Polycyclic aromatic hydrocarbons or "PAHs" are another chemical group that is very hazardous. They are mutagenic and can cause cancer.  The cancer-causing nature of soot, known since the 1800's, is largely attributed to these chemicals. 

 

Burn pits and burning fuels cause the release of metals previously bound to other materials.  They are broken down into particles small enough to be inhaled and do damage.  Toxic heavy metals are discussed below.   Chemicals in the air were inhaled by those in their vicinity and their soot landed on the ground and in nearby buildings. 

 

For the last few decades, industrial facilities which burn petroleum fuels install "scrubbers" which remove much of the soot.  They are also required to install other equipment to capture toxic heavy metals that are released (metals are discussed below).  And the exhaust systems on cars, trucks, and buses also have filters to capture some of the exhaust.

 

In addition to cancer, combustion byproducts can cause many respiratory health problems.  They are especially dangerous for people who have pre-existing conditions such as asthma and emphysema.  And they pose health risks to newborns, especially low birth weight or premature infants whose lungs aren't fully formed.  These types of health damage may be a greater concern to base families than to those in military service.  But the longer term cancer risks can affect anyone who is exposed to them.

 

A relatively unique feature of military bases is that many of them had burn pits.  These were often located in large open areas and were used to practice fire fighting skills and dispose of unwanted waste materials.  A wide variety of waste oils, fuels, old equipment, and other waste was thrown into burn pits.  Depending on what was being discarded (e.g., old plastic or vinyl materials), the potential to create new and more dangerous contaminants in air was present (e.g., plastic incineration ban create the highly toxic chemical, vinyl chloride).

 

At El Toro the burn pit was set ablaze at least weekly, during the day, upwind of the elementary school.  The soot contained more than the usual petroleum fuel combustion byproducts because so many types of materials were burned in the pit.  Teachers complained of an oil residue on the desks, books, and other areas inside the school.  Information provided by one of the teachers is included in the new book,  "A Few Good Men, Too Many Chemicals".

 

 

C. Pesticides

 

Basic Properties

 

Pesticides include chemicals that control or kill insects, grass, weeds, mold and fungus, and that eliminate unwanted animals such as rodents.   They have been called "economic poisons" because they are poisons used to reduce economic damage or improve economic yield.  They are widely used on military bases as well as in most residential, commercial, and agricultural operations. 

 

Some pesticides are relatively safe unless they are consumed in large quantities (e.g., warfarin, which is used to kill rodents, is also used as a blood thinner for people with various medical conditions).  But many pesticides used to control the growth of vegetation along airstrips, roadways, sidewalks, and in other locations can contain extremely dangerous chemicals, including dioxins.  Many pesticides used for insect control are now banned (e.g., DDT, chlordane and heptachlor).  Numerous pesticides have been shown to cause cancer and to persist and build up in exposed people and in animals (including those used for food). 

 

Many of the pesticides used in the past are very persistent in the body, meaning that they are stored in the body for years and in some cases decades. For many persistent pesticides, it is because they are toxic and able to store up in the body, with levels that increased with every exposure, that they were banned.   Pesticides stored in the body are slowly released into the circulation, causing ongoing internal exposure and harm to the individual.  If a pregnant woman is carrying these chemicals, her unborn baby will be exposed to them, and they will be present in the breast milk that she feeds her baby.

 

Pesticides used in or around food supplies can contaminate the food, and in some cases accumulate in the food supply, just as they can accumulate in people if they are persistent.  In addition, the use of pesticides above ground water supplies (e.g., drinking water aquifers) or surface water supplies (lakes, rivers), can also result in the exposure of people, agricultural animals and crops and pets.

 

A very wide range of pesticides have been used on military bases.  Some of the pesticides of most concern are discussed below.  Additional information on pesticides can be located in resources listed at the end of this report. If a base has been designated as a "Superfund Site" (NPL site) by the federal government, or was investigated by a state agency, there will be a record of the chemicals they found, and that should include many of the pesticides located on the base.  Not all pesticides are reportable at Superfund sites, and not all toxic chemicals are persistent. So there is no way to identify all pesticides used on the bases.

 

 

Agent Orange

 

Agent orange was a pesticide used to kill plants for various purposes - to clear runways, roadways, sidewalks, and other standard weed control activities, as well as it's widely publicized use in Vietnam as a defoliant during the war.  Consequently, exposures on US military bases could occur at the time that it was used in Vietnam as a result of intentional application, or while cleaning equipment and aircraft returning from Southeast Asia. 

Many of the health problems attributed to agent orange were due to the contaminant "dioxin" (2,3,7,8-tetrachlorodibenzo-p-dioxin or TCDD) which was present in the pesticide as a result manufacturing practices. TCDD specifies the specific dioxin (there are many) that is highly toxic and caused so much health damage in the past.  TCDD can harm the nervous system, immune system, blood forming system, liver, reproductive system, and many other areas of the body.  It is genotoxic (see "genetic damage and cancer" above) and chromosome abnormalities and other types of genetic damage can be passed from one generation to the next.  Agent orange exposure has been linked to cancer and to birth defects and other problems in the children of exposed parents.

 

Many immediately obvious health problems can occur shortly after exposure to TCDD.  Since agent orange is no longer used, those problems are not described here, but are described in the information sources at the end of this report.

 

There are  chemically-similar pesticides still in use, absent the TCDD contamination (i.e., other chlorophenoxy herbicides). For this reason, and because many pesticides are hazardous, exposure to pesticides during service merits evaluation.  Unfortunately, dozens of pesticide ingredients are currently used, so it is beyond the scope of this report to list them all and discuss their health hazards. If you know what pesticide you used, you may want to consult the resources listed at the end of this report that provide detailed information on the potential health effects of pesticides. For example, "agent white" was also used during the same era, can cause serious health problems, and is covered in books on pesticides and on toxicology in general.

 

The DoD has acknowledged many, but not all of the health problems that are described in medical scientific studies of TCDD.  A list of diseases and conditions in Veterans and their children that are now recognized by the DoD as caused by agent orange is available (the Veteran's Administration list of "Presumptive Exposure Diseases") at http://www.publichealth.va.gov/exposures/agentorange/diseases.asp.  The Blue Water Navy group's website at:  www.bluewaternavy.org includes links to the Documentation Library and updated news on related Veteran's issues.  Information on VA benefits application related to AO is at:  http://www.vva.org/Guides/AgentOrangeGuide.pdf

 

 

DDT and Chlordane

 

DDT and Chlordane are a very persistent chemical pesticides used to kill insects.  They are now banned, but were used extensively in the US and elsewhere.  Residues can still be found on military bases in homes, soil, and in water contamination. Heavy exposures, such as those that might occur if someone were applying these pesticides, can cause serious long term health problems. 

 

Other highly susceptible people include infants and children, since these pesticides were applied inside and outside of homes.  Heavy exposure could occur in babies and children if a chemical was applied to baseboards and flooring where the children lie or crawl.  Some base housing was dismantled because the levels of these pesticides were so high and the residues could not be removed. 

 

DDT and chlordane are in the pesticide group "organochlorines".  Health problems they cause include damage to the liver, kidney, blood forming and nervous system, heart, GI and immune systems, and the reproductive system.  They are mutagenic and can cause cancer as well as damage to a developing baby.

 

 

D.  Toxic Heavy Metals

 

Basic Properties

Heavy metals occur naturally in soil, rock, and many other natural materials in extremely small quantities.  Their name derives from the fact they are literally heavy - their high "molecular weight" means that they weigh more than other lighter metals.  For example, a  one inch cube of aluminum is very light, but the same size cube of lead, a heavy metal, is much heavier.  Some heavy metals are essential trace nutrients that our bodies need to stay alive.  However, many others are highly toxic, even at extremely low exposure levels. 

 

Areas where high levels occur naturally often have populations plagued with health problems.  Areas of Michigan with high lead levels in water have many people with a type of cardiovascular disease that is caused by lead's damage to their veins and arteries.  Workers exposed to toxic heavy metals suffer a range of diseases and often premature death. In the past, these metals were widely used in many industrial applications.  Most have been phased out, with safer alternatives replacing them, and there are ongoing international campaigns to reduce people's exposure to toxic heavy metals and reduce damage from their effects.

 

Toxic heavy metals have been studied extensively and are tightly regulated due to the harm they can cause.  Those considered in the discussion below are arsenic, cadmium, chromium IV (a toxic form of chromium), lead, and mercury.  Less common toxic heavy metals aren't discussed here, but are described in the information sources at the end of this report. Uranium is a heavy metal that falls in that category, as well as being radioactive (see section below on radioactive materials).

 

 

Sources of Exposure

 

Toxic heavy metals (subsequently referred to just as "heavy metals" for simplicity) occur naturally in soil, plants, rock and also in many of the materials that are extracted from the earth.  Crude oil and other fossil fuels used for transportation and heating (oil, gas, coal, etc) contain heavy metals, and they are also present in the air contamination that results from burning these fuels.  They can be inhaled and after the settle onto the ground and water, can contaminate food, soil, and drinking water.  Toxic heavy metals create health hazards if they migrate into water systems or contaminate food. 

 

Heavy metals are extracted from rock during mining, smelting refining, and otherwise processing metals for use.  In some cases they are in the product (e.g., lead used in ammunition, steel, paint).  Metals manufacturing involves concentrating the metals to much greater concentrations than what occurs naturally in rock.  In some cases, heavy metals may be the unwanted byproduct of processing and so are found in slag or waste. Few mining operations exist on military bases, but many government and private company facilities are involved in these activities including those that work on weapons production and research. These may be in the same area as bases, posing potential risks to soil, water, and food.

 

Toxic heavy metals continue to be used in some products and past uses have included ammunition, paints, coatings, and fuel additives (e.g., leaded gasoline).  These and other products containing heavy metals are commonly found on military bases and in other industrial and aviation locations. 

 

Exposure can occur through working with fuels and other products that contain the metals (e.g., many enamels and other paints), through inhaling exhaust (discussed in more detail below), through contaminated food, water, soil (e.g., inhaling dust) and other activities.

 

An important source of heavy metals in the environment overall, but especially near bases is fuel combustion.  Areas near highways and high fuel-use facilities often have soil contaminated with heavy metals that have been deposited on the ground over time. These metals move into the water supply, food, dust in the air, and essentially contaminated the entire environment in areas that are highly polluted with heavy metals. 

 

 

Health Effects

 

The health damage discussed in this section results from exposure regardless of how exposure occurs (e.g., ingestion, inhalation, skin exposure), unless otherwise noted. 

 

Toxic heavy metals target the nervous system which can result in a wide range of health problems, ranging from mild memory loss or headaches to severe dementia and mental retardation. Numbness and tingling in the hands and feet, and eventual paralysis and lack of use of the arms and legs has occurred following heavy exposure to toxic heavy metals.  The damage may not be obvious until long after exposure occurs.

 

Most toxic heavy metals can damage the liver, kidneys, which can lead to very serious health consequences. Kidney and liver damage are relatively "silent" killers, since the disease is typically not obvious until substantial damage has been done. The function of these two organs is essential to sustain life.  In addition, kidney damage can result in secondary harm to the cardiovascular system and it is therefore not surprising that studies of people exposed to toxic heavy metals found that they suffered premature deaths from strokes and other cardiovascular diseases.

 

When heavy metals are heated and form an aerosol (e.g., fumes from welding), they pose unique and dangerous hazards to the respiratory system.  These fumes can cause permanent damage to the lungs. This is a specialized type of exposure and harm.  Even the non-toxic heavy metals may pose health risks under these types of industrial use conditions.

 

Exposure to lead or mercury prior to birth or during childhood can be especially damaging.  It can cause mental retardation, cognitive damage, and learning disabilities.

 

Some heavy metals can suppress the immune system, meaning an exposed person is less able than most people to fight off diseases such as cancer.  Many heavy metals are also genotoxic and can cause mutations (discussed above).  This means that they can damage a developing baby or cause cancer.  Some are toxic to the reproductive system, causing fertility problems and other reproductive problems.

 

Certain heavy metals remain in the body for decades, meaning that exposure early in life or during young adulthood can result in ongoing harm from the metals slowing being released into the system over many decades.  The "half-life" of lead is 27 years, which means that only half of the body's lead is eliminated within 27 years.  If exposure was high, it will take many "half-lives" to eliminate it, essentially resulting in a lifetime toxic burden of lead.

 

 

E.  Radioactive Materials

 

Radioactive material release ionizing radiation that can cause genetic damage and cancer.  They can be naturally occurring, man-made (rare), or can be an "enhanced" or "depleted" to increase or decrease the intensity of their radioactivity.  Uranium is an example of a radioactive element that exists as many radioisotopes and is often processed to increase it's radioactivity for specific uses.

 

At high exposure levels, radioactive materials pose an immediate health threat, and some of the damage that they cause is obvious: burns nausea, and other readily identified health damage.  Longer-term delayed-onset health damage can occur whether exposures are high or low.  Health risks, including cancer, may not be evident for years or even decades.  In this regard the damage is similar to chemical exposures that cause mutations and other damage that isn't evident for many years (see section above on genotoxicity and cancer).  If genetic damage and abnormal cell growth are initiated by radiation, they can cause cancer. 

 

Radioactive materials vary greatly in the power and types of radioactive emissions they release. Their alpha, beta, or gamma emissions can have the power to pass through paper, glass, or metal, respectively.  Many radioactive elements decay (break down and emit radiation) through a process that creates another radioactive element.  The "decay chain" can include radioisotopes of varying power, and even exist in different forms (e.g., solid versus gas).

 

Radioisotopes they have varied abilities to move in the body, remain in the body, and cause damage.  For example, lead has a radioactive form (Lead-210 is part of the uranium decay chain) that can stay in the body for many years.  Other radioisotopes are rapidly eliminated from the body. 

 

Radium is a radioactive material that was used in paint because it glowed in the dark (as it was releasing energy).  It was used on illuminated watch dials, symbols on planes, and for other purposes.  Radium contamination occurred at the El Toro air base because it was used in paint.

 

Uranium is one of the more common radioisotopes associated with military bases, due to it's multiple uses.  Depleted uranium is used as ballast in planes.  It is also used in some weapons, and in various other materials designed for military applications.  "Depleted" uranium has a lower intensity of radioactivity than naturally occurring uranium, but it still emits ionizing radiation and is not safe.  It is especially harmful if it is vaporized (as with explosions) and is then inhaled. The ultra fine particles can deposit in the lungs and emit the spectrum of radioactive emissions (alpha, beta, and gamma) as the uranium decays. 

 

Since uranium is solid at room temperature, being in the vicinity of a small amount of the solid form that is intact and has been depleted is not as dangerous as inhaling depleted uranium.  But uranium as an element is toxic, aside from it's radioactive properties.  And it invariably contains some level of radioactivity.  So exposure to uranium imposes some cancer risk, and risks of infertility and of having children with birth defects.  As with all other genotoxic carcinogens, the degree of health risk depends on how much exposure occurred and other individual factors.

 

Most people will not know they were exposed to low doses of radiation unless they are told that they have been in the vicinity of a radioactive material. Consequently, it is important to determine whether a particular job involved exposure, if there were radioactive materials in the vicinity.

 

 

F.  Asbestos and Other Fibers

 

Asbestos was widely used in vehicles, industrial equipment, and other applications where high heat could be generated by engines.  It was also used extensively as a far retardant, in insulation, and in situations where there was a risk of fire.  While it has largely been phased out of use as a fire retardant, some products still contain asbestos (e.g., some brake pads). 

 

Those who worked with asbestos are at higher risk if the asbestos was flaking, if it was in lose fibrous form, and essentially if it could be inhaled.  The very fine particles can become embedded in the lung and cause a specific type of lethal lung cancer - mesothelioma.

 

Building and demolition, the burning of materials and equipment in fire pits, and other standard operations, could result in exposure to asbestos if asbestos components were involved.  Those who worked or lived with it and inhaled the small particles are at highest risk, but even very low exposures to asbestos leads to some degree of health risk.

 

 

G.  Engine Maintenance Products

 

Many types of engine maintenance products were used on military bases and such products often contain hazardous chemicals.  It is beyond the scope of this report to describe the ingredients and toxic properties of these products, but it is worth noting that they have contained solvents such as TCE (e.g., in cleaning and degreasing agents), and many other equally toxic chemicals. 

 

Many products used in engine maintenance have ingredients that are also found in petroleum fuels and some contain metal particles for polishing.  Transmission fluid and motor oil are two examples of products that often contain toxic ingredients. Welding and other activities that are often required in maintenance and repair of aircraft and vehicles can generate metal fumes, as described in the "toxic heavy metals" section above.

 

If you were heavily exposed to a particular product that you do not know to be safe while you served, you may want to research the product you used.  This is especially true if you have health problems that aren't explained by your family history, hobbies, or non-military work activities.  Researching product ingredients can be difficult, but the internet provides avenues to carry out this research through standard searches for information.  Some of the sources below may be useful in identifying additional products used in various activities that are typically carried out on military bases.

 

 

 

IV. Sources of Additional Information

 

Online Sources:

 

            National Institutes of Health

 

ToxNet is the best web access to reach the full global range of published scientific literature on the hazards of chemicals.  You can search any chemical at:   http://toxnet.nlm.nih.gov/

 

This website allows you to retrieve a wide range of information from many different databases.  There are links to individual published studies in scientific journals.  These can be very complex, and require "translation" by a medical professional or scientist.  Information in the individual medical studies is often summarized in government documents, books, and reports (some below) that are more accessible and far less time consuming to read. 

 

The fundamental scientific evidence that supports the conclusions of any company, agency, or organization is found in the scientific studies themselves.  You can use this website to go to the original source and to then look at what has been written in summaries about the various studies.

 

 

            US EPA

 

To search for specific chemical or product of interest (or a military base where you served) use the search box on the home page of EPA at : www.epa.gov.   You may see numerous documents listed, and they will contain widely ranging materials on chemicals, contaminated sites, studies, and other topics.  To make the process simpler, links to information on some of the chemicals discussed in this report are provided below. 

 

Chemical-specific Documents

 

On the webpages below, which contain links to many documents, look for those titled "Toxicological review of...." and that refer to the IRIS review.

 

Arsenic

Webpage with links to recent toxicology reviews:

http://cfpub.epa.gov/ncea/iris_drafts/recordisplay.cfm?deid=219111

 

 

Chromium VI

Webpage with links to recent toxicology reviews: http://cfpub.epa.gov/ncea/iris_drafts/recordisplay.cfm?deid=221433

 

 

PAHs

Webpage with links to recent toxicology reviews:

http://cfpub.epa.gov/ncea/iris_drafts/recordisplay.cfm?deid=194584

 


TCE

EPA's recent assessment, approved by the Scientific Advisory Board, and pending finalization:   http://yosemite.epa.gov/sab/sabproduct.nsf/0/773DC7E8C5C1332D852574F200699A89/$File/IRIS_TOX_REVIEW_TCE_ERD.PDF

 

Appendix to the report linked above:

http://yosemite.epa.gov/sab/sabproduct.nsf/0/773DC7E8C5C1332D852574F200699A89/$File/IRIS_TOX_REVIEW_TCE_ERD_APPENDICES-4.29.10.pdf

 

 

Tetrachloroethylene (perc)

Webpage with links to recent toxicology reviews: http://cfpub.epa.gov/ncea/iris_drafts/recordisplay.cfm?deid=192423

 

Webpages related to cancer causing properties: 

http://www.epa.gov/ttnatw01/hlthef/tet-ethy.html

 

and at NIH the link is:

http://ntp.niehs.nih.gov/ntp/roc/eleventh/profiles/s169tetr.pdf

 

 

 

EPA's links to additional sources covering many chemicals: 

 

The website for IRIS toxicology summaries that are being finalized, which are current, is:  http://cfpub.epa.gov/ncea/iris_drafts/erd.cfm?excCol=Archive&archiveStatus=both

 

The webpages for completed IRIS toxicology summaries, though most are old, is:  http://cfpub.epa.gov/ncea/iris/index.cfm?fuseaction=iris.showSubstanceList&list_type=date

 

 

            NIH, National Toxicology Program

 

"Report on Carcinogens" covering many chemicals: http://ntp.niehs.nih.gov/?objectid=035E57E7-BDD9-2D9B-AFB9D1CADC8D09C1

 

 

            CDC/ATSDR on chemicals:

 

CDC/ATSDR provides summaries of studies and related information on the toxicity of chemicals in "toxicological profiles".  The website for ATSDR Toxicological Profiles is: http://www.atsdr.cdc.gov/toxprofiles/index.asp 

 

The toxicology summaries are listed alphabetically by chemical name.  Unfortunately, most are very out of date. For example, the TCE and perc are more than 14 years old, and lack essential cancer studies and other information. The "public health statements" and other summaries written for the general public are often very poor, omitting information about hazards and downplaying the harm they may cause.  So these documents are NOT recommended as a primary source of information.  However, the full toxicological profile documents often contain a summary of information that contains useful information, if the reader keeps in mind that the documents don't include all of the relevant toxicology information.  Some of the current toxicology profiles documents are listed below.

 

Benzene

Toxicological Profile for Benzene:

http://www.atsdr.cdc.gov/toxprofiles/tp3.pdf 

 

 

DDT

Toxicological Profile for DDT and other similar pesticides:  http://www.atsdr.cdc.gov/ToxProfiles/tp35.pdf

 

 

Jet Fuels

CDC's Toxicological Profile for Jet Fuels #4 and #7 (1995) available at  http://www.atsdr.cdc.gov/ToxProfiles/tp76.pdf  

 

 

 

            Books

Many other sources were used for this report and provide additional information on a wide range of chemicals that are used at military bases and in other locations.  Some of the books listed below are not available free online.  But most are available at medical school libraries that are open to the public and may be obtained through interlibrary loan at public libraries.

 

International Agency for Research on Cancer, IARC Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans,  IARC Publisher, Lyon France (online no cost).

 

National Institutes of Health, NIOSH:  Registry of Toxic Effects of Chemical Substances, Washington, DC.  (online no cost).

 

Casarett and Doull's Essentials of Toxicology, McGraw Hill Publisher,  New York

 

Clinical Toxicology of Commercial Products, Williams and Wilkins Publisher, Baltimore MD.

 

Dangerous Properties of Industrial Materials by Irving Sax

 

Occupational and Environmental Medicine, McGraw Hill Publisher, New York

 

Pesticides and Human Health by KM Cunningham-Burns and W Hallenbeck, Springer-Verlag      Publisher, NY (includes older pesticides that may persist on military bases)

 

Sittig's Handbook of Toxic and Hazardous Chemicals and Carcinogens by Richard Pohanish.

 

 

V.  Medical Monitoring

 

The following excerpt from a medical journal article provides useful and reasonable guidance on offering medical monitoring to people who have been chemically-exposed and are at risk of disease.  This guidance, from medical specialists, could inform a responsible program for Veterans and their family members exposed to toxic agents.  It could also be useful to Veterans when they are communicating with their own medical care providers about chemical exposures and the types of medical care screening and care that it may require.

 

 

"Discussion

 

Technology deemed effective in early detection, cure, and/or extending life expectancy of individuals exposed to carcinogenic agents and who have an increased risk of latent risk is available.  Thus, in our opinion it is immoral not to offer such a remedy to these individuals.  The legal concept of future medical monitoring for such cases ties in with the advancement in medical biotechnology.  In order to undertake a medical monitoring programme, the following guidelines have been considered and found compelling: 

 

- the individuals to be monitored should be at increased risk of a specific latent disease, injury, or other medical condition as a result of the specific carcinogenic exposure;

 

- there should be methods, such as medical histories, examinations, tests, and/or procedures, available that can detect this specific disease, injury, or other medical condition at a latent stage;

 

- these methods should not represent undue risk to those being monitored;

 

- the necessary follow-up examinations, tests, and procedures to make a conclusive diagnosis, as well as the health care services for the medical management of the disease, injury or other medical condition should be available and accessible;

 

- these methods should enable those being monitored to have a better quality and/or longer length of life after diagnosis of a previously unrecognized disease, injury, or other medical condition than they otherwise would have had if there were no medical monitoring programme;

 

- there should be a system established and maintained to review the findings of the medical monitoring programme."            

 

 

Source:  "Toxic and carcinogenic chemical exposure: medical monitoring for early detection of latent disease"  by N. Brautbar  and M. Wu. (published in the  European Journal of Oncology, Volume II, Number 3,  pages 157-163,  2006). 

 

 

___________________________________________________________________________________

 

Statement of Interest:  The authors state that they have no financial interest in the DOD, VA or the medical treatment of Veterans or their families.  No funding was sought or accepted to prepare this report. 

 

Contact Information:  This was a voluntary effort and so no structure exists to field calls or respond to comments, so we request you keep comments to a minimum.  However, if you need to communicate about the technical content of this report, you can e-mail:  info@sciencecorps.org   Communications about the issue of informing and providing medical monitoring and care to those exposed to toxic chemicals during military service can write to Robert O'Dowd at:  rodowd@live.com

 

 

2012  Sciencecorps

Lexington, Massachusetts, USA