Hearing Date: March 25, 2003 Committee: House Government Reform Question: During the Gulf War, how many troops were ultimately exposed to sarin gas? Why have the numbers kept going up? If, in fact, additional information was held – for how long and why? Answer: The Department of Defense always has provided information it had on our Service members' possible exposures to low levels of chemical warfare agents as soon as the information was available. Our estimates of the number of possibly exposed Service members changed as we developed more accurate information on the amounts of chemical warfare agents present, better information on the locations of Service members during a specific time frame and as our modeling improved. At the time of the June 1996 announcement that Service members probably destroyed chemical weapons at Khamisiyah, we did not know the extent of possible exposures to low levels of chemical warfare agents. We knew that there had been no known injuries and no reports of acute symptoms of chemical warfare agent exposure at the time. In an effort to collect more information about the effects of the demolition, the Deputy Secretary of Defense mailed a memorandum to the approximately 20,000 soldiers believed to be within 50 kilometers of Khamisiyah during demolition activities informing them of the possible presence of chemical weapons and requesting that they provide any information they might have about the event. In a parallel effort, the Presidential Advisory Committee on Gulf War Veterans' Illnesses (PAC) requested predictive modeling of the demolitions at Khamisiyah and the bombings at Muhammadiyat and Al Muthanna. In November 1996 and February 1997, the Institute for Defense Analyses (IDA) reviewed the results of that modeling and recommended using an ensemble of multiple atmospheric models to account for the fact that different models will produce different but equally plausible results. The IDA also recommended demolition testing to improve information about the source characteristics in the weapons that had been demolished. The Office of the Special Assistant to the Deputy Secretary of Defense for Gulf War Illnesses (OSAGWI) initiated investigations focused on determining the number of rockets present, the amount and purity of chemical warfare agent in the rockets, how soldiers placed the demolition charges on the stacks of rockets, and where units were during and immediately after the demolition. In May 1997, the Department of Defense tested at Dugway Proving Ground how rockets like those at Khamisiyah were damaged by demolition. At Aberdeen, the evaporation characteristics of agents spilled as a result of the demolition were determined. In July 1997, the Department of Defense and CIA announced the results of modeling with the best information available at the time, which indicated that 98,910 Service members were possibly exposed. DoD sent letters to these Service members notifying them of their possible exposure to low levels of chemical warfare agents. After publishing the results of our modeling, the Department requested a review by an independent panel of scientists renown for their expertise in this area. The panel recommended some improvements for future modeling efforts. The results were also reviewed by the U.S. Senate Committee on Veterans Affairs' Special Investigative Unit, which commented that the results of the modeling grossly overstated the number of Service members possibly exposed because the summation of all models was used to define the hazard area rather than the intersection of all the models. In addition, the Department recognized several weaknesses of the initial effort to identify Service members possibly exposed. First, we knew that the chemical warfare agents released had been a mixture of sarin and cyclosarin, but because we lacked toxicity data on cyclosarin, the modeling only considered the release of sarin. Second, chemical warfare agents are highly reactive chemical compounds. The very chemical and physical properties that make them dangerous also make them susceptible to reacting with substances in the environment. These reactions, in turn, can result in significant reductions in an agent's effectiveness. The overall effect of this interaction is an estimated reduction (or removal) of the agent available over time (sometimes called degradation) to create a potential exposure hazard. The 1997 modeling did not consider this degradation. Third, the UNSCOM investigations continued with more findings reported each month. Using newly released UNSCOM data, the CIA was able to refine and improve its assessments of the amount of chemical warfare agent that had been released in the Khamisiyah demolition. Finally, and most importantly, we knew that the database of information about the location of military units during the war was seriously deficient. That, in turn, affected our ability to identify what individuals may have been exposed. To identify additional unit locations and to verify existing locations, the Department assembled former Gulf War brigade, divisional, and non-divisional operations officers (G3s/S3s) whose area of responsibility included Khamisiyah during March 10-13, 1991 to review, refine, and enhance their units' location information. These conferences continued from September 1997 through June 1998. This effort significantly enhanced the contents of the database, improved our knowledge of unit locations from 55 percent to 85 percent, and reduced the uncertainties associated with locating U.S. units around Khamisiyah during the demolitions. With all of the new information and following suggestions of the independent scientific peer review, the Department modeled again the demolition at Khamisiyah. Using the same ensemble modeling methodology, but using improved versions of the models, the Department was able to include more accurate amounts of nerve agent released, and deposition and degradation of the chemical warfare agent. Driven largely by the better accounting for units' locations, the Department was able, in December 2000, to more accurately estimate the number of Service members possibly exposed at 100,923, and we took action to appropriately notify these Service members. At that time, we notified approximately 35,000 additional Service members of their possible exposure to low levels of nerve agent and notified approximately 32,000 Service members that the most recent modeling and analysis indicated that they had not been exposed. Although we were (and are) confident about the units possibly exposed, we know that some individual may not have been with their units, and some parts of units may have been located in places not with the main unit. Consequently, we continue to uncover and receive information about units and Service members who were probably in the hazard areas. As we collect this new information, we update the numbers that we believe may have been exposed (and notify Service members accordingly). At the present time, the Department believes that 101,754 were potentially exposed to low levels of nerve agent. Mrs. MALONEY. She further states that 148 Americans died in the war, but that roughly 160,000 have fallen ill; and that 11,000 have died since the Gulf war-much higher than other men and women in the military-and that they have collected a series of 57 symptoms for which there is no known cause, which is the Gulf war syndrome. I would want to ask what we are doing to protect the health of the men and women that were exposed and the possibility, God forbid, that they may be exposed yet again. And I am the cochair of the Parkinson's Disease Task Force, along with Fred Upton; it is a bipartisan effort. And my father suffered from Parkinson's. But it has been reported that some of the Gulf war veterans have suffered symptoms similar to Parkinson's. And each year we have been working with the Defense Department, and we have received funding for Parkinson's research on neurotoxin exposure, seeing if that is a reason for the brain damage that causes Parkinson's. But I would argue that, likewise, it may be a study for what we can do to help the men and women that may have been exposed to chemicals. So my question right now is more of a proactive one of, what are we doing in research? As I understand it, we have no cure for Gulf war syndrome. And what are we doing to find-are we spending some of our research dollars in trying to find a cure for neurotoxin disease that may be caused by the sarin gas or other things? What are we doing? I am very thankful to the Department of Defense for funding the Parkinson's research. My question is, is this likewise connected to the Gulf war syndrome? Dr. WINKENWERDER. To your general question of what are we doing? We are continuing to fund with millions of dollars ongoing research into many of these questions that you have raised. As I alluded to earlier, it's difficult to determine with the levels of certainty that one would like in this case, if one is talking about evaluating these individuals that served, when the baseline of information and what was collected and what people may or may not have been exposed to is not good. The information is not good, so by definition, to do good research, you need good information. That shouldn't prevent us from funding additional research, as we have done, to look at some of these questions of what would low levels of exposures do to laboratory animals. Certainly we would never do this to any individual on an experimental basis. But studying what happens with animals and looking at some of these things is very important. Mrs. MALONEY. Specifically, is the Parkinson's research that you are funding-and I thank you for that research. Is that connected to the Gulf war syndrome? Dr. WINKENWERDER. I am going to turn to Dr. Kilpatrick. Dr. KILPATRICK. Let me just address it. It is being pursued in two directions. One is a clinical basis, looking at people; and then that is very tightly tied to a program looking at chemical nerve agents in particular and the effects that they have on brain function. There are projects funded at $5 million a year over the next 3 years; 1.5 mil lion is looking at repeated low-level exposures of animals to sarin nerve agent, to look at long-term health consequences. That is very applicable to what Gulf war veterans' concerns are. The other part of the money each year is spent toward what we call the high end of low-level exposure, below symptomatic response to nerve agents, one exposure, and then seeing what are the physiological responses. And those data from those research sets are really very closely shared with people looking at Parkinson's disease, because they are really looking at the same pathway potentially as far as disease cause. Dr. ROSWELL. If I may respond to that from a combined perspective. Since the Gulf war, over $200 million in federally funded research has been focused on possible causes for Gulf war syndrome. I would like to set the record straight. One of those studies has looked at death rates in veterans in the Gulf war, and in fact, the overall death rate for veterans who served in the Gulf war is not increased compared to their military counterparts who were deployed outside the theater of operations. If you look at specific-cause mortality in veterans who served in the Gulf war, there is a very slight increase in death due to trauma, such as automobile accidents. But other than that, the mortality rate is not increased in any subcategory, and the overall mortality is not increased. And I certainly wouldn't want to create a fear for the men and women currently serving in Iraq. Let me point out that Parkinson's disease is one of several neurodegenerative diseases that DOD and VA are currently studying. VA recently funded the creation of a neuroimaging Center of Excellence for neurodegenerative diseases to look not only at Parkinson's but also other diseases, even when unpublished data suggested that there might be an increase in a degenerative disease known as amyotrophic lateral sclerosis, or Lou Gehrig's disease. Secretary Principi moved quickly to presumptively service-connect veterans who suffered from that illness and served in the Gulf war, so that they received disability compensation. I would also point out that 160,000 veterans of the Gulf war have received approved disability claims. But most of those claims are for diseases that we would expect to see in a military age population, and it is a relatively small number for undiagnosed illnesses or the Gulf war syndrome you spoke of. Mrs. MALONEY. When you mentioned the clinical trials, are you doing them on our veterans? Are we tracking our veterans and seeing if-particularly those that we know were exposed to sarin gas? That would be helpful to see, because some of them apparentlyI am talking to doctors that treat Parkinson's. They have told me that they are developing Parkinson's-like symptoms. Dr. ROSWELL. We have extensively reviewed literature for symptomatic exposures to the organophosphate, which is the class of compounds that sarin nerve gas falls into. The study suggests that there is cognitive impairment in people who suffer symptomatic exposures, but I am not aware of evidence that conclusively links any |