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- 0.36
Dimethylcyclopentane

c-1,3- 0.34
Dimethylcyclopentane

c-1,2- 0.54
Dimethylcyclopentane

Methylcyclohexane 2.27

Ethylcyclopentane 0.26

1,2,4- 0.25
Trimethylcyclopentane

1,2,3- 0.25
Trimethylcyclopentane

c-1,3- 0.42
Dimethylcyclohexane

1-Methyl-3- 0.17
ethylcyclohexane

1-Methyl-2- 0.39
ethylcyclohexane

Dimethylcyclohexane 0.43

1,3,5- 0.99
Trimethylcyclohexane

1,1,3- 0.48
Trimethylcyclohexane

1-Methyl-4- 0.48
ethylcyclohexane

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- 0.61
ethylbenzene

1-Methyl-2- 0.29
isopropylbenzene

1,4-Dimethyl-2- 0.70
 ethylbenzene

1,2-Dimethyl-4- 0.77
ethylbenzene

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