[Peace] pesticide misuse

[Dlind49 at aol.com]

PESTICIDE EXPOSURES DURING ODS
Dr. Doug Rokke, Ph.D. 
(Major, MS, USAR)
12th Preventive Medicine Command (ODS)
3rd U.S. Army Medical Command Bauer's Raiders (ODS)
prepared with assistance for National Academy of Science - Institute of 
Medicine
May 8, 2001

INTRODUCTION:
    The anticipated endemic diseases and other health problems based on 
medical intelligence reports- AFMIC- that could have been dispersed by 
various pests led those of us who were members of the 12th Preventive 
Medicine Command; the theater command and professional staff for occupational 
and public health; to specifically identify, recommend, acquire, and use 
various pesticides to control pest vectors and consequent exposures.   As 
stated in the OSAGWI report: Pesticides were identified and selected for use 
in areas where individuals ate, slept, worked, and relaxed during leisure 
activities.  Pesticides included liquid, solid, and gaseous formulations.  
While some pesticide were sprayed or placed on terrain, equipment, or 
structures; other pesticides were sprayed directly onto clothing, bedding, or 
the skin.   Pesticides were used prior to deployment, during deployment in 
theater, and upon re-deployment. Consequently, individuals were exposed to a 
continuous mixture of pesticides. Some pesticides used during ODS were 
acquired through official sources.  These pesticides can be classified as:  
(1) organophosphorous compounds, (2) carbamate compounds, (3) organochlorine 
compounds, (4) pyretroid compounds, (5) and DEET.  However, while pesticide 
compounds available for purchase and use in the United States are usually 
approved by the EPA or FDA, pesticides acquired in other countries are not. 
Additional pesticides were acquired though local purchase because of Army, 
Navy, and Air Force supply system failures.   Consequently; the purity, 
chemical composition, quantity, or concentration of these local purchase 
pesticides is unknown because records were destroyed.  Therefore the 
determination of actual dispersal formulations, appropriate dispersal 
techniques, consequent environmental persistency may be difficult if not 
impossible.  The result is that the health and environmental effects caused 
by exposures to these pesticides may be difficult to anticipate because 
correlation between exposures and health or environmental effects escaped 
detection.   These last concepts are very important and must be considered 
during any discussion of pesticide use with consequent human and animal 
exposures during all phases of the Persian Gulf War.   Today, irrefutable 
evidence exists that pesticide exposures have, do, and will cause adverse 
health effects.  These effects depend on: (1) type of pesticide (chemical 
composition); (2) pesticide concentration; (3) route of exposure; (4) 
duration of exposure; (5) combinations or reactions with other types of 
chemical, biological, or radiological exposures; (6) decontamination efforts, 
effectiveness, and timeliness; and (7) the scope, type, and timeliness of 
medical care provided to any person or animal that has been exposed to a 
particular pesticide or combination of pesticides. 



TRAINING AND EDUCATION:
The safe use of pesticides was and still is a concern.  Although, we knew we 
that we must use pesticides to control various pests very little if any 
education and training was completed.  Individuals assigned to preventive 
medicine units, usually with the military medical occupational specialty 
(MOS) code 91S, military police,  and individuals assigned to unit field 
sanitation teams (FST), any MOS, were responsible for pesticide application.  
Therefore, these individuals should have been provided specific training and 
education on safe use of pesticides.  Initial or minimal civilian pesticide 
training is at least 24 hours if not 40 hours in length.  These programs are 
usually prepared and conducted by professional scientists employed by the 
USDA Cooperative Extension service.  Although, individuals involved in 
pesticide applications during ODS should have completed similar training they 
did not for many reasons. Consequently, misuse of pesticides was a rampant 
problem.     

PRE-DEPLOYMENT: 
    The medical intelligence regarding potential pests and consequent 
diseases provided by the Armed Forces Medical Intelligence group (AFMIC), 
information available from non-military and non-governmental sources, and 
discussions with other PM personnel identified many serious concerns that we 
should consider.   Consequently, we as preventive medicine and military 
operations personnel analyzed the information and determined that pesticides 
must acquired, distributed, and used to control the various vectors that 
could carry or transmit these diseases. Once this analysis was complete 
pesticides and various procedures were identified to meet anticipated needs.  
We then ordered the identified pesticides and additional equipment needed to 
use these pesticides.  While we were able to acquire some pesticides prior to 
deployment that we loaded on our trucks and took with us, we had to wait for 
other pesticides to be acquired and shipped to us in theater by the military 
supply (logistics) command.  Although, some pesticides and some dispersal 
equipment was acquired no personnel protective equipment other than standard 
issue NBC protective equipment was available and thus it was not acquired and 
taken with us to Saudi Arabia. 

DEPLOYMENT:
The urgent need for pesticides and non-availability of U.S. source EPA and 
FDA approved pesticides to meet the identified needs resulted in the local 
purchase of pesticides throughout the theater of operations.  Therefore, the 
chemical composition, purity, uses, and PPE requirements for these pesticides 
were not known.  In many cases we did not even know what they were other than 
they would kill pests. While OSAGWI report authors acknowledge this on page 
57 of the January 3, 2001 report both they and the RAND report authors 
decided to ignore this potential problem with consequent exposures and 
adverse health and environmental effects.   One of the reasons that 
information is incomplete is that documentation was deliberately destroyed.  
This includes the theater chemical and biological logs that were ordered 
destroyed in Florida during December 1996.  This deliberate destruction has 
been verified by Seymour Hersch (refer to "Against All Enemies" page 71) and 
GAO investigators.   As reported by the OSAGWI report authors pesticides were 
applied in all areas.  However, because pesticides included local purchase 
and U.S. supplies,  in many cases the actual pesticide quantities, specific 
name of the pesticides, pesticide formulations, application procedures, 
application locations, required safety precautions, and expected effects were 
unknown.  Once more, the deliberate disregard by OSAGWI investigators of the 
local purchase issues suggests that IOM must specifically contact those PM 
personnel who were involved in actual pesticide work during ODS.   Pesticides 
were applied where individuals ate, slept, and worked as reported by OSAGWI.  
Individuals also applied pesticides directly to their uniforms and to their 
skin.  Pesticides were also used extensively to delouse enemy prisoners of 
war (EPW's) and on cots, clothing, basically all over. Lindane was used via 
sprayers to delouse EPW's.  The DELOUSING procedures and equipment are WWII 
vintage.  Another issue that has been ignored until considered by my 
colleagues as we prepared this is paper on the potential pesticide exposures 
storage and consequent outgassing, with temperature variations, of pesticides 
from wood that was used as flooring and other structures.  Pesticides were 
liberally sprayed over on to the wood once built but also may have come with 
impregnated pesticides.  The next issue was local purchase and consumption of 
food, specifically fresh fruits and vegetables that may have pesticide 
residuals.  These foods were served in military dining facilities and also 
consumed  in host nation facilities.  Although several preventive medicine 
and medical personnel were on scene, the delousing was done by military 
policemen. OSAHA / NIOSH approved PPE was not used and pesticide training and 
education for these individuals was extremely limited.  Consequently, 
individuals were exposed with several nurses now reporting serious adverse 
health effects.  As usual recognition of exposures, health effects, and 
medical care is ineffective.  In almost all instances of pesticide use in 
theater safety precautions were incomplete or ineffective. Therefore we know 
that unacceptable exposures occurred. However, it is very difficult to 
determine actual extent of exposures because of record destruction, 
retaliation against anyone who spoke up about problems a time of use, and 
lack of prompt medical assessment and care.  

RE-DEPLOYMENT:
The preparation for shipment of equipment and movement of personnel from 
Iraq, Saudi Arabia, Kuwait, and other wartime support locations required 
decontamination including pesticide application to eliminate any pests that 
could threaten our agricultural system. Consequently various facilities were 
set up to clean (decontaminate) equipment. Unfortunately, the process was 
incomplete because of time constraints, individual carelessness, equipment 
deficiencies, and inadequate training. The important consideration is the 
transfer of pesticides and consequent uncontrolled individual exposures.     

PERSONAL PROTECTIVE EQUIPMENT:
All pesticides sold in the U.S. are provided with material Safety data Sheets 
(MSDS's) that specify PPE requirements.  Preventive medicine and other 
military personnel who applied pesticides during any phase of the war did not 
possess nor use appropriate personnel protective equipment to include: 
respirators, eye protection, coveralls, boots, or gloves.  Personnel only had 
their M17 or M40 protective mask, MOPP of BDO chemical agent suit, standard 
uniforms, and issue gloves.  This equipment does not meet OSHA or NIOSH 
standards! Respirators with OSHA / NIOSH approved organic filters were never 
acquired. Safety glasses or goggles were unavailable.  I raised this issue of 
PPE before deployment, during deployment, and as we re-deployed.   However, 
appropriate PPE was never provided to any individual involved in pesticide 
application that I am aware of through observation or discussions with my PM 
and FST colleagues during or since ODS. It is very disturbing that the OSAGWI 
report authors barely discussed the fact that approved PPE was unavailable. 
The OSAGWI report authors also did not define PPE (page 73) and thus a 
serious issue is avoided because to PPE would verify the dangerous PPE 
deficiencies that exist in PM units.   
COMBINED EXPOSURES:
Any analysis of pesticide exposures and potential adverse health effects and 
environmental must not be done in isolation.   ODS was fought on a toxic 
battlefield with many different types of exposures.  These exposures 
included: (1) uranium, (2) other low-level radioactive materials, (3) 
chemical warfare nerve agents. (4) biological warfare agents, (5) industrial 
chemicals, (6) endemic diseases, (7) pyridostigamine bromide, (8) various 
immunizations, (9) oil well fire combustion byproducts, (10) CARC paint, (11) 
non-ionizing (RF) radiation, (12) human and animal waste, (13) pesticide 
solvents or carriers (14) and pesticides.    Each of these individual 
exposures may or will affect the same physiological systems that may or will 
be affected by pesticide exposure. Consequently any discussion of pesticide 
exposures must consider the inter-relationships between multiple exposures 
and how these combined exposures may affect individual health. These 
interactions thus make a study of individual exposures and potential adverse 
health or environmental effects complicated. Physiological assessments, 
medical treatment, and a prognosis must consider all additive, subtractive, 
synergistic, or potentiating effects for not just single but combined 
exposures. For example: An individual who was exposed to a carbamate 
pesticide such as carbaryl after consuming PB (Mestinon), which is itself 
carbamate compound will experience an additive effect and consequent nerve 
agent poisoning. Both of these compounds are cholinesterase inhibitors that 
affect nerve impulse transmission. The detected releases of nerve agents from 
collateral damage releases also contributed to adverse health effects from 
combined exposures. This could account for the thousands of soldiers who got 
sick immediately upon ingestion of PB during ODS.  This is just one example 
that must be considered.  Consequently because very few if any studies 
published in peer review literature or any other literature have looked at 
the health effects of these combined exposures, the members of the committee 
must expand their search for answers beyond limited single agent or peer 
reviewed literature.       

HEALTH EFFECTS:
We did have immediate reports of adverse health effects (neurological) caused 
by pesticide exposures similar to those reported by farmers and people who 
were exposed to pesticides in their homes or where they worked. While very 
few if any were acute exposure cases, too many individuals experienced minor 
neurological problems for this to be ignored. However, because of other more 
pressing problems individuals just kept on working without adequate medical 
assessment or care. If individuals received fat soluable pesticide exposures 
during any phase of military service and then received an additional 
exposures they bodies threshold level could be exceeded with consequent 
adverse health effects.   Today, Gulf War veterans from around the world are 
experiencing and reporting neurological problems that may be related to the 
misuse of and consequent inhalation, ingestion, or absorption of pesticides 
and / or pesticide mixtures. I am personally experiencing and my physicians 
have documented neurological problems.    

RECENT EVENTS:  During 1992, while assigned as an environmental scientist and 
educator (IPA) with the U.S. Army Corps of Engineer's Construction 
Engineering Research Laboratory, co-located with the University of Illinois 
at Urbana - Champaign, I visited Sheppard Air Force Base in Texas. As part of 
my responsibilities I completed a hazardous materials use assessment and 
found serious misuse,  that I reported, of pesticides.  These findings and 
incident correspond with the subsequent exposure and serious neurological 
degradation of Major Michael Donnelly.  Major Donnelly had originally been 
exposed to preventive medicine applied pesticides and collateral damage 
released nerve agents during Military operations in Iraq and Saudi Arabia.    
Then again,  during the summer of  2000, military medical personnel 
participating in Golden Medic 2000, under the command and control of the 
330th Medical Brigade,  were deployed to the field to live and work in tents 
and fixed structures located at Camp Parks, California.  Pesticides had been 
liberally sprayed into these structures and on to the terrain just prior to 
the arrival of the military medical personnel.  Several dozen individuals 
became very sick requiring immediate medical care. However, Camp Parks 
installation officials had not made adequate arrangements for emergency 
medical care because they refused to authorize assigned medical assets to 
provide emergency care to the deployed personnel. Consequently individuals 
who became ill had to obtain medical care at their own expense form private 
agencies.  Today, some of those medical professionals are still experiencing 
adverse health problems caused by misuse of pesticides and ineffective 
medical care.   

SUMMARY:
As one of the few licensed pesticide applicators in the 12th P.M. during ODS, 
 I was very disturbed by: (1) the limited acquisition of some pesticides; (2) 
unavailability of approved pesticides; (3) local purchase of pesticides; (4) 
unavailability of and lack of use of PPE; (5) inadequate reporting; (6) 
destruction of records; (7) inadequate knowledge of pesticide formulations; 
(8) inadequate knowledge of specific pesticide adverse health effects; (9) 
inadequate knowledge of adverse health effects from combinations of 
pesticides, chemical warfare agents, PB,  and other hazardous materials; and 
(10) inadequate education and training of PM or FST personnel.   Historically 
and today, individuals in agriculture community, pesticide applicator 
community, and the general public who have been exposed to various pesticides 
show subtle and acute adverse health effects. Since most of these exposures 
were single in nature and not combined with a multitude of toxic exposures 
such as individuals encountered during ODS we must consider not only the 
suspected or proven adverse health effects of pesticides exposures but the 
previously unknown adverse health effects when we combine pesticides with 
immunizations, chemical and biological warfare agents, ingestion of 
pyridostigamine bromide (PB), depleted uranium, other radioactive materials, 
endemic diseases, oil well fire combustion byproducts, CARC paint, industrial 
chemicals, hazardous materials, and other occupational and environmental 
exposures. 
Another significant problem that IOM must address is the method by which the 
committee members derive their conclusions. As previously discussed the use 
of only peer reviewed literature to derive your conclusions while ignoring 
actual written or verbal reports from those who were involved is a serious 
error.  During the Gulf War those of us who were there as scientists, 
engineers, and physicians investigated events, collected data, analyzed 
collected information, and made decisions.  Although, it would have been 
ideal if we could have followed procedures such as required for peer reviewed 
report publication that was impossible. When things are blowing up around 
you, people are dying, you have incomplete information because it is 
unavailable, you can not acquire it, and you do not possess proper 
instrumentation you can not prepare reports that fulfill per reviewed 
publications criteria.  Consequently, there is very little if any information 
about what actually happened regarding pesticide use and effects published in 
peer reviewed journals.  I do not know of anyone who was actually involved in 
pesticide operations who has written and published an article in a peer 
reviewed journal.  However, many reports were written, verbal reports or 
comments made, and recommendations offered by those of us who were involved 
with pesticides or other exposures during any phase of ODS. Consequently, DA 
and DOD officials have tried to quash this information through retaliation 
that includes: lost jobs, verbal threats, directives to shut up, ransacked 
houses, lost pay, denial of medical care, destroyed documents, burned 
offices, blown up cars, and any other technique that will prevent information 
dissemination and correlation between exposures and consequent adverse health 
and environmental effects.  Today, Army Regulation 40-5: Preventive Medicine 
is being rewritten. However, those of us with the most experience and who 
will have the primary obligation for safety are not being permitted to 
participate in the review and rewriting process.  The majority of preventive 
medicine and medical assets are in reserve units. However, reserve personnel 
participation in development of guidelines is restricted to ensure political 
correctness.     

RECOMMENDATIONS:
1. The committee members must request that DOD officials provide all copies 
of actual ODS pesticide reports.
2. While per reviewed literature should be used; the committee members must 
not limit the derivation of their conclusions to only these documents.
3. The committee members should recommend based on acknowledged misuse of 
pesticides, willfully denied or delayed physical medical assessments, 
inability to determine actual exposures, inability to identify which 
pesticides were used in theater, inadequate safety procedures, and reported 
neurological problems in ODS veterans that veterans be awarded presumption of 
exposures and consequent medical care and / or compensation for documented 
adverse health effects such as neurological abnormalities, respiratory 
problems, and cancers.
4. The committee members should recommend that all military personnel 
involved in pesticide application complete an initial USDA approved pesticide 
applicators certification course (at least 40 hours) and that they maintain 
proficiency through annual re-certification.
5. The committee members should recommend that specific pesticide use 
protocols be adopted and implemented by DOD officials. 
6. The committee members should recommend that Reserve and National Guard 
medical professionals be involved in all protocol development specifically 
Army Regulation 40-5: Preventive Medicine.