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An Assessment of the Potential Health Ef- Fects of Burn Pit Exposure Among Vet- Erans

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An Assessment of the Potential Health Ef- Fects of Burn Pit Exposure Among Vet- Erans AN ASSESSMENT OF THE POTENTIAL HEALTH EF- FECTS OF BURN PIT EXPOSURE AMONG VET- ERANS HEARING BEFORE THE SUBCOMMITTEE ON HEALTH OF THE COMMITTEE ON VETERANS’ AFFAIRS U.S. HOUSE OF REPRESENTATIVES ONE HUNDRED FIFTEENTH CONGRESS SECOND SESSION THURSDAY, JUNE 7, 2018 Serial No. 115–65 Printed for the use of the Committee on Veterans’ Affairs ( Available via the World Wide Web: http://www.govinfo.gov U.S. GOVERNMENT PUBLISHING OFFICE 35–728 WASHINGTON : 2019 VerDate Aug 31 2005 16:07 Dec 10, 2019 Jkt 000000 PO 00000 Frm 00001 Fmt 5011 Sfmt 5011 Y:\115TH\SECOND SESSION, 2018\HEALTH\6.7.18\TRANSCRIPT\35728.TXT LHORNE leonard.horne on VACREP0180 with DISTILLER COMMITTEE ON VETERANS’ AFFAIRS DAVID P. ROE, Tennessee, Chairman GUS M. BILIRAKIS, Florida, Vice-Chairman TIM WALZ, Minnesota, Ranking Member MIKE COFFMAN, Colorado MARK TAKANO, California BILL FLORES, Texas JULIA BROWNLEY, California AMATA COLEMAN RADEWAGEN, American ANN M. KUSTER, New Hampshire Samoa BETO O’ROURKE, Texas MIKE BOST, Illinois KATHLEEN RICE, New York BRUCE POLIQUIN, Maine J. LUIS CORREA, California NEAL DUNN, Florida CONOR LAMB, Pennsylvania JODEY ARRINGTON, Texas ELIZABETH ESTY, Connecticut CLAY HIGGINS, Louisiana SCOTT PETERS, California JACK BERGMAN, Michigan JIM BANKS, Indiana JENNIFFER GONZALEZ-COLON, Puerto Rico BRIAN MAST, Florida JON TOWERS, Staff Director RAY KELLEY, Democratic Staff Director SUBCOMMITTEE ON HEALTH NEAL DUNN, Florida, Chairman GUS BILIRAKIS, Florida JULIA BROWNLEY, California, Ranking BILL FLORES, Texas Member AMATA RADEWAGEN, American Samoa MARK TAKANO, California CLAY HIGGINS, Louisiana ANN MCLANE KUSTER, New Hampshire JENNIFER GONZALEZ-COLON, Puerto Rico BETO O’ROURKE, Texas BRIAN MAST, Florida LUIS CORREA, California Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public hearing records of the Committee on Veterans’ Affairs are also published in electronic form. The printed hearing record remains the official version. Because electronic submissions are used to prepare both printed and electronic versions of the hearing record, the process of converting between various electronic formats may introduce unintentional errors or omissions. Such occur- rences are inherent in the current publication process and should diminish as the process is further refined. (II) VerDate Aug 31 2005 16:07 Dec 10, 2019 Jkt 000000 PO 00000 Frm 00002 Fmt 5904 Sfmt 5904 Y:\115TH\SECOND SESSION, 2018\HEALTH\6.7.18\TRANSCRIPT\35728.TXT LHORNE leonard.horne on VACREP0180 with DISTILLER C O N T E N T S Thursday, June 7, 2018 Page An Assessment Of The Potential Health Effects Of Burn Pit Exposure Among Veterans ................................................................................................................ 1 OPENING STATEMENTS Honorable Neal Dunn, Chairman .......................................................................... 1 Honorable Julia Brownley, Ranking Member ....................................................... 3 Honorable Phil Roe, Chairman, House Veterans Affairs Full Committee .......... 4 WITNESSES Tom Porter, Legislative Director, Iraq and Afghanistan Veterans of America .. 5 Prepared Statement ......................................................................................... 35 Kenneth Wiseman, Associate Legislative Director, Veterans of Foreign Wars of the United States ............................................................................................. 7 Prepared Statement ......................................................................................... 36 Ralph L. Erickson, M.D., Dr.PH , Chief Consultant, Post-Deployment Health, Office of Patient Care Services, Veterans Health Administration, U.S. De- partment of Veterans Affairs .............................................................................. 9 Prepared Statement ......................................................................................... 38 Accompanied by: Drew A. Helmer M.D., M.S., Director, War Related Illness and Injury Study Center and Airborne Hazards Center of Excellence, VA New Jersey Health Care System, Veterans Health Administration, U.S. Department of Veterans Affairs STATEMENT FOR THE RECORD Burn Pits 360 (Tom Porter) .................................................................................... 42 Government Accountability Office (GAO) .............................................................. 63 Victor J. Dzau, MD, President, National Academy of Medicine, on behalf of The National Academies of Sciences, Engineering, and Medicine ............... 68 Veterans Warriors ................................................................................................... 69 Whistleblowers of America ...................................................................................... 71 Tragedy Assistance Program for Survivors, Wounded Warrior Project, Viet- nam Veterans of America .................................................................................... 74 (III) VerDate Aug 31 2005 16:07 Dec 10, 2019 Jkt 000000 PO 00000 Frm 00003 Fmt 5904 Sfmt 5904 Y:\115TH\SECOND SESSION, 2018\HEALTH\6.7.18\TRANSCRIPT\35728.TXT LHORNE leonard.horne on VACREP0180 with DISTILLER VerDate Aug 31 2005 16:07 Dec 10, 2019 Jkt 000000 PO 00000 Frm 00004 Fmt 5904 Sfmt 5904 Y:\115TH\SECOND SESSION, 2018\HEALTH\6.7.18\TRANSCRIPT\35728.TXT LHORNE leonard.horne on VACREP0180 with DISTILLER AN ASSESSMENT OF THE POTENTIAL HEALTH EFFECTS OF BURN PIT EXPOSURE AMONG VETERANS Thursday, June 7, 2018 U.S. HOUSE OF REPRESENTATIVES, COMMITTEE ON VETERANS’ AFFAIRS, SUBCOMMITTEE ON HEALTH Washington, D.C. The Subcommittee met, pursuant to notice, at 3:01 p.m., in Room 334, Cannon House Office Building, Hon. Brad Wenstrup [Chair- man of the Subcommittee] presiding. Present: Representatives Dunn, Bilirakis, Radewagen, Higgins, Mast, Roe, Brownley, Takano, Kuster, O’Rourke, and Correa. Also Present: Representatives Esty, Wenstrup, Ruiz, and Gabbard. OPENING STATEMENT OF NEAL DUNN, CHAIRMAN Mr. DUNN. All right. Good afternoon, and thank you all for join- ing us today. The subject of today’s meeting is an assessment of the potential health effects of burn pit exposure among veterans. And I would like to ask unanimous consent for the following non- Subcommittee Members to sit on the dais and participate in today’s hearings: Congresswoman Esty from Connecticut, Congressman Wenstrup from Ohio, Congressman Ruiz from California, and Con- gresswoman Gabbard from Hawaii. Without objection, that is so or- dered. Before we begin, I want to take a moment to say what an honor it is to have been selected to serve as the Chairman of this Sub- committee. I am the son of a multigeneration Army family. I also had the privilege of serving as an Army surgeon. I am also the fa- ther of a combat veteran. I have treated many thousands of soldiers, sailors, airmen, and veterans in my career. And I have treated them in VA hospitals and clinics, DoD facilities, civilian facilities, and intense and MASH units in a combat zone, so—I have worked in most of the American territories, from Puerto Rico and the USVI to the Trust Territories of Oceania. I feel personally familiar with the health needs of our Nation’s veterans, and I am committed to meeting those needs. We have great veterans, deserving veterans, in all of the places that I mentioned. And as a Nation, I feel that we are failing most of them to one degree or another. (1) VerDate Aug 31 2005 16:07 Dec 10, 2019 Jkt 000000 PO 00000 Frm 00005 Fmt 6633 Sfmt 6633 Y:\115TH\SECOND SESSION, 2018\HEALTH\6.7.18\TRANSCRIPT\35728.TXT LHORNE leonard.horne on VACREP0180 with DISTILLER 2 I look forward to work with all of my colleagues on this Com- mittee, and I do mean all of my colleagues on this Committee. And I thank you for your commitment to our veterans. With that, I think we can also agree that this is a critical time for the Department of Veterans Affairs health care system, particu- larly with the signing of the MISSION Act just this week. I am grateful to Chairman Roe and former Subcommittee Chairman Wenstrup for their leadership and support. I am very much looking forward to continuing this Subcommittee’s long history of rigorous oversight to ensure that our veterans have the timely quality care that they deserve. Today’s hearing concerns regarding the potential long-term health effects of burn pit exposure. This is a critical issue facing today’s servicemembers and veterans, and should be an equally critical issue for VA’s clinical and research programs. The testimony provided for today’s hearings by the veteran serv- ice organizations and other advocacy groups and the anecdotal re- ports of serious issues following exposure to burn pits in Iraq and Afghanistan are worrisome to say the least. They also make it clear that, despite a high level of attention, far more questions remain than answers on the exact nature and impact of burn pit exposure. The Airborne Hazards and Open Burn Pit Registry, which Con- gress mandated in 2013, is an important tool for the VA to use to track and monitor those who are exposed to burn pits during their service. I have concerns that the Registry is not being used to its greatest potential to communicate with veterans exposed to burn pits who are worried about their current and long-term health and well-being. This registry should be used to guide the VA’s research into toxic exposures. Just 3 weeks ago, we held a joint hearing with the Subcommittee on Oversight and Investigations that exposed fears that the VA re- search program was not properly prioritizing
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