On some days, Russell Keith could simply look up at the sky to gauge how busy his day would be as a paramedic at the largest U.S. base in Iraq.
Dark green smoke meant the contractor could count on a 30 to 40 percent spike in his patient load, he told the Senate Democratic Policy Committee last week during a hearing on contractor oversight.
Keith never knew which substance -- medical waste, body fluids, batteries, plastic or tires -- that would sometimes be set alight with jet fuel and cause the dark, acrid smoke pouring from the sprawling, 10-acre burn pit to turn green. But he did know that patients complaining of burning throats, eyes and painful breathing would fill the infirmary on those days.
"There is no such thing as the EPA here, folks," Keith said he told new hires at Joint Base Balad. Then, he would tell them, half-joking: "The burns pits are nasty. Try not to breathe." Now he says that if he had known what was being burned, he would have advised the recruits to never to get off the bus.
Military guidelines say burn pits should be used only to dispose of refuse in emergency situations until approved incinerators can be obtained. The guidelines stipulate that hazardous materials, medical waste and batteries should not be burned.
But those regulations seem to have been largely ignored at many camps in Iraq and Afghanistan, and contractors say they were unaware of restrictions about what could be thrown in the pits. In July 2007, when Keith left the 20,000-troop Balad base, burn pits from four years earlier were still active and the smoke was still pervasive, even though the camp had also started to use incinerators. Balad -- which is about 42 miles north of Baghdad in the Sunni Triangle -- said it closed its final burn pit last month and is now using incinerators for all waste disposal.
Details about exactly who has been in charge of overseeing the burn pits, what substances have been burned there, and how many pits continue to operate in Iraq and Afghanistan are still difficult to pin down, potentially hampering efforts to address the problem.
Under the Logistics Civil Augmentation Program, the Army hired out contractors to perform selected services in Iraq and Afghanistan. Running many of the burn pits was outsourced to a company called KBR, testified former employees.
Rick Lamberth, a former KBR employee, came to work in Iraq and Afghanistan for periods between summer 2004 and July 2009. He estimates there are currently at least 100 burn pits in Iraq and 30 in Afghanistan. The U.S. Central Command keeps no official tallies on the number of burn pits, and the Multi-National Corps-Iraq did not respond to requests for comment.
About the bases: They are not makeshift creations. The Iraq base where Lamberth spent most of his time, Camp Speicher, is a small city with driving ranges, a Pizza Hut, a KFC, swimming pools, a 10,000-square-foot store the base members nicknamed "Wal-Mart" -- and six burn pits. One of the pits was 25 feet by 25 feet and about 50 feet deep, he said, and was upwind from living quarters as close as a quarter-mile away. So the smoke was unavoidable -- it constantly wafted down to the soldiers' housing, he testified. And it would cover every surface -- like pollen.
"From as close as 10 feet away, I saw nuclear, biological and medical waste, including bloody cotton gauze, plastics, tires, petroleum cans, oils and lubricants thrown into burn pits," Lamberth testified, saying he witnessed such activities at six large camps in Iraq and two in Afghanistan. "Vermin, wild dogs and jackals would roam the pits, carrying off debris," he added.
"The ash that came from the pits looked like burned notebook paper and fell like a black, sooty snowfall," he said. "Soot from the pits would cover your clothes and stick to the walls of buildings."
The Department of Defense maintains that though the burning practices -- especially when done in hot, dry, dusty conditions -- can cause temporary irritation of the eyes, nose and throat in some people, the burn pits pose no long-term health risks. DOD backs its assertion with results of a study conducted by the U.S. Army Center for Health Promotion and Preventive Medicine in 2007.
Study is faulted
Anthony Szema, chief of the allergy section at the Veterans Affairs Medical Center in Northport, N.Y., said military sampling efforts in that study were full of holes. Among the biggest problems, he said, are the study's failure to measure the extremely fine particles, which create the biggest health risks, and that it was conducted during Iraq's rainy season, which would not reflect the year-round exposure on the base.
"This would be like testing for snow in Albany, N.Y., during the summer," Szema said. "Testing will not detect any snow, but this does not mean that it does not snow in Albany."
Legislation passed last month prohibits the use of burn pits for hazardous and medical waste except if the Defense secretary sees no alternative and mandates a DOD report on burn pit use. But restrictions on burning hazardous materials and medical waste are nothing new. "That was already within the standard operating procedure," a U.S. Central Command spokesman said.
U.S. Central Command anticipates that burn pits will continue to be used for nonhazardous waste, though it could not provide numbers about how widespread the practice will be.
More than 200 KBR employee-contractors (including Keith and Lamberth), veterans and families of service members have signed onto a lawsuit against KBR, alleging negligence and harm from the burn pits at military sites in Iraq and Afghanistan.
"No one wants half a paramedic," Keith said. He is currently unemployed and medically disqualified from returning to Iraq because of neurological damage and signs and symptoms of Parkinson's disease his doctors say are associated with toxin exposure.
KBR asserts that it never operated or provided support services for the burn pit at Joint Base Balad and that it "does not decide where to locate or operate a burn pit. That decision is made by the Army," the firm said in a statement last week. "KBR operates burn pits in accordance with guidelines approved by the Army."
But Elizabeth Burke, one of the attorneys bringing suit against KBR, said the lawsuit is not being filed against the Army itself because her clients say the pits were largely run by the contractor. Her clients' maladies include multiple cancers, respiratory disease, pulmonary complications, chronic coughing, debilitating headaches, and neurological and skin disorders.
The Army did not respond to requests for comment on the KBR statement by publication time. "You must understand that the Army was running the burn pits, and they were also in charge of the construction of the incinerators," testified Lt. Col. Darrin L. Curtis, a former Air Force bioenvironmental engineer.
'This is an alarming trend'
When Lamberth complained to superiors about the burn pits, he said, he was told to "stop making waves" and was threatened with lawsuits and the loss of his job. Lamberth said one superior told him that even if the company did get caught, it had already made more than enough money to pay any fines and still turn a profit.
Balad officials did worry about the smoke when it hindered their ability to run flight operations. They would douse the pits with water to reduce the smoke so flights could continue, Curtis said at the hearing.
"Until 2004, I mostly saw 80-year-old veterans," testified Szema, the VA physician. "However, from 2004 to present, I have begun seeing young women and men who were previously healthy athletes. ... These individuals suffer from a variety of respiratory illnesses, including asthma and difficulty breathing during exertion.
"This is an alarming trend," Szema added, "since we reported double the rate of new-onset adult asthma diagnoses among Iraq-deployed versus stateside troops."
The Department of Veterans Affairs, as part of a larger study comparing the health of 30,000 combat veterans who were deployed to Iraq and Afghanistan and 30,000 veterans who never deployed, plans to measure the health effects of self-reported exposure to burn pits.
Rep. Tim Bishop (D-N.Y.), a longtime advocate on this issue, is pushing to go even further and hopes to pass legislation establishing a burn pit registry that would officially document all troop exposures to open burn pits.
While Keith was in Washington last week, he stopped by the Vietnam Veterans Memorial.
"My uncle died from cancer after exposure to Agent Orange," he said. "They didn't know about the health impact of Agent Orange until the '80s and '90s. I'm afraid one day down the line, we will wake up and notice 5,000 people with Parkinson's disease and realize they all had one thing in common: They were in Iraq at the same time."