Doctor: Lung Damage For Thousands Of Soldiers Goes Undiagnosed
NASHVILLE, Tenn. -- Thousands of soldiers are returning from Iraq and Afghanistan with mysterious breathing problems.
Vanderbilt pulmonologist Dr. Robert Miller first discovered they had permanent lung damage.
But Dr. Miller is now concerned the military is not ready to admit how many soldiers are actually injured.
Chief Warrant Officer Neil Rogers was one of Dr. Miller's first patients.
Rogers came back from four tours of duty in Iraq and Afghanistan with an injury you can't see.
"It's incurable and untreatable," Rogers said.
He often feels like someone is sitting on his chest. And when he climbs stairs, he said, it's like breathing through a straw.
"I've lost the person I was, and I'm having a hard time adjusting to the person I am," Rogers said.
"How bad is it now?" NewsChannel 5 Investigates asked.
"Right now, walking up and down the isle at Walmart is about my limit," Rogers said.
Standard Army breathing tests did not show that Rogers was sick.
So, Fort Campbell send him to Dr. Miller at Vanderbilt Medical Center. Dr. Miller ordered a controversial test, a lung biopsy, which is major surgery.
That test found Rogers and dozens of other soldiers from Fort Campbell had permanent lung damage.
"It's serious enough to compromise your quality of life," Dr. Miller said.
But soon after he figured out why soldiers were getting sick, the Army suddenly stopped sending soldiers to him and criticized the test he used.
"The Department of Defense has not embraced this issue," Dr. Miller said.
NewsChannel 5 Investigates asked, "Why do you think they stopped sending soldiers to you?"
Dr. Miller responded. "I don't think they wanted the soldiers to undergo the biopsies we were performing."
"I think it gave some legitimacy to this they didn't want to give," Dr. Miller said.
Dr. Miller is concerned the Department of Defense is not ready to admit how many soldiers are sick.
He has compared the number of sick soldiers to what was seen with Agent Orange after the Vietnam War. The common thread for the sick soldiers is they were exposed to toxic air.
Rogers first noticed breathing problems after his first tour in Iraq. He had spent two months stationed near a huge sulfur plant fire.
"You couldn't see the end of the runway," Rogers remembered.
A YouTube video shows his camp near Mosul with soldiers wearing masks, but the masks didn't protect against sulfur.
"Everybody felt it immediately, the burning in the chest, your nose is running and burning and you felt like you couldn't catch your breath," Rogers said.
Dr. Miller's lung biopsies showed the small passage ways inside Rogers' lung were damaged.
But, most surprisingly, he found lung damage to other soldiers who were not exposed to the sulfur plant fire.
He's concerned that controversial burn pits, located on the outskirts of many Army camps in Iraq and Afghanistan, have led to many soldiers returning with permanent lung damage.
Soldiers have posted videos of burn pits on YouTube. They are huge holes where the Army dumps its trash and sets it on fire. They can be up to 10 acres long, and burn all kinds of waste around the clock.
In a written response to our questions, the U.S. Public Health Command said the Department of Defense has asked for a review of the role of biopsies in diagnosing the breathing problems.
They expect a report within a year.
"If the Army won't give a biopsy, they will never know. With no diagnosis, that means no VA payout, no army payout nothing," Rogers said.
Rogers used his diagnosis to get full VA benefits, but even that was a struggle.
He and Dr. Miller worry thousands of injured soldiers are not getting the benefits they deserve.
"This was due to inhalation that they had during service, and we have a responsibility to take care them with this injury," Dr. Miller said.
NewsChannel 5 Investigates asked, "And that's not happening now?"
Dr. Miller responded, "And that's not happening now."
The VA recently established a burn pit registry so soldiers exposed to burn pits can sign up, and the VA can track their medical histories.
Neil Rogers said that is different than diagnosing them and getting them benefits.
Below are the questions and responses from the Blanchfield Army Community Hospital at Fort Campbell (BACH) concerning this story. We asked for an on-camera interview, but they declined to provide one.
Q: Why are Fort Campbell Soldiers not being sent to Vanderbilt Medical Center any longer to receive lung biopsies if they perceive lung damage occurred while deployed?
A: Army medicine has the full capability to treat cases of respiratory illness within our system for health. For Soldiers assigned at Fort Campbell, Blanchfield Army Community Hospital's (BACH) Allergy, Asthma and Immunology providers evaluate Soldiers who have respiratory complaints, beginning with a review of Soldiers' history and conducting a physical exam. Before the suggestion of a lung biopsy, there are many possibilities to consider such as asthma, allergies, infection and more. Diagnostic studies are then ordered based on each patient's presentation and clinical guidelines. At BACH, an Immunologist begins with pulmonary function testing and X-ray or CT imaging. Treatment is targeted based on the presumptive diagnosis. If further evaluation is needed, Soldiers are referred to a pulmonologist at Brooke Army Medical Center. The treating pulmonary specialists at BAMC determine whether or not an invasive study such as a lung biopsy is necessary based on clinical presentation and results of other studies. BAMC's pulmonary specialists are currently performing a study on Soldiers who present pulmonary concerns during or after deployments involving airborne exposures. Regarding the potential role of biopsy, the Department of Defense has asked the Defense Health Board to review the role of biopsy in the evaluation of dyspnea on exertion. They have met on this issue and a report is expected within a year.
Q: Can bronchitis or lung damage result from sulphur dioxide burning fire pits while deployed?
A: According to the U.S. Army Public Health Command, "DoD is concerned about the potential for health effects from exposure to ambient air in Central Command, (CENTCOM) including naturally occurring particulate matter, smoke from open-pit ("burn pit") burning, industrial pollution, etc., as are many service members. DOD has conducted air sampling and analysis in CENTCOM for more than 10 years, and we concur that potential health effects are plausible. As such, we have conducted medical surveillance of redeployed service members, specifically looking for long-term health effects. To date, no long-term health effects have been associated with exposure to open-pit burning. DOD monitoring has shown short-term respiratory effects (cough, sore throat, increase in asthmatic symptoms among service members who have asthma, etc.) are associated with exposure to burn pit smoke. Additionally, the Institute of Medicine, in its review of DOD's surveillance information on burn pits, indicated that long-term health effects are plausible. DoD continues to monitor both the air in CENTCOM and its medical databases."
Q: If a lung biopsy is not performed, how can the medical community accurately determine a Soldier's benefit rating in the medical board process?
A: BACH providers and providers across Army Medicine work to rule out any other possible conditions before performing invasive studies such as a lung biopsy. The American Medical Association Guides to the Evaluation of Permanent Impairment is the most commonly used guidance for assessing percent whole body disability. These guidelines base impairment on pulmonary function testing. Benefits are based on disability or impairment and not diagnosis. Pulmonary Function testing is part of the Integrated Disability Evaluation System for both VA and DoD. Operation Enduring Freedom, Operation Iraqi Freedom, Operation New Dawn and 1990–1991 Gulf War Veterans and service members who are still on active duty who may have been exposed to burn pit smoke and other airborne hazards can register on the VA's Airborne Hazards and Open Burn Pit Registry to document their exposures and report health concerns. The web-based questionnaire will allow enrollees an opportunity to obtain an evaluation and will keep enrollees informed about studies and treatments and help the VA monitor the health conditions affecting Veterans. The VA plans to use the data to improve programs and help Veterans with deployment exposure concerns and will provide information on active duty enrollees to the DoD for follow-up.