WASHINGTON — Whether exposure to war zone burn-pits causes long-term health issues has created heated debate among military officials, veterans, Congress members and currently deployed troops.

Unfortunately, a long-awaited report does little to provide definitive answers or cool down the controversy.

A recent Institute of Medicine (IoM) report done at the request of the VA concluded that it could not say whether troops’ exposures to emissions from open-air burn-pits cause ongoing health effects. The report leaves open the possibility that the burn-pits or other sources of air pollution could be causing respiratory problems in deployed troops, which some researchers maintain is occurring.

Among the reasons for the IoM’s inconclusive results were "insufficient data” on troops’ exposures to open-air burn-pits as well as high background levels of ambient pollution from other sources and lack of information on the quantities and composition of wastes burned in the pits, all of which “complicate interpretation of the data,” according to the authors.

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“In light of its assessment of health effects that may result from exposure to air pollutants detected at [Joint Base Balad in Iraq] and its review of the literature on long-term health effects in surrogate populations, the committee is unable to say whether long-term health effects are likely to result from exposure to emissions from the burn pit,” the report summary stated.

While the IoM committee could not come to a conclusion about the health effects of the burn-pits, it did state that, “a broader consideration of air pollution than exposure only to burn pit emissions,” might be associated with long-term health effects in Iraq and Afghanistan, “particularly in highly exposed and/or susceptible populations, mainly because of high ambient concentrations of [particulate matter].”

The report recommended that further study be conducted to evaluate the health status of troops from their time of deployment to Joint Base Balad into the future to determine health problems that might not show until many years later.

“We didn’t find a smoking gun,” IoM committee report member Mark Frampton, MD, of the University of Rochester Medical Center, told U.S. Medicine. “The monitoring data that was done by the military at the Balad Pit didn’t show huge differences from what we know is in air pollution in polluted cities around the world. There was a high level of particulate matter, certainly higher than air quality standards around the world, but much of that didn’t seem to be coming from the burn pit. It was from other sources around the base and from windblown dust. What we can’t be sure about is whether something was missed.”

Frampton said that, while the committee did not find evidence “implicating the burn-pits,” he explained this “doesn’t mean that they are not having long-term health effects.”

“The only way to really answer that question is to study the people that have been exposed, and that hasn’t been done so far,” he said.

Burn-pits a Health Hazard?

The health impact of burn-pits has been a hot-button issue. Troops and veterans have expressed concern that their respiratory and other ailments are linked to exposure to those areas, where materials such as chemicals, paint, medical and human waste, aluminum cans, munitions and other unexploded ordnance, petroleum and lubricant products, plastics and Styrofoam, rubber, wood or discarded food are incinerated. Some researchers also have raised concern, particularly when it comes to respiratory issues. In a study published in September, VA researcher Anthony Szema, MD, noted that what he and other researchers have dubbed “new-onset Iraq/Afghanistan war lung injury” (ILI) is common, and rates of symptoms leading to a diagnosis requiring spirometry are high. His research suggests that dust, aeroallergens and uncontrolled burning of trash in Balad burn-pits without the use of incinerators prior to November 2009 may be among the causes of ILI.