Review Will Determine Links to Toxic Exposures in Southwest Asia
Chief Warrant Officer 2 Charles “Chaz” Scroggins, 5-158 Aviation Regiment, Task Force Ready Blackhawk pilot, battles the sandstorm blowing through Kandahar Airfield, Afghanistan, in 2010. Photo by Sgt. 1st Class Sadie Bleistein, 101st Combat Aviation Brigade
WASHINGTON — In what could be the first conditions added to the new PACT Act, the VA is conducting a scientific review to determine any relationship between three conditions—acute leukemias, chronic leukemias, and multiple myeloma outside of the head and neck—and toxic exposures for servicemembers who deployed to Iraq, Afghanistan, Somalia, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen, Uzbekistan, and the entire Southwest Asia theater of operations.
This scientific review will help VA determine whether these conditions become presumptive conditions for veterans. When a condition is considered presumptive, VA automatically assumes service connection for the disease and provides benefits accordingly. That means that eligible veterans do not need to prove that their service caused their disease to receive benefits for it.
The Biden administration has made it clear that it wants to expand benefits and services for toxic-exposed veterans and their families. For the first time, VA will use a new process for establishing presumptive conditions as codified by the PACT Act, which expanded VA healthcare and benefits for veterans exposed to burn pits, Agent Orange and other toxic substances.
The process considers all available science and data—including veteran claims data—to establish new presumptive conditions, when appropriate, for veterans as quickly as possible. It is not as reliant as in the past on research outside the VA.
“We won’t rest until we understand whether there’s a connection between these deadly conditions and the service of our nation’s heroes,” said VA Secretary Denis McDonough. “But make no mistake: veterans shouldn’t wait for this review process to conclude to apply for the support they deserve. If you’re a veteran living with acute leukemia, chronic leukemia, or multiple myeloma, don’t wait — apply for your VA care and benefits today.”
When a veteran applies for benefits that aren’t—or not yet—presumptive, VA considers their claim on a case-by-case basis and grants disability compensation benefits if sufficient evidence that the disability is related to their military service.
Cancers of the head and neck are already considered presumptive under the PACT Act, so this research will focus solely on acute leukemias, chronic leukemias and multiple myeloma originating outside of the head and neck.
The VA said those conditions were chosen for scientific review based on existing scientific data and close consultations with veterans, veteran service organizations, Congress and other key stakeholders.
Fine Particulate Matter
In the Federal Register, the VA explained the assessment will examine the link between the three conditions and exposure to fine particulate matter (PM2.5) from airborne hazards and open burn pits for servicemembers who were deployed in the listed areas.
“Multiple myeloma, when it originates in the head or neck, is considered a presumptive condition pursuant to the PACT Act,” the agency explained in the notice for comment published in late July. “However, cases of multiple myeloma originating outside of the head and neck have not yet been evaluated for association with exposure to PM2.5 from airborne hazards and open burn pits in the Southwest Asia theater of operations, Somalia, Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen and Uzbekistan. Additionally, a scientific review of acute leukemias, chronic leukemias and multiple myeloma and exposure to PM2.5 and its associated chemical composition from airborne hazards and open burn pits in the Southwest Asia theater of operations, Somalia, Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen, and Uzbekistan would provide an opportunity to review an organ system (blood) not included in the PACT Act.”
The VA also explained the rationale for the selection of the three conditions based on their biological properties that could signal correlation between those diseases and the described exposures. “Lymphomas already are included in the PACT Act, and leukemias and multiple myeloma represent the remaining types of cancer of blood-forming tissues,” according to the notice. “The latest classifications of these cancer types recognize that some leukemias and lymphomas are different forms of the same disease, as chronic lymphocytic leukemia and small lymphocytic lymphoma. The bone marrow can be sensitive to the toxicity of specific chemicals including waste that may have been disposed of in open burn pits, including, among others, arsenic, lead and mercury.”
VA said it solicits public comment on the importance of completing this assessment of scientific literature and historical claims data for these conditions or others. “Once the conclusions of this scientific assessment have been peer-reviewed, they may be used to inform decisions regarding veteran’s qualifying period of service, such as those who served on active military, naval, or air service in the Southwest Asia theater of operations during the Persian Gulf War, as well as Somalia, Afghanistan, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen, or Uzbekistan from September 11, 2001, until the present time,” it added.
The PACT Act already has added presumptives for more than 20 disease categories. Since President Joe Biden signed the PACT Act into law last August, VA has delivered more than $1.6 billion in PACT Act-related benefits to veterans and their survivors.