NO. 94-C-1392

MEDICAL CAUSATION
CONCERNING THE MUSTARD GAS EXPOSURES

TO THE HONORABLE JUDGE OF SAID COURT:

MUSTARD GAS EXPOSURES AND PERSISTENCE

During the Gulf War air campaign, coalition aircraft flew 990 sorties against 23 Iraqi chemical and biological weapons research, production and storage facilities. U.S. Department of Defense, Gulf News, 4(2): at p. 1 (March, 2000). Three months before the air war began, Livermore National Laboratory predicted that chemical warfare agent fallout would cover the positions of U.S. troops in Saudi Arabia. USA Today, p. 1 (August 14, 1997). Though this classified research was performed for the U.S. Air Force, the study never reached General Schwarzkopf during the Gulf War. USA Today, p. 1 (August 15-17, 1997). From the beginning of the air war until its end, each of the nearly 14,000 M8A1 chemical alarms deployed in the war went off an average of two or three times a day. U.S. Congress, Committee on Government Reform and Oversight, Gulf War Veterans’ Illnesses: VA, DoD Continue to Resist Strong Evidence Linking Toxic Causes to Chronic Health Effects, at p. 18 (November 17, 1998). The most sophisticated chemical detection equipment in the Gulf War was with the Czech Republic chemical detection forces. They detected mustard gas on January 24, 1991, near Hafir al Batin where hundreds of thousands of U.S. troops were massed. Ibid, at pp. 15. The U.S. Department of Defense has admitted that “the Czech detections were valid.” Ibid. French forces also detected mustard gas during the air bombing campaign. Ibid, p. 17.

There were three different ways Gulf War veterans could be exposed to mustard gas fallout: inhalation of vapors and contaminated dust, ingestion of contaminated drinking water or food and contaminated dust, and dermal contact with contaminated dust and contaminated soil. See J. of Tox. & Env. Health, 59: 281-502 (March, 2000), p. 293. Regarding the binding of chemical warfare agents to the very fine dust in the Persian Gulf, see: Korenyi-Both, Col. A.L., et al., “The Role of the Sand in Chemical Warfare Agent Exposure Among Persian Gulf War veterans: Al Eskan Disease and ‘Dirty Dust’”, Military Medicine, 165:321-336 (May, 2000); and U.S. Department of Defense, Dusty Agents: Implications For Chemical Warfare Protection, AST-2660z-055-88 (formerly secret, now declassified) (January 27, 1998).

“Sulfur mustard can be very persistent in soil ... when sprayed onto soil, a vesicant action was still apparent after two weeks; when the agent leaked into the soil, however, a vesicant action was still present after three years (U.S. Dept. of Army, 1974). Rosenblatt, et al (1995) stated that the persistence of sulfur mustard in soil is due to the formation of oligomeric degradation products that coat the surface of the mustard agent and that are resistant to hydrolysis.” National Research Council, J. of Toxicology & Env. Health, 59: 281-501, at p. 473 (March, 2000).

MUSTARD GAS CAUSED BIRTH DEFECTS IN GULF WAR VETERAN CHILDREN

Because sulfur mustard is a strong DNA alkylating agent, genotoxic effects occur through cross-link formation, inhibition of DNA synthesis and repair, point mutatins and chromosome and chromatid aberrations. Agency for Toxic Substances and Disease Registry, Toxicological Profile for Mustard Gas, TP-91/22, Atlanta, GA.: A TSDR (1992). See also: National Research Council, J. of Toxicology & Env. Health, 59: 281-501, at p. 488-90 (March, 2000); National Toxicology Program, Fifth Annual Report on Carcinogens: 1989, Washington, D.C., U.S. Department of Health and Human Services (1989); and Fox, M., Scott, D., “The Genetic Toxicology of Nitrogen and Sulphur Mustard,” Mutat. Research, 75:131-168 (1980). Even brief exposure can cause chromosomal damage. Wulf, H.C., Aasted, A., Darre, E., et al., “Sister Chromatid Exchanges in Fishermen Exposed to Leaking Mustard Gas Shells,” Lancet, Vol. I for 1985: 690-691 (March 23,1985).

In a large epidemiological study of tens of thousands of Gulf War veterans, it was shown that Gulf War veterans are two to three times more likely to have birth defects in their children than the general population. Annals of Epidemiology, 11(7): 504-511 (October, 2001).

There are reports of an increase in major congenital malformations in Iraq since the Gulf War. See: Scott, R. & Douglas, H., “World Health Organization (WHO) Should Undertake Full Inquiry into Gulf War Illness,” British Medical Journal, 318:1422 (May 22, 1999). See also: “Iraq Cancer, Birth Defect Hike May Be Related to Gulf War Syndrome,” Houston Chronicle, p. 26A (March 19, 1998).

Likewise, in the nearby the Persian Gulf nation of Bahrain, within reach of mustard gas fallout, by comparing the incidence of spontaneous abortions in the five years before and after the Gulf War of 1991, a significant rise was observed after the Gulf War. Rajab, KE, et al., “Incidence of Spontaneous Abortion in Bahrain Before and After the Gulf War of 1991", (Medline Record) (March, 2000).

It is also noteworthy, that since Saddam used mustard gas and nerve gas on the inhabitants of Halabjah, Iraq in 1988, the surviving population has suffered from high rates of cancer, birth defects, neurological disorders and other illnesses. International Herald Tribune. (March 12, 1998).

There were no other widespread mutagent exposures in the Gulf War environment that would explain the increased birth defect rates:

1.) Pyridostigmine bromide (p.b.) does not cause birth defects. Rats and rabbits administered 50 to 93 times the typical human dose of p.b. during pregnancy demonstrate no adverse effects on pregnancy, litter size, malformation rate or fetal development. Golumb, B.A., A Review of Scientific Literature As It Pertains to Gulf War Illnesses: Pyridostigmine Bromide, Vol. 2, RAND, 1999.

2.) Sarin exposure also has not been linked to birth defects. National Research Council, J. of Toxicology & Env. Health, 59:281-501 (March, 2000), pp. 402-404.

MUSTARD GAS CAUSED CANCER IN GULF WAR VETERANS
AND ABNORMAL PULMONARY FUNCTION TESTS

The International Agency for Research on Cancer (IARC) has classified mustard gas as a Group I carcinogen. IARC, “Overall Evaluation of Carcinogenicity: An Updating of IARC Monographs, Volumes 1-42,” IARC Monogr. Eval. Carcinogen. Risk Chem. Man., Supp. 7 (1987), p. 67. “[A]nimal studies, mutagenicity studies, geno-toxicity data, and the fact that sulfur mustard is a potent DNA alkylating agent all provide supporting evidence for the carcinogenicity of this chemical agent ...[D]aily oral doses should be limited to ...6 x 10^-6 mg./kg./d.” National Research Council, Subcommittee on Chronic Reference Doses for Selected Chemical Warfare Agents, J. of Toxicology & Env. Health, 59:281-501 (March, 2000), pp. 287 & 482.

By 1996, the cancer rate was already much higher among Gulf War veterans than the general U.S. population of males, despite the “healthy warrior effect” of the Gulf War veterans initially being a much healthier group of people than the general male population of the U.S. Higher cancer rates were already evident five years ago concerning multiple myeloma, cancer of the brain and nervous system, pancreatic cancer, testicular cancer, kidney cancer, cancers of the pluripotential stem cells, and lung cancer. Testimony of Dr. William Marcus (Board Certified Toxicologist) to the U.S. Congress, Committee on Government Reform and Oversight (June 25, 1996).

A rise in cancer rates has been reported in Iraq since the Gulf War. Scott, R. & Holdstock, D., “World Health Organization (WHO) Should Undertake Full Inquiry Into Gulf War Illness,” British Medical Journal, 318:1422 (May 22, 1999). See also: “Iraq Cancer, Birth Defect Hike May Be Related to Gulf War Syndrome,” Houston Chronicle, p. 26A (March 19, 1998).

There were no other widespread carcinogenic exposures in the Gulf War environment that would explain the increased cancer rates among Gulf War veterans. Other exposures have been eliminated as the cause:

1.) The oil well fire smoke. A U.S. Interagency Air Assessment team of scientists studied the potential health effects of the oil well fires. The U.S. Army Environmental Hygiene Agency collected nearly 4,000 ambient air and soil samples between May and December, 1991. The total predicted excess carcinogenic risks did not exceed 3 excess cancers per 1,000,000 attributed to this exposure. The Environmental Protection Agency considers this level of risk to be de minimis, or indistinguishable from background. Final Report: Kuwait Oil Fire Risk Assessment Project, 5 May - 3 December, 1991, Report No. 39-26-L192-91, February, 1994.

2.) Depleted Uranium D.U. has been eliminated as a cause, other than possibly in a few soldiers who have d.u. fragments in them from friendly-fire explosions, or crawled into newly blown-up Iraqi vehicles and inhaled a significant amount of d.u. dust. See Harley, N., Foulkes, E., et al., A Review of the Scientific Literature As It Pertains to Gulf War Illness, Volume 7: Depleted Uranium, Rand Corporation (1999).

Respiratory problems have also been found in Gulf War vets. In a pulmonary function test study of 53 Gulf War veterans, doctors found mucosal inflammation of the larynx and trachea in every Gulf War veteran. This chronic inflammatory change in their upper airways could not be attributed to smoking or allergies. Das, A.K., et al, “Variable Extra Thoracic Air Flow Obstruction and Chronic Laryngotracheitis in Gulf War Veterans,” Chest, 115(1): 97-101 (Jan., 1999).

Dated: December 10, 2001.

                                                                                                         Respectfully submitted,

                                                                                                         PITTS & ASSOCIATES

                                                                                                         ______________________________                                                                                                          Gary B. Pitts                                                                                                          State Bar No. 16054200                                                                                                          8866 Gulf Freeway, Suite 117                                                                                                          Houston, Texas 77017-6528                                                                                                          (713) 910-0555                                                                                                          (713) 910-0594 Fax

                                                                                                         ATTORNEYS FOR INTERVENORS,                                                                                                          MICHAEL WILLIAM DONNELLY, ET AL,                                                                                                          IHSAAN ABDUL-MALIK, ET AL, KEVIN                                                                                                          R. ALLEN, ET AL, PATRICIA D.                                                                                                          BRASWELL, ET AL, LLOYD P. ALLARD, III, ET AL

I hereby certify that a true and correct copy of the above and foregoing document was served upon all counsel of record by certified mail, return receipt requested, on this the ___ day of _________, 200___.

                                                                                                         ______________________________

                                                                                                         Gary B. Pitts