"We just went about our business because there was a war going on," said Williams, a retired chief warrant officer who was responsible for maintaining some 250 aircraft for the U.S. Army's 101st Airborne Division.
He returned home from that second stint in Iraq in 2006 and subsequently was diagnosed with an irreversible lung disease that his doctor suspects could be related to smoke from one of the hundreds of burn pits that dotted Iraq and Afghanistan during the course of the two wars. The pits were used to burn off the garbage that accumulates at military bases, everything from Styrofoam and metal to paints, solvents, human waste and medical waste.
A new Department of Veterans Affairs registry, mandated by Congress, will be used to try to determine if there is a link between the burn pits and long-term health problems.
Military personnel who were stationed near an open burn pit can sign up. Researchers will use the database to monitor health trends in participants, and the VA will alert them to major problems detected.
Over the long term, the findings could make it easier for veterans who served near burn pits to obtain disability payments.
Williams, 56, of Huntsville, Ala., was initially told that he would have to prove that his illness, diagnosed as constrictive bronchiolitis, was service-related. He walked out of the room. Eventually, after he traveled to Washington and met with members of Congress, the VA increased his disability rating 10 percent.
He said he's hoping the registry will pave the way for other soldiers to avoid a similarly exasperating process. If researchers find certain illnesses are linked to exposure to burn pits, then the VA would be more likely to declare those illnesses a presumptive condition, eliminating the need for a veteran to prove that his or her illness is service-related.
Sixty-three burn pits were still being used in Afghanistan as of Dec. 26; those in Iraq were closed by December 2010. Camps with fewer than 100 people are not required to report the use of a burn pit, so there could be more, but generally much smaller ones. Proponents say the burn pits were so widespread that the large majority of veterans from Iraq and Afghanistan could participate in the registry.
In 2009, the military updated its policies on burn pits to prohibit the burning of hazardous materials such as certain medical waste, batteries and tires, and whenever possible, to situate them where the smoke would not blow over work and living quarters.
"When our service members voice concerns about burn pit exposures as well as other health issues, we take our responsibility seriously to investigate these exposures and possible health risks, and to implement any protective measure that are indicated and feasible," said Defense Department spokeswoman Cynthia O. Smith.
The creation of the burn pit registry has been several years in the making.
Air Force Lt. Col Darrin Curtis said in a memo disclosed by the Army Times in 2008 that he believed a particularly large burn pit at Joint Base Balad, one of the largest air bases in Iraq, was an acute health hazard, and he was amazed that it was allowed to operate without restrictions.
Congressional hearings followed that featured sick veterans, contractors and family members who had lost a loved one from illnesses they attributed to burn pits. The Pentagon said that none of the monitoring conducted at Balad identified an increased risk for long-term health problems. It has maintained that position over the years but also acknowledges that some personnel have persistent symptoms, possibly as a result of elevated exposures to the smoke, existing health conditions or other unknown factors.
An Institute of Medicine study requested by the VA and made public in 2011 concluded there was insufficient data to determine whether burn pit emissions had long-term health consequences. The study found the pollutants measured at Balad were generally present at a concentration so low that it would not be expected to cause any harm, even if a person was exposed to that concentration for a lifetime. The two exceptions were particulate matter and acrolein.
Particulate matter is a mixture of small particles and liquid droplets that can lead to acute respiratory problems. But the high concentrations at Joint Base Balad came primarily from local sources such as traffic and dust storms, rather than the burn pit, according to the institute, which advises the government on health issues.
Acrolein is a liquid primarily used as a herbicide and in making other chemicals. Exposure can lead to eye, nose and throat irritation. Although the concentration exceeded precautionary levels set by the Environmental Protection Agency, it was still far below the concentration that led to nasal and lung damage in laboratory animals, the study said.
The Pentagon said it is continuing to study the potential hazards of burn pit exposure.
The VA opposed the legislation setting up the burn pit registry even though it has registries for those exposed to Agent Orange in Vietnam and for those who served during the Gulf War. The department did not oppose trying to track potential burn pit-related illnesses, just the mechanism proposed.
"We said it was not the best scientific approach for learning about long-term health outcomes and it really wasn't necessary for outreach because we have other programs in place," said Dr. Paul Ciminera, director of the VA's Post-9/11 Era Environmental Health Program.
As to whether the burn pits lead to health problems in soldiers, Ciminera cited the Institute of Medicine report. "We need to do further research to see what the long-term effects could be," he said.
Democratic Sen. Tom Udall of New Mexico, the lead Senate sponsor of the registry legislation, said he pushed ahead despite VA objections because the department seems to instinctively reject concerns that veterans are harmed by their surrounding environment. He cited Agent Orange as an example and said the VA initially resisted a link between the defoliant and the health of soldiers who served in Vietnam.
Many supporters of the registry, including Williams, are also participants in a class-action lawsuit filed against KBR Inc., which contracted with the government to operate several of the burn pits in Iraq and Afghanistan. Some 50 lawsuits were consolidated into one case in a Maryland federal court. The plaintiffs are seeking damages for various injuries, emotional distress and fear of future disease. KBR is seeking to dismiss the lawsuits on grounds it deserves the same immunity that prevents the plaintiffs from suing the federal government.
"Every type of waste imaginable was and is burned in these pits," the plaintiffs said in their suit.
Veterans groups were big backers of the registry, and an often-divided Congress overwhelmingly sides with them rather than the VA.
"You've been told since you're a little kid: 'Don't put a Styrofoam cup in a fire and breathe it because it's bad for you," said Ray Kelley, national legislative director for the Veterans of Foreign Wars. "They do that all day long on these stops along with Lord knows what else, from human waste to all sorts of garbage. You're inhaling that on a daily basis. It can't be good for you."