 You know, as soon as I arrived in country, there in Palada, I noticed a stench. For me, it just smelled like I was living next to a landfill. Just that stench of burning rubber or something. It was just nasty. I had started coughing and had a lot of phlegm. I would hear, you know, asking other soldiers, oh, it's just a rachic russor, it's going to take a couple of weeks to clear out your system. We thought, your body has to de-climatize, it takes so many weeks. Everybody talks about war doing that to you. But the symptoms just progressed. That's when I started picking up there's something wrong, something going on in my body that I keep getting sick. I always wanted to be a soldier since I was a kid. I was able to fulfill my goals. I was 17 years of age when I enlisted in the Army. I served six years active duty, then joined the reserves. I got accepted to the State Police Academy. I was a state trooper for 14 years. I still remember I was at a small diner with my dad. He just asked me, so any word on you going to Iraq? I said, no dad, it's been fortunate. And not even 10 minutes, my phone rang. Next thing, I'm in Iraq. This Sunday before Thanksgiving, November of 2007, I landed there in Iraq. Balaan, Iraq. Balaan was a pretty nice base. Subway, Burger King, you know, people had it made. Actually, I had to go to the clinic because I developed a real bad cough and I ended up having an respiratory infection. And the medical officer I saw, he had this Iraqi cry, but I'm like, I've already been here for a month, how much longer? I returned around the 30th of October 2008. Not even two weeks, I was already in the emergency room. I think they had already sent him home from his job at that point. Like, you can't come back, you need to find an answer to what's wrong with you because we can't have you here. Just breathe, take a deep breath, okay? Take a deep breath. Watch your car. What happened that you ended up here? I started bleeding. A lot? A lot of blood. Good, good shot of blood. So every night laying in bed, just constantly sick, I Googled soldiers coming back dying from Iraq. I don't know, just kind of some phrase that would give me a connection and just found this community of people that were all sharing their stories. That we're all going through the same things we were going through. So that was just a sigh of relief because I was like, we're not alone. We're not crazy, it's not in our head. There actually is something going on that there's an explanation to. Alright, we have a burn pit down here. Let me get a good shot of it. I have no idea what they're burning over here. Burn pits were used in Iraq and are still used in Afghanistan to dispose, they are open air, just what it says, pits, into which all of the waste that is developed or that is produced at a particular place are put. And then those wastes are burned, so it's everything from styrofoam to plastic bottles to munitions to human waste to in some cases body parts, you name it, all put in these open air burn pits and then set afire. In many cases, these were burn pits that burned 24-7. They never went out and a thick black cloud of toxins basically hung over the base. And remember how we got into Iraq, you never forget what Donald Rumsfeld said, that you go to war with the army you have, not the army you want. So there was no thought, as best I can tell, to how to deal with the waste in a safe and responsible way. So your choice is either to bury it or burn it. Those are really the only two choices and the decision was made to burn it. Our data established a link for constrictive bronchiolitis following service in both Iraq and Afghanistan. And I'm concerned that open pit burning is one of those causes. Constrictive bronchiolitis is a disorder that affects the small airways of the lung and spares the rest of the lung, which is why you probably don't see changes on chest CT scan and chest X-ray. Some of the providers have told them that there's nothing wrong with them. Some of them have told them they're deconditioned. It's important to this group of people that they have someone who will listen to them and it's important to them that their symptoms are explained. The center is a non-profit organization founded by my family in memory of my brother who was Marine Corps Sergeant Thomas Joseph Sullivan. The initial symptoms of his illness began while he was in Iraq. The treatment he was offered was primarily psychological and what he was looking for was physiological treatment, physiological diagnosis for physiological symptoms. After he died, the primary care physician who was responsible for his care told us, his family, in a meeting, that he had believed, and to some extent still believed, that Tom had suffered from a psychosomatic illness. We then learned, of course, that all of Tom's symptoms were very similar to the symptoms that people are getting after breathing in the toxic fumes and chemicals in burn pits, sand and dust. The VA has tracked over 400,000, nearly half a million, service members from the post 9-11 era wars who have medically unexplained physical symptoms. I want to know what causes these illnesses and now it's not just about Tom, it's about hundreds of thousands of people potentially who are sick. Michelle Pierce is a fighter. She battled stomach cancer in 2008 and then doctors discovered another tumor in her lung. It's a cough that never goes away. Your sinuses are burning, your eyes are burning. All of a sudden you'll get a fever. Since returning from home in July, I have suffered from a number of respiratory problems related to the exposure. When we met that whole community of people that were having the same symptoms is when we realized that we had to open that pathway for them too. That's when God put it in our heart to invest our time and our energy in being the voice for other people. Kind of finding somewhere where they can go and just click and say, okay, there are doctors, these are the healthcare providers that have researched and discovered this illness. We'll just put that information there and throw this information in here and put a registry together. We developed it as a platform to show the VA and DoD that there is a need. And so every day there's an entry on the registry. So if the VA can't see that, then I don't know what else to say. We would like to see them step up and say, okay, let's take the torch from here and do what needs to be done because I don't have the resources to respond to all of these thousands of people that need help. In both Afghanistan and Iraq, open air burn pits were widely used at forward operating bases. Disposing of trash and other debris was a major challenge. Commanders had to find a way to dispose of waste while concentrating on the important mission at hand. The solution that was chosen, however, had serious risks. Everybody that went to Iraq and Afghanistan knew that if they walked off the base, they were exposing themselves to danger. They all knew that. I mean, sadly, that's a fact of life and war. But the fact that they were exposed to potentially fatal levels of danger on their own bases is something that we have to address and we have to rectify to the greatest extent we can. When we first got involved in the issue, the first thing we looked at was to get the burn pits banned. That was number one. The second thing we then went after was to begin to construct a registry of those who had been exposed to the burn pits. This bill is a step towards finding the answers we owe them. The legislation will establish and maintain an open burn pit registry for those individuals who may have been exposed during their military service. The VA and the Department of Defense have really been very slow to assert that burn pit exposure has long-term health implications. Perhaps the only way they're going to draw that conclusion is if they've got some data that's irrefutable. We were going to just sit back and say, okay, you're the next Agent Orange and you need to sit 35 years in the back burner and wait until let's see how many people die until then. And then we'll get you what you need. We weren't going to do that. We want to work with them in delivering the right type of registry, the right information, the truth. At this point in time, we've developed a questionnaire. It'll be a point in time snapshot of what they're exposed to, what they self-report they're exposed to, what their health concerns are, what their current health conditions are. We would like everyone who deployed to participate in this registry, even if they today don't have any symptoms or concerns. That way we get the broadest picture of what people's exposures were. The purpose of this registry is to register people who've been exposed to burn pits and airborne hazards. This particular registry asks more questions about residential history, non-military occupational history, current occupational status. There's no question in here as to what burn pit you were stationed near. We really don't want to just focus on burn pits. Burn pits are obviously something you can see and it's very possible you have acute health effects from the smoke and the gases, but the uncertainty is what the long-term consequences are. From the information we have, the probability is that most symptoms would resolve after deployment. I think that it's important in a questionnaire like that that it meet some type of standard for occupational medicine. Unfortunately, there are a lot of delays and it may be that the action is going to be more based on the politics than on the science. It's a step in the right direction and I'm delighted that we were able to get the registry. But I will say that the Department of Defense and VA, I wish were sort of more receptive to the notion that we've got a real serious long-term health problem on our hands here. And that it's something that we've got to deal with. The clearest and most obvious question that's omitted is the question, have you ever been diagnosed with constrictive bronchiolitis? We have not seen a large increase in constrictive bronchiolitis cases. Most cases of constrictive bronchiolitis are seen in other aspects, in other situations such as lung transplant. There are some cases that are seen with exposure to flavorings such as popcorn flavorings. And so we're not certain exactly what it means, what Dr. Miller has seen. The only reason I can think that those questions would be left out intentionally is that the VA, for some reason, does not want to have that information in its possession. For the past four and one-half years, I was a senior epidemiologist in the Office of Public Health at the Department of Veterans Affairs. In December 2012, I resigned my position in the U.S. Civil Service because of serious ethical concerns that I'm here to testify about today. The Office of Public Health conducts large studies of the health of American veterans. However, if the studies produce results that do not support the Office of Public Health's unwritten policy, they don't release them. This applies to data regarding adverse health consequences of environmental exposures such as burn pits in Iraq and Afghanistan and toxic exposures in the Gulf War. On the rare occasions when embarrassing study results are released, data are manipulated to make them unintelligible. We were interested in inhalational hazards like potential exposure to burn pits and dust and fumes. And, you know, I was being told, don't look at the data, you know, we're not going to explore the data thoroughly and that sort of thing. These studies cost tens of millions of dollars. It's a U.S. Taxpayers Fund and what they were doing was against the interest of the veterans who participated in the studies and against the interest of U.S. veterans in general. It was just an untenable position for me because my supervisors were doing things that were greatly unethical. I think the VA and the DOD are very used to having control over the information and they don't. They don't have control over it. Rosie Torres can do her own registry on the Burn Pits 360 website using Vistaprint and whatever she can put together. And she's going to keep doing it while the VA spends 1.5 million dollars or more collecting information that may never be useful to anyone. You know, I don't want to speculate, but I will say that it is, I mean, look at how long it's taken to fully recognize the implications of Agent Orange. I mean, it was just, what, summer of 2011 that a whole family of conditions were added to the list of presumptive causes. You know, the last one of our troops left Vietnam in 1975 and so whatever that is, 36 years that it took to get that done. Now, one of the things that I'm determined isn't going to happen is it's not going to take 36 years for us to properly deal with those that we have exposed to burn pits. In the beginning, the language that was written was definitely saying that there's not an association between the exposure and the illnesses. Slowly they're acknowledging a little that these people are not going to go away and that there needs to be a change, but I'm not happy with the pace that they're going, at the rate they're going with, with acknowledging all that. Acceptance is a huge thing that I've had to deal with, is just accepting the fact that I'm not the same person who I was before the exposure. You know, we're hanging that flag up the other day and it makes me proud. And although we've been through things with DOD and VA, to me that's just the price of war. Every war has its price. It's like I mentioned before, I would do it all over again, which may sound crazy, but it's just something that's in your heart and you desire to do it. It's like you do it at all costs. I absolutely am patriotic until the day I die. I mean, I'll honor that flag. So until the day I hang that flag on my coffin, you know. Yeah. Yeah.
 You know, as soon as I arrived in country, there in Palada, I noticed a stench.
 For me, it just smelled like I was living next to a landfill.
 Just that stench of burning rubber or something. It was just nasty.
 I had started coughing and had a lot of phlegm.
 I would hear, you know, asking other soldiers, oh, it's just a rachic russor, it's going to take a couple of weeks to clear out your system.
 We thought, your body has to de-climatize, it takes so many weeks.
 Everybody talks about war doing that to you. But the symptoms just progressed.
 That's when I started picking up there's something wrong, something going on in my body that I keep getting sick.
 I always wanted to be a soldier since I was a kid. I was able to fulfill my goals.
 I was 17 years of age when I enlisted in the Army.
 I served six years active duty, then joined the reserves.
 I got accepted to the State Police Academy. I was a state trooper for 14 years.
 I still remember I was at a small diner with my dad.
 He just asked me, so any word on you going to Iraq?
 I said, no dad, it's been fortunate.
 And not even 10 minutes, my phone rang.
 Next thing, I'm in Iraq.
 This Sunday before Thanksgiving, November of 2007, I landed there in Iraq.
 Balaan, Iraq.
 Balaan was a pretty nice base. Subway, Burger King, you know, people had it made.
 Actually, I had to go to the clinic because I developed a real bad cough and I ended up having an respiratory infection.
 And the medical officer I saw, he had this Iraqi cry, but I'm like, I've already been here for a month, how much longer?
 I returned around the 30th of October 2008.
 Not even two weeks, I was already in the emergency room.
 I think they had already sent him home from his job at that point.
 Like, you can't come back, you need to find an answer to what's wrong with you because we can't have you here.
 Just breathe, take a deep breath, okay?
 Take a deep breath.
 Watch your car.
 What happened that you ended up here?
 I started bleeding.
 A lot?
 A lot of blood.
 Good, good shot of blood.
 So every night laying in bed, just constantly sick, I Googled soldiers coming back dying from Iraq.
 I don't know, just kind of some phrase that would give me a connection and just found this community of people that were all sharing their stories.
 That we're all going through the same things we were going through.
 So that was just a sigh of relief because I was like, we're not alone.
 We're not crazy, it's not in our head.
 There actually is something going on that there's an explanation to.
 Alright, we have a burn pit down here.
 Let me get a good shot of it.
 I have no idea what they're burning over here.
 Burn pits were used in Iraq and are still used in Afghanistan to dispose, they are open air, just what it says, pits, into which all of the waste that is developed or that is produced at a particular place are put.
 And then those wastes are burned, so it's everything from styrofoam to plastic bottles to munitions to human waste to in some cases body parts, you name it, all put in these open air burn pits and then set afire.
 In many cases, these were burn pits that burned 24-7. They never went out and a thick black cloud of toxins basically hung over the base.
 And remember how we got into Iraq, you never forget what Donald Rumsfeld said, that you go to war with the army you have, not the army you want.
 So there was no thought, as best I can tell, to how to deal with the waste in a safe and responsible way.
 So your choice is either to bury it or burn it. Those are really the only two choices and the decision was made to burn it.
 Our data established a link for constrictive bronchiolitis following service in both Iraq and Afghanistan.
 And I'm concerned that open pit burning is one of those causes.
 Constrictive bronchiolitis is a disorder that affects the small airways of the lung and spares the rest of the lung,
 which is why you probably don't see changes on chest CT scan and chest X-ray.
 Some of the providers have told them that there's nothing wrong with them. Some of them have told them they're deconditioned.
 It's important to this group of people that they have someone who will listen to them and it's important to them that their symptoms are explained.
 The center is a non-profit organization founded by my family in memory of my brother who was Marine Corps Sergeant Thomas Joseph Sullivan.
 The initial symptoms of his illness began while he was in Iraq. The treatment he was offered was primarily psychological
 and what he was looking for was physiological treatment, physiological diagnosis for physiological symptoms.
 After he died, the primary care physician who was responsible for his care told us, his family, in a meeting,
 that he had believed, and to some extent still believed, that Tom had suffered from a psychosomatic illness.
 We then learned, of course, that all of Tom's symptoms were very similar to the symptoms that people are getting after breathing in
 the toxic fumes and chemicals in burn pits, sand and dust.
 The VA has tracked over 400,000, nearly half a million, service members from the post 9-11 era wars who have medically unexplained physical symptoms.
 I want to know what causes these illnesses and now it's not just about Tom, it's about hundreds of thousands of people potentially who are sick.
 Michelle Pierce is a fighter. She battled stomach cancer in 2008 and then doctors discovered another tumor in her lung.
 It's a cough that never goes away. Your sinuses are burning, your eyes are burning. All of a sudden you'll get a fever.
 Since returning from home in July, I have suffered from a number of respiratory problems related to the exposure.
 When we met that whole community of people that were having the same symptoms is when we realized that we had to open that pathway for them too.
 That's when God put it in our heart to invest our time and our energy in being the voice for other people.
 Kind of finding somewhere where they can go and just click and say, okay, there are doctors, these are the healthcare providers that have researched and discovered this illness.
 We'll just put that information there and throw this information in here and put a registry together.
 We developed it as a platform to show the VA and DoD that there is a need. And so every day there's an entry on the registry.
 So if the VA can't see that, then I don't know what else to say.
 We would like to see them step up and say, okay, let's take the torch from here and do what needs to be done because I don't have the resources to respond to all of these thousands of people that need help.
 In both Afghanistan and Iraq, open air burn pits were widely used at forward operating bases.
 Disposing of trash and other debris was a major challenge.
 Commanders had to find a way to dispose of waste while concentrating on the important mission at hand.
 The solution that was chosen, however, had serious risks.
 Everybody that went to Iraq and Afghanistan knew that if they walked off the base, they were exposing themselves to danger.
 They all knew that. I mean, sadly, that's a fact of life and war.
 But the fact that they were exposed to potentially fatal levels of danger on their own bases is something that we have to address and we have to rectify to the greatest extent we can.
 When we first got involved in the issue, the first thing we looked at was to get the burn pits banned. That was number one.
 The second thing we then went after was to begin to construct a registry of those who had been exposed to the burn pits.
 This bill is a step towards finding the answers we owe them.
 The legislation will establish and maintain an open burn pit registry for those individuals who may have been exposed during their military service.
 The VA and the Department of Defense have really been very slow to assert that burn pit exposure has long-term health implications.
 Perhaps the only way they're going to draw that conclusion is if they've got some data that's irrefutable.
 We were going to just sit back and say, okay, you're the next Agent Orange and you need to sit 35 years in the back burner and wait until let's see how many people die until then.
 And then we'll get you what you need. We weren't going to do that.
 We want to work with them in delivering the right type of registry, the right information, the truth.
 At this point in time, we've developed a questionnaire.
 It'll be a point in time snapshot of what they're exposed to, what they self-report they're exposed to, what their health concerns are, what their current health conditions are.
 We would like everyone who deployed to participate in this registry, even if they today don't have any symptoms or concerns.
 That way we get the broadest picture of what people's exposures were.
 The purpose of this registry is to register people who've been exposed to burn pits and airborne hazards.
 This particular registry asks more questions about residential history, non-military occupational history, current occupational status.
 There's no question in here as to what burn pit you were stationed near.
 We really don't want to just focus on burn pits.
 Burn pits are obviously something you can see and it's very possible you have acute health effects from the smoke and the gases,
 but the uncertainty is what the long-term consequences are.
 From the information we have, the probability is that most symptoms would resolve after deployment.
 I think that it's important in a questionnaire like that that it meet some type of standard for occupational medicine.
 Unfortunately, there are a lot of delays and it may be that the action is going to be more based on the politics than on the science.
 It's a step in the right direction and I'm delighted that we were able to get the registry.
 But I will say that the Department of Defense and VA, I wish were sort of more receptive to the notion that we've got a real serious long-term health problem on our hands here.
 And that it's something that we've got to deal with.
 The clearest and most obvious question that's omitted is the question, have you ever been diagnosed with constrictive bronchiolitis?
 We have not seen a large increase in constrictive bronchiolitis cases.
 Most cases of constrictive bronchiolitis are seen in other aspects, in other situations such as lung transplant.
 There are some cases that are seen with exposure to flavorings such as popcorn flavorings.
 And so we're not certain exactly what it means, what Dr. Miller has seen.
 The only reason I can think that those questions would be left out intentionally is that the VA, for some reason, does not want to have that information in its possession.
 For the past four and one-half years, I was a senior epidemiologist in the Office of Public Health at the Department of Veterans Affairs.
 In December 2012, I resigned my position in the U.S. Civil Service because of serious ethical concerns that I'm here to testify about today.
 The Office of Public Health conducts large studies of the health of American veterans.
 However, if the studies produce results that do not support the Office of Public Health's unwritten policy, they don't release them.
 This applies to data regarding adverse health consequences of environmental exposures such as burn pits in Iraq and Afghanistan and toxic exposures in the Gulf War.
 On the rare occasions when embarrassing study results are released, data are manipulated to make them unintelligible.
 We were interested in inhalational hazards like potential exposure to burn pits and dust and fumes.
 And, you know, I was being told, don't look at the data, you know, we're not going to explore the data thoroughly and that sort of thing.
 These studies cost tens of millions of dollars.
 It's a U.S. Taxpayers Fund and what they were doing was against the interest of the veterans who participated in the studies and against the interest of U.S. veterans in general.
 It was just an untenable position for me because my supervisors were doing things that were greatly unethical.
 I think the VA and the DOD are very used to having control over the information and they don't.
 They don't have control over it.
 Rosie Torres can do her own registry on the Burn Pits 360 website using Vistaprint and whatever she can put together.
 And she's going to keep doing it while the VA spends 1.5 million dollars or more collecting information that may never be useful to anyone.
 You know, I don't want to speculate, but I will say that it is, I mean, look at how long it's taken to fully recognize the implications of Agent Orange.
 I mean, it was just, what, summer of 2011 that a whole family of conditions were added to the list of presumptive causes.
 You know, the last one of our troops left Vietnam in 1975 and so whatever that is, 36 years that it took to get that done.
 Now, one of the things that I'm determined isn't going to happen is it's not going to take 36 years for us to properly deal with those that we have exposed to burn pits.
 In the beginning, the language that was written was definitely saying that there's not an association between the exposure and the illnesses.
 Slowly they're acknowledging a little that these people are not going to go away and that there needs to be a change,
 but I'm not happy with the pace that they're going, at the rate they're going with, with acknowledging all that.
 Acceptance is a huge thing that I've had to deal with, is just accepting the fact that I'm not the same person who I was before the exposure.
 You know, we're hanging that flag up the other day and it makes me proud.
 And although we've been through things with DOD and VA, to me that's just the price of war. Every war has its price.
 It's like I mentioned before, I would do it all over again, which may sound crazy, but it's just something that's in your heart and you desire to do it.
 It's like you do it at all costs.
 I absolutely am patriotic until the day I die. I mean, I'll honor that flag.
 So until the day I hang that flag on my coffin, you know.
 Yeah.
 Yeah.