In the annals of military history, many battles were not only fought on foreign soil but within the bodies of the service-men and -women themselves. This invisible warfare was instigated by the exposure to various toxins, often used as weapons or as unintended byproducts of military operations.
With insights from Mary Stout, who served two terms as National President of Vietnam Veterans of America and fought strenuously for years to get veterans the justice they deserve over the course of four decades, this article will delve into the history and chemical nature of military toxins and beyond. The connections between these toxins and the development of autoimmune diseases, supported by the latest scientific evidence, are discussed.
A notorious example of a military toxin is Agent Orange, an herbicide and defoliant chemical widely used during the Vietnam War. However, the story does not stop there. From the Gulf War Syndrome to the burn pits in Iraq and Afghanistan, our military personnel have faced a spectrum of toxic threats.
One of the less spoken of and more insidious health effects of these exposures is the increased risk of autoimmune diseases. Rheumatoid arthritis, lupus, and multiple sclerosis are just a few examples of the numerous known autoimmune diseases that develop after repeat exposure to Agent Orange.
One of the most infamous toxins in military history is Agent Orange. Named after the orange stripe on the barrels it was stored in, this herbicide was employed extensively during the Vietnam War with long-lasting health effects that continue to be a subject of research and concern.
The History of Agent Orange
Agent Orange was one of the so-called “Rainbow Herbicides,” a group of chemicals used by the U.S. military to defoliate the dense jungles of Vietnam. From 1961 to 1971, approximately 20 million gallons of these herbicides were sprayed, with Agent Orange constituting a large majority. The intent was to remove the lush forest cover that provided a tactical advantage to the Viet Cong and North Vietnamese troops and to destroy the crops that fed the enemy forces.
However, the impact extended far beyond the war’s tactical aspects. Mary Stout stated that “the herbicides in Agent Orange were not the problem. It was dioxin, a byproduct of the manufacturing process, that was believed to cause illness in veterans.” Exposure to these byproducts has led to severe health consequences for many veterans, local Vietnamese people, and subsequent generations.
The Chemical Composition of Agent Orange
Agent Orange is a 50/50 mixture of two chemicals: 2,4-D (2,4-dichlorophenoxyacetic acid) and 2,4,5-T (2,4,5-trichlorophenoxyacetic acid). However, the production process of Agent Orange often led to the creation of an impurity – TCDD (Tetrachlorodibenzo-p-dioxin), one of the most toxic dioxin compounds known to man. Mary explains that in order to make Agent Orange, “chemicals were heated together. The higher the temperature, the faster the process. But that also results in a higher concentration of dioxin. The military needed lots of Agent Orange, and fast, so manufacturers used the highest possible temperatures in the production.”
TCDD is an incredibly potent toxin. It is not easily broken down in the environment and can accumulate in the fat tissues of animals and humans, leading to a variety of potential health issues.
The Health Implications of Agent Orange
The health effects of Agent Orange are both immediate and long-term, many of which are still being studied and understood. Direct exposure can cause skin disorders like chloracne and may lead to several types of cancers, including lung, larynx, and prostate cancer, as well as multiple myeloma.
Notably, it is also linked to the development of various autoimmune diseases. Studies have suggested associations between Agent Orange exposure and increased risk of developing diseases like systemic lupus erythematosus and rheumatoid arthritis. The toxin’s potent ability to disrupt the immune system is likely a contributing factor, although more research is needed to understand these complex interactions fully.
Why weren’t studies conducted immediately to determine the health implications of Agent Orange byproducts?
Mary revealed that both the New Jersey Agent Orange Commission, Massachusetts Agent Orange Commission, and other state commissions were working on ways to detect the presence of dioxin in veterans but that “the VA [Department of Veterans Affairs] was dragging its feet on a study mandated by H.R.1961, which had become law in 1963. There was little support from other veterans service organizations. Members of Congress wanted definitive proof that dioxin was the causative agent in any illness.”
Angie Auletta, an epidemiologist with the Environmental Protection Agency, explained to Mary how difficult it is to find that “silver bullet” correlation between chemicals and illnesses that Congress was demanding because you can’t test chemicals on people. “What scientists look for is an increased risk of illnesses in exposed communities,” continues Mary. “There were already scientists looking at dioxin exposure, but VA discredited every study by questioning the methodology, the sample size, or anything else they could find to throw into doubt the scientific work. At the same time, however, they couldn’t work out a protocol for the legislatively mandated study. Eventually, the VA transferred the study to the Centers for Disease Control, which also never did the study.”
What was the process like to get veterans proper compensation?
Mary elucidated her rigorous battle plan for getting justice, “we would propose legislation to have an independent scientific body review all dioxin-related studies and inform VA of their findings on a regular basis. Along with this, we needed to have VA rescind its regulation that only chloracne was related to Agent Orange exposure. NVLSP [the National Veterans Legal Services Project] accomplished that by bringing the Nehmer class-action suit, which they won in 1986. We also needed to have a presumption that anyone who served in Vietnam had been exposed to Agent Orange.”
“Then we started our work with members of the VVA [Vietnam Veterans of America] Board to get their approval and with members of Congress to get legislation written and introduced. Rep. Tom Daschle and his staff took the lead in writing the legislation for the House of Representatives and John Kerry took on the task in the Senate. We felt the most important part of the legislation was the establishment of an independent scientific group to look at all the studies. It could not be the VA or any other government agency. Sen. Kerry convinced us that we had to ask for the most credible group, which was the National Academy of Sciences. He argued that it was the only group Congress would recognize as fully credible. We reluctantly agreed.”
“It took four years of work with the VVA Agent Orange Committee, the VVA Board, members of Congress, VVA Legislative Coordinators, State Councils, and Chapters to finally have a change to get the legislation before the House Veterans’ Affairs Committee. During that time, there were numerous hearings in both the House and Senate Veterans’ Affairs Committees. We tried to get the committees to allow testimony from scientists working in the field, but those requests were most often denied.” Mary stated that the press was very keen to talk to the first woman elected to head a veterans service organization, so she took advantage of this to raise awareness of Agent Orange and the issues facing Vietnam veterans, doing many interviews for radio, TV, and print media.
All of this effort is merely a fraction of her extensive work to get compensation for those exposed to Agent Orange.
While Agent Orange may be one of the most infamous military toxins, it is far from being the only one that has affected the health of service-men and -women. From the mysterious Gulf War Syndrome to the toxic burn pits in Iraq and Afghanistan, exposure to harmful substances continues to have long-lasting effects on our military personnel.
Gulf War Syndrome and Its Causes
During and after the Gulf War in the early 1990s, many veterans began reporting a complex array of symptoms that didn’t fit into any known diagnosis, including fatigue, headaches, joint pain, indigestion, insomnia, dizziness, respiratory disorders, and memory problems. This condition is now referred to as Gulf War Syndrome or Gulf War Illness, and it is believed to affect as many as one in four of the 697,000 U.S. veterans who served in the Gulf War.
The exact cause of Gulf War Syndrome remains unclear, but several military-related toxins are suspected to play a role. These include exposure to pesticides, nerve gas, certain vaccines, and the widespread use of pyridostigmine bromide pills given to troops as a protective measure against nerve gas.
Burn Pits in the Iraq and Afghanistan Wars
During the more recent wars in Iraq and Afghanistan, a standard method of waste disposal was the use of open-air burn pits. These pits were used to dispose of a variety of waste materials, including plastics, medical waste, and even ammunition. The combustion process released a cocktail of pollutants, many of which are known to have potential health risks.
The long-term health effects of exposure to burn pit emissions are still under study, but there is mounting evidence that they can contribute to a variety of respiratory diseases, cancers, and autoimmune disorders.
Other Military-related Toxins
In addition to the examples above, military personnel have been exposed to a range of other potentially harmful substances throughout history. These include asbestos used in military vehicles and buildings, lead and other heavy metals, and depleted uranium used in armor-piercing ammunition.
Exposure to certain toxins can contribute to the development of autoimmune diseases by causing changes in the immune system. Toxins can trigger inflammation, damage DNA, alter the gut microbiome, and cause epigenetic changes—all of which can lead to a misdirected immune response.
In the context of military toxins, studies have shown that veterans exposed to Agent Orange, Gulf War toxins, and burn pit emissions have an increased risk of autoimmune diseases. The exact mechanisms are still under study, but it is clear that these toxins can have profound and lasting effects on the immune system.
Specific Autoimmune Diseases Linked to Military Toxins
Studies have suggested links between exposure to military toxins and several specific autoimmune diseases. For instance, there is strong evidence associating Agent Orange exposure with an increased risk of developing diabetes mellitus type 2. Similarly, Gulf War veterans have been found to have higher rates of systemic lupus erythematosus and rheumatoid arthritis.
Research on veterans of the Iraq and Afghanistan wars exposed to burn pit emissions also shows a worrying increase in autoimmune disorders, including rheumatoid arthritis and lupus.
The exact causative relationships and underlying mechanisms between these toxins and specific autoimmune diseases are areas of active research. By understanding these links better, we can develop more effective strategies to prevent and treat these conditions in our veterans and active service members.
Bearing the invisible scars of their service, many veterans are left to deal with the impact of exposure to military toxins long after their active duty ends. From rheumatoid arthritis to systemic lupus erythematosus, these autoimmune diseases pose ongoing health challenges. However, with the appropriate treatment, support from advocacy groups, and the promise of ongoing research, there is hope for improved outcomes and quality of life.
Treatment Options for Autoimmune Diseases
Treatment of autoimmune diseases typically focuses on managing symptoms, reducing immune system overactivity, and maintaining the body’s ability to fight disease. This can involve a combination of medications, physical therapy, and lifestyle changes. Immunosuppressive drugs, pain management, physiotherapy, and even surgical intervention may be used depending on the specific disease and the individual’s condition.
Although there is currently no cure for most autoimmune diseases, ongoing research holds the promise of new and improved treatments. Advances in areas like immunotherapy and personalized medicine could lead to more effective and targeted treatment strategies.
The Department of Veteran Affairs (VA) provides disability compensation for service-connected Infectious Diseases and Immune Disorders, a policy also observed by the Department of Defense (DoD) if the conditions render a service member unfit for duty. For Reservists, eligibility hinges on the disease or disorder stemming from a Line of Duty injury. The VA’s Schedule for Rating Disabilities (VASRD) provides various rating options tailored to the main symptoms of each condition.
The VASRD offers ratings for the following autoimmune diseases, infectious diseases, and immune disorders:
Bacterial Infectious Diseases
Parasitic Infectious Diseases
Viral Infectious Diseases
When it comes to calculating disability ratings for multiple conditions, the VA adheres to the “Pyramiding Principle,” which allows only one rating for overlapping symptoms. However, if the conditions have distinctly separate symptoms, each can be rated individually. If the symptoms are inseparable, the VA will amalgamate them to form a single rating under the code that best captures the predominant disability. For a detailed list of how specific Infectious Diseases and Immune Disorders are rated, you can visit the VASRD’s official page here.
Advocacy and Legal Actions
Several advocacy groups work tirelessly to support veterans affected by military toxins. These organizations provide resources, help raise awareness, and lobby for policy changes to better recognize and address the health effects of military toxins. Notable examples include the Vietnam Veterans of America, the National Gulf War Resource Center, and Burn Pits 360.
In addition, there have been several critical legal actions related to military toxins and autoimmune diseases. For example, in 1991, the U.S. Congress passed the Agent Orange Act, acknowledging that certain diseases, including some autoimmune diseases, are presumptively connected to Agent Orange exposure.
The Importance of Continued Research and Support
While significant progress has been made, much remains to be done to fully understand the complex relationships between military toxins and autoimmune diseases. Continued research is essential to unravel these links and develop effective preventive strategies and treatments.
Equally important is the ongoing support for our veterans and active service members—those who bear the brunt of these health issues. It’s crucial that we continue to advocate for their health rights, provide them with the resources they need, and recognize their unique health challenges.
In closing, the true toll of military toxins is a burden borne not only on the battlefields abroad but also within the bodies of our service members. By shedding light on this critical issue, we aim to inspire more comprehensive research, improved medical treatments, and stronger advocacy for those affected.
Encyclopædia Britannica (2023, June 10). Agent orange.
Cleveland Clinic (2023, February 10). Agent orange effects & symptoms.
US Department of Veterans Affairs (2013, November 25). Military Exposures » Agent Orange » Facts About Herbicides.
US Department of Veterans Affairs (2013, December 17). Gulf War Veterans’ Medically Unexplained Illnesses.
de la Monte, S. M., & Goel, A. (2022). Agent Orange Reviewed: Potential Role in Peripheral Neuropathy and Neurodegeneration. Journal of military and veterans’ health, 30(2), 17–26.
Ebel AV, Lutt G, Poole JA, Thiele GM, et. Al. Association of Agricultural, Occupational, and Military Inhalants With Autoantibodies and Disease Features in US Veterans With Rheumatoid Arthritis. Arthritis Rheumatol. 2021 Mar;73(3):392-400.
Jones, K. A., Smith, B., Granado, N. S., Boyko, E. J., Gackstetter, G. D., Ryan, M. A., Phillips, C. J., Smith, T. C., & Millennium Cohort Study Team (2012). Newly reported lupus and rheumatoid arthritis in relation to deployment within proximity to a documented open-air burn pit in Iraq. Journal of occupational and environmental medicine, 54(6), 698–707.
Grady, E. P., Carpenter, M. T., Koenig, C. D., Older, S. A., & Battafarano, D. F. (1998). Rheumatic findings in Gulf War veterans. Archives of internal medicine, 158(4), 367–371.
James L., Johnson, R., Lewis, S., Carpenter, A., Engdahl, B., Krug, H.E., & Georgopoulos, A.P. (2021). Lupus Anticoagulant in Gulf War Illness and Autoimmune Disorders: A Common Pathway Toward Autoimmunity. Journal of Immunological Sciences.
Stout, M. (2018). The fight for justice for Vietnam veterans. The VVA Veteran, 38(2), 27–29.
Institute of Medicine (US) Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides. (1994). Veterans and Agent Orange: Health Effects of Herbicides Used in Vietnam. National Academies Press (US).
Henriksen, G. L., Ketchum, N. S., Michalek, J. E., & Swaby, J. A. (1997). Serum dioxin and diabetes mellitus in veterans of Operation Ranch Hand. Epidemiology (Cambridge, Mass.), 8(3), 252–258.
Michalek, J. E., Ketchum, N. S., & Akhtar, F. Z. (1998). Postservice mortality of US Air Force veterans occupationally exposed to herbicides in Vietnam: 15-year follow-up. American journal of epidemiology, 148(8), 786–792.
Uhl, M., & Ensign, T. (1980). GI guinea pigs: How the Pentagon exposed our troops to dangers more deadly than war: Agent orange and atomic radiation. Playboy Press.
Hickman, J. (2016). The burn pits: The poisoning of America’s soldiers. Skyhorse Publishing.