Radiation Exposure and Liver Flukes: Little-Known Veterans' Issues Get Attention in Congress

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Sign from the Plum Brook Reactor Facility warns of radiation. (
Sign from the Plum Brook Reactor Facility warns of radiation. (Photo: DVIDS)

When Robert Celestial arrived on Lowja Island in the Marshall Islands' Enewetak Atoll in 1977, he was given a shovel and gloves and told to get to work. Like his fellow troops, he waded into the muck at the bottom of an atomic bomb crater and began digging.

He was dressed in shorts.

"We were young soldiers. We didn't know what we were doing," Celestial told Military.com last year. "So many of my friends have passed away."

Since at least 2018, Celestial has worked for passage of the Mark Takai Atomic Veterans Healthcare Parity Act, a bill that would recognize hundreds of veterans who participated in decontamination and containment work in Enewetak from 1977 to 1980 as "atomic veterans."

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The designation would make these veterans eligible for Department of Veterans Affairs health care and benefits if they have or develop specific illnesses linked to radiation exposure.

The bill -- and several others that address ignored or little-known instances of exposure by U.S. service members to pollutants, chemicals or radiation -- may be closer than ever to becoming law this year, according to the chairmen of the Senate and House Veterans Affairs Committees.

Both committees are considering legislation that would grant presumptive status for illnesses found in veterans who participated in cleanup operations. Other bills would direct the VA or National Academies of Sciences to study the health of veterans exposed to toxins in locations overseen by the Defense Department -- places like Fort McClellan, Alabama; Palomares, Spain; and Vietnam.

"Every day, more and more veterans come forward publicly to speak out about their exposures during service, and we continue to hear about new toxins," House Veterans Affairs Committee chairman Rep. Mark Takano, D-Calif., said during a hearing Wednesday. "It is abundantly clear that we must act now."

"While each legislative victory is a step in the right direction, it is clear that our next step must be bold -- veterans deserve nothing less," Sen. Jon Tester, D-Mont., chairman of the Senate Veterans Affairs Committee, said last week. "We must provide health care and benefits to all veterans suffering from the effects of toxic exposure: past, present and future. It is a cost of war -- pure and simple."

The VA provides health care and benefits for U.S. veterans with illnesses or injuries considered related to military service.

This includes "atomic veterans" who developed cancer as a result of participating in above-ground nuclear tests from 1945 to 1962 or were near Hiroshima or Nagasaki, Japan, in the 1940s.

The Enewetak Atoll veterans have not received that designation, which complicates their process for receiving benefits if they develop any of the 21 cancers determined to be service-connected to radiation exposure.

The federal government maintains that the Enewetak veterans wore protective clothing and radiation monitoring devices and "encountered low levels of radiological contamination" because they were not allowed unrestricted access to heavily contaminated areas.

The Mark Takai Atomic Veterans Healthcare Parity Act would extend benefits to the veterans who took part in the cleanup, including places that remain contaminated today.

The cleanup crews of another U.S. radiological disaster -- one that began on Jan. 17, 1966, when an Air Force B-52 Stratofortress bomber carrying four hydrogen bombs collided with its KC-135 Stratotanker refueling tanker mid-flight -- are also seeking presumptive status.

In the accident, three bombs landed near the village of Palomares, Spain. Although none of their nukes exploded, conventional components in two of the bombs detonated, sending plutonium across a square mile.

More than 1,600 Air Force personnel responded to the cleanup, most of them without protective equipment. They were exposed to dangerous levels of plutonium in the soil, on crops, in the water they drank and the local food they consumed during the mission, according to the office of Democratic Sen. Richard Blumenthal of Connecticut.

The Palomares Veterans Act, sponsored by Blumenthal and Rep. Jahana Hayes, D-Conn., would grant presumptive status to veterans suffering from cancer as a result of their participation in the cleanup and would extend dependency and indemnity compensation to their survivors.

"Decades later, many of these airmen are suffering and dying from the health conditions that likely came from handling this radioactive dust. But the VA still does not count Palomares as a radiation risk event," said Hayes, making a case for her legislation during a hearing Wednesday.

Stateside, at Fort McClellan, Alabama, more than 600,000 service members are thought to have been exposed to toxic substances during training, exercise and research, from 1927 to 1999, when the installation was shuttered as the result of the Base Realignment and Closure process.

The National Academy of Medicine concluded in 2005 that McClellan, where the Army conducted chemical weapons training and dumped nearly 30,000 gallons of Agent Orange, was contaminated with volatile organic compounds, polychlorinated biphenyls, pesticides, radiation, explosives and heavy metals. The base is also located near a Monsanto plant that released chemicals into the local landfill and creeks.

The Fort McClellan Health Registry Act would require the VA to create a national listing for veterans of the post, to track and understand the scope of health conditions seen in them.

Van Dillard, who trained at the base in the early 1980s, calls it "the most toxic place in the U.S."

"I finally got a lawyer and got service-connected for some of the stuff I have going on," said Dillard, who suffers from colon cancer. "But not everything. It shouldn't be that hard."

"[Monsanto] paid $700 million to the residents of the town there," he added. "Not one soldier gets automatic compensation for being stationed there."

The VA recognizes that toxic chemicals were used at Fort McClellan and acknowledges that some veterans may have been exposed, but it doesn't recognize any health conditions as presumed related to exposure -- a designation that eases the benefits claims applications process.

Instead, like many health conditions that have not been proven connected to exposures during military service, the VA encourages veterans to file claims that are decided on a case-by-case basis.

"Amazingly, no comprehensive study has ever been conducted on our veterans who served at Fort McClellan. These veterans served and sacrificed for us, and they have paid a terrible price for it. We owe it to them to do better," bill sponsor Rep. Paul Tonko, D-N.Y., said Wednesday.

Legislation on one of the more obscure exposures seen in veterans takes on the liver fluke, a parasite found in freshwater fish in Southeast Asia, including Vietnam. When consumed, it can cause irritation and scarring and lead to the development of bile duct cancer.

Lawmakers want the VA to study the prevalence of cholangiocarcinoma, or bile duct cancer, in Vietnam veterans. That study would not just evaluate those who may have been exposed to liver flukes, but also those who contracted bile duct cancer in other ways, including through hepatitis infections.

Bill sponsor Rep. Lee Zeldin, R-N.Y., said a study at the Northport, New York, VA Medical Center in 2018 of 50 veterans "highlighted a greater need for examination of this issue."

"It's absolutely critical that we tackle this issue head on. The clock is ticking," Zeldin said.

Under the direction of VA Secretary Denis McDonough, the department launched a 180-day review in February of its programs and is developing a new model for determining presumptions based on environmental exposure, said Ronald Burke, deputy under secretary for policy and oversight in the Veterans Benefits Administration.

Burke told House lawmakers during the hearing that a new "holistic approach" will be taken to review disability claims filed for environmental exposures, with expanded training for health care providers; improved surveillance, research and epidemiology; increased use of benefits data; and encouraging veterans to file a claim.

"Our research indicates that an overly cumbersome process, and an assumption of denial, discourages veterans from filing toxic- and environmental exposure-related claims at the secretary's direction," Burke said. "We are undertaking efforts to encourage veterans who believe their symptoms are related to toxic exposure to participate in health registries; part of that effort will include encouraging veterans to get a compensation and pension exam, and to submit a claim to VA."

"Oftentimes, the absence of a presumption serves as a disincentive for an individual veteran to come forward with her claim, which obviously speaks to a trust issue we have on the claims process," McDonough told Military.com on March 26. "So the first thing I'd say is [if] people ... have a claim and they've not come forward with it, please come forward. … People do not need to come forward as a group. They should come forward with their individual claim."

Momentum is growing in Congress to pass several of these pieces of legislation, if not a comprehensive package that includes presumptive care for veterans with illnesses thought to be linked to burn pits used in the Middle East and elsewhere since 1990.

Lawmakers expressed confidence Wednesday that a sweeping veterans' environmental exposure bill would pass.

"We cannot continue to tackle this topic one disability at a time," Takano said. "[Today's hearing is] an opportunity to continue the conversation with VA and other interested stakeholders to ensure that we consider all views as we craft comprehensive legislation."

"Today's hearing made it painfully clear that the time to act for toxic-exposed veterans is now. Thousands of veterans are suffering. They need us to meet this moment with meaningful action to deliver the care and benefits they have earned before it is too late," said Illinois Rep. Mike Bost, the committee's highest-ranking Republican.

-- Patricia Kime can be reached at Patricia.Kime@Monster.com. Follow her on Twitter @patriciakime.

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