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Military Burn Pits and Cancer Risk
What is a burn pit?
A burn pit is an approach to waste disposal that has been used by the US military at
bases in the Middle East, mainly in Afghanistan and Iraq beginning in 2001. Burn pits
are large areas where tons of waste products (including trash, plastics, wood, metal,
paints, solvents, munitions, and medical and human waste) are burned in the open air.
Typically, JP-8 jet fuel, which contains benzene, has been used as an accelerant. Burn
pits create large volumes of toxic smoke and other substances. They give off more air
pollution than contained burning, because the burning takes place in an open area and
at lower temperatures.
Military personnel and contractors who have spent time near burn pits likely had high
levels of exposure to air pollution, especially those people assigned to tend the pits.
However, other people have been exposed as well, due to burn pit emissions being
carried to surrounding areas by the wind.
Toxic exposures linked with burn pits
Environmental sampling of the air and soil near burn pits has documented the presence
of several chemical compounds shown in studies to be linked with inflammation and
body tissue damage, particularly in the respiratory tract. Incomplete combustion of
organic and inorganic material in burn pits results in high volumes of toxic particulate
matter (PM) in the air that includes metals, benzene, polychlorinated dibenzo-p-dioxins
and dibenzo-p-furans (PCDD/Fs), polycyclic aromatic hydrocarbons (PAHs), volatile
organic compounds (VOCs), and other compounds.
There is extensive evidence in other situations that PM in air pollution is linked to heart
disease, asthma, chronic obstructive pulmonary disease (COPD), lung cancer, and an
overall increased risk of death.
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Although it’s almost impossible to prove that burn pits cause these same health issues,
this evidence suggests that the health issues reported by veterans with exposures from
burn pits and other chemicals linked to their deployment are reason for concern.
Personnel at these military bases have also been exposed to other air pollutants from a
combination of local and regional sources. This includes dust made up of industrial
emissions and waste, as well as aircraft and ground transportation emissions that mix
with soil and are spread by the wind.
Do exposures to burn pit emissions cause cancer?
Studying the health effects of exposure to burn pit emissions is difficult. Ideally, there
would be records that show who was exposed to the emissions, exactly what they were
exposed to, how much exposure they had, and how long they were exposed. But in
general, only indirect assessments of exposure are possible. Because of this, studies of
health problems possibly linked with exposures to burn pit emissions fall into 3 main
groups:
● Studies that use information about the types of pollutants found in burn pit smoke to
estimate whether such exposures might cause cancer (and how likely this is)
● Studies that measure the pollutants in the air, soil, and water around burn pits to
estimate exposure and cancer risk in military personnel
● Studies of the blood or body tissue of military personnel with burn pit exposure that
measure the presence of pollutants known to be linked with genetic alterations
These types of exposures have also been studied in relation to health outcomes in other
occupational groups, such as firefighters, and for comparison, in civilian groups without
these exposures. These kinds of studies are especially important, given that cancers
generally take many years to develop, and military burn pit exposures have taken place
relatively recently.
What do expert agencies say?
In general, the American Cancer Society does not determine if something causes
cancer (that is, if it is a carcinogen), but we do look to other respected
organizations for help with examining the evidence.
A 2011 report from the US National Academies of Sciences, Engineering, and
Medicine (NASEM) found that there was limited/suggestive evidence of a link between
exposure to combustion products and reduced lung function in the populations studied,
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but there was inadequate/insufficient evidence of a link at that time between combustion
products and cancer. But because some of the chemicals linked with burn pit emissions
can cause cancer, and the fact that it can take many years for cancer to develop after
an exposure, the authors of the report concluded that they couldn’t rule out that
veterans exposed to burn pit emissions are at higher risk for cancer, and they
suggested that further studies should be done.
Since then, NASEM has published other reports on burn pits and possible links to other
health outcomes.
Other expert organizations have not assessed the possible link between burn pit
emissions and cancer directly, but they have made determinations on some of the
chemicals in burn pit emissions:
● International Agency for Research on Cancer (IARC): IARC, which is part of the
World Health Organization, has classified some of the chemical substances found
in burn pit emissions as “known to be carcinogenic to humans.”
● US National Toxicology Program (NTP): The NTP has classified at least one
chemical found in burn pit emissions (dioxin) as “known to be a human
carcinogen.”
To learn more about how these organizations study and classify cancer causes, see
Determining if Something Is a Carcinogen1 and Known and Probable Human
Carcinogens2.
Can Afghanistan and Gulf War veterans be tested for exposure to
contaminants from burn pits?
At this time, there are no widely available, simple lab tests that can show if someone
was exposed to burn pit contaminants. Because of this, the US Department of Veterans
Affairs (VA) presumes that all veterans who served in certain places at certain times
might have been exposed, and therefore might be eligible for certain medical benefits
for service-related disabilities.
Benefits for exposed veterans
Military service is associated with a range of risks, especially in war zones. Although
some of these risks are unique to military occupations, others may be similar to risks in
civilian occupations, but with higher exposure amounts or longer-term exposures in
military settings.
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Measuring exposures, especially in a war zone, is extremely difficult and is therefore not
done. Pre-and post-deployment surveillance of exposures and health outcomes should
be less difficult but is also typically not done. Thus, when veterans become ill with a
condition that might be related to their service, they often face the challenge of proving
that their health problems are service-related in order to receive health and disability
benefits.
In the past, many Afghanistan and Gulf War veterans faced denial that their health
problems were associated with exposure to burn pit emissions, similar to the challenges
faced by veterans exposed to Agent Orange3 during the Vietnam War. Definitive
evidence of disease causation may not have existed – and may never exist – for these
exposures, but gaps and delays in the scientific evidence had left veterans without
access to treatment and benefits for long periods of time. This was of particular concern
because these associations are often plausible, even if they’re not proven.
In circumstances where there is plausible (but not sufficient) evidence linking military
service to health problems and disability, Congress and the VA can rely on the
presumption that these problems are linked to a person’s service.
At this time, Afghanistan and Gulf War veterans may qualify for presumptive disability
benefits (compensation and health care) if they served at certain times and have
developed certain health conditions that have led to at least a 10% disability. For more
details on the conditions covered and other eligibility requirements, visit the VA website
at https://www.va.gov/disability/eligibility/hazardous-materials-exposure/specific-
environmental-hazards/4.
In August of 2022, Congress passed the PACT Act, a new law that expanded VA
health care and benefits for veterans exposed to burn pits and other toxic
substances. This included an expansion of the types of cancers that are now
presumed to be service-connected disabilities. These cancers include:
● Brain cancer, including glioblastoma
● Gastrointestinal cancer of any type
● Head or neck cancer of any type
● Kidney cancer
● Lymphatic cancer of any type
● Lymphoma of any type
● Melanoma
● Pancreatic cancer
● Reproductive cancer of any type
● Respiratory (breathing-related) cancer of any type
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The VA will process disability compensation claims for these and other presumptive
conditions for veterans who served any amount of time in the Southwest Asia theater of
operations (including Iraq, Kuwait, Saudi Arabia, and several surrounding areas) from
August 2, 1990, to the present, or Afghanistan, Uzbekistan, Syria, Djibouti, Egypt,
Jordan, Lebanon, or Yemen from September 11, 2001, to the present.
Even if you’ve filed a compensation claim in the past that was denied, you can file a
supplemental claim for any condition now considered presumptive.
The Airborne Hazards and Open Burn Pit Registry
In 2014, the VA launched the Airborne Hazards and Open Burn Pit Registry (AHOBPR)
in response to concerns about respiratory illnesses linked with exposure to burn pits,
and the need to gather data on long-term health effects that may be linked with
exposure to burn pit emissions. This voluntary registry will help researchers study the
long-term effects of exposure to airborne hazards during deployments in Southwest
Asia. For more information, go to:
https://veteran.mobilehealth.va.gov/AHBurnPitRegistry/#page/home5, or
https://www.publichealth.va.gov/exposures/burnpits/registry.asp6, or
https://www.publichealth.va.gov/docs/exposures/ten-things-to-know-fact-sheet.pdf7
What veterans can do for their health
Be sure your doctor knows if you have a history of potentially hazardous exposures
during your military service. If there is a chance you might be at increased risk of
cancer, your doctor might advise you to get certain cancer screening tests8 and to
promptly report any suspicious symptoms.
Afghanistan and Gulf War veterans are at risk for many types of cancer just like
everyone else, even if they haven’t been exposed to contaminants during their
deployment. You can help lower your risk of cancer (and other diseases) by not
smoking9, staying at a healthy weight10, getting regular physical activity11, and eating a
healthy diet12 (including avoiding or limiting alcohol13).
If you are concerned about past exposure to burn pit emissions, you may want to join a
support group online or through your local VA hospital.
To learn more
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Along with the American Cancer Society, other sources of information and support
include:
Department of Veterans Affairs Toll-free numbers: Special Health Issues: 1-800-749-
8387 Benefits (including disability compensation): 1-800-827-1000 Exposure to burn
pits and other specific environmental hazards:
https://www.va.gov/disability/eligibility/hazardous-materials-exposure/specific-
environmental-hazards/14 The PACT Act and your VA benefits:
https://www.va.gov/resources/the-pact-act-and-your-va-benefits/15
Hyperlinks
1. www.cancer.org/healthy/cancer-causes/general-info/determining-if-something-is-a-
carcinogen.html
2. www.cancer.org/healthy/cancer-causes/general-info/known-and-probable-human-
carcinogens.html
3. www.cancer.org/healthy/cancer-causes/chemicals/agent-orange-and-cancer.html
4. www.va.gov/disability/eligibility/hazardous-materials-exposure/specific-
environmental-hazards/
5. veteran.mobilehealth.va.gov/AHBurnPitRegistry/#page/home
6. www.publichealth.va.gov/exposures/burnpits/registry.asp
7. www.publichealth.va.gov/docs/exposures/ten-things-to-know-fact-sheet.pdf
8. www.cancer.org/healthy/find-cancer-early/american-cancer-society-guidelines-for-
the-early-detection-of-cancer.html
9. www.cancer.org/healthy/stay-away-from-tobacco.html
10. www.cancer.org/healthy/eat-healthy-get-active/take-control-your-weight.html
11. www.cancer.org/healthy/eat-healthy-get-active/get-active.html
12. www.cancer.org/healthy/eat-healthy-get-active/eat-healthy.html
13. www.cancer.org/healthy/cancer-causes/diet-physical-activity/alcohol-use-and-
cancer.html
14. www.va.gov/disability/eligibility/hazardous-materials-exposure/specific-
environmental-hazards/
15. www.va.gov/resources/the-pact-act-and-your-va-benefits/
References
Brown MA. Science versus policy in establishing equitable Agent Orange disability
compensation policy. Mil Med. 2011;176: 35-40.
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Institute of Medicine. Long-Term Health Consequences of Exposure to Burn Pits in Iraq
and Afghanistan. 2011. Washington, DC: The National Academies Press.
https://doi.org/10.17226/13209.
Mallon CT, Rohrbeck MP, Haines MK, et al. Introduction to Department of Defense
research on burn pits, biomarkers, and health outcomes related to deployment in Iraq
and Afghanistan. J Occup Environ Med. 2016;58: S3-S11.
McLean J, Anderson D, Capra G, Riley CA. The potential effects of burn pit exposure
on the respiratory tract: A systematic review. Mil Med. 2021;186: 672-681.
National Academies of Sciences, Engineering, and Medicine. Respiratory health effects
of airborne hazards exposures in the Southwest Asia Theater of Military Operations.
Washington, DC: The National Academies Press, 2020.
Pugh MJ, Jaramillo CA, Leung KW, et al. Increasing prevalence of chronic lung disease
in veterans of the wars in Iraq and Afghanistan. Mil Med. 2016;181: 476-481.
Szema AM, Caruana DL, Sanfelici A, Promisloff R. Presumptive Benefits for War
Fighters Exposed to Burn Pits and Other Toxins Act of 2021: Cadit qaestio. J Occup
Environ Med. 2021;63: e250-e251.
US Department of Veterans Affairs. The PACT Act and your VA benefits. 2022.
Accessed at https://www.va.gov/resources/the-pact-act-and-your-va-benefits/ on August
25, 2022.
Last Revised: August 25, 2022
Written by
The American Cancer Society medical and editorial content team
(www.cancer.org/cancer/acs-medical-content-and-news-staff.html)
Our team is made up of doctors and oncology certified nurses with deep knowledge of
cancer care as well as journalists, editors, and translators with extensive experience in
medical writing.
American Cancer Society medical information is copyrighted material. For reprint
requests, please see our Content Usage Policy (www.cancer.org/about-
us/policies/content-usage.html).
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