Military Service Toxic Exposure: Mental Health Risks

The men and women who serve in our military make a multitude of sacrifices. Even when not involved directly in combat, they are often exposed to many health risks and dangers that those in the civilian world rarely face. These risks are not only physical but also come in the form of exposure to toxic substances which have been found to affect mental health.

Although underreported, conditions such as anxiety, phobias, and PTSD can develop as a consequence of toxic exposure. To facilitate a greater understanding of this phenomenon, this article will explore the link between military service, toxic exposure, and the development of depression, anxiety, phobias, and PTSD and the mechanisms that increase the likelihood of experiencing such mental health conditions.

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[This is a guest post written by Claire Szewczyk, from Hill & Ponton disabilities attorneys for veterans.]

Toxic Chemicals Exposure During Military Service

While we often think of the greatest risk that active-duty military face is combat itself, exposure to toxic substances during military service has been linked to a range of lethal and debilitating, acute and long-term health problems, including cancer, respiratory illnesses, and neurological disorders.

The unfortunate reality is that the threat of toxic exposure is an everyday possibility for a significant number of servicemen and women.

Military Exposures

A variety of chemical agents have been used during warfare going back to ancient times when Greeks and Romans utilized smoke from burning toxic plants, such as poison ivy or oleander, to incapacitate enemies during battle. WW I saw the widespread use of chlorine and mustard gas with debilitating long-term effects in those who survived the attacks. 

• Nerve agents such as sarin or VX gas
• Riot control agents such as tear gas
• Herbicides such as Agent Orange used in the Vietnam war

It should be noted that veterans who were involved in combat encounters are likely at increased risk of being exposed to these harmful substances. However, those that did not perform in combat roles could be exposed via proximity to the war zone.

Occupational Hazards

Many military personnel utilize or encounter toxic substances in their daily operations. For example, there are a plethora of industrial jobs within the military that use substances that create contact and airborne hazards such as:

• Solvents
• Fuels
• Cleaning agents
• Paints
• Pesticides
• Herbicides

Some veterans may have even handled nuclear materials and been exposed to elevated levels of radiation.

Environmental Exposures

Even if veterans did not work with toxic substances in their roles, they may have been exposed simply due to environmental contamination. Many military bases and installations have a history of exposing their service members to toxic substances factors such as:

• Groundwater contamination
• Soil contamination
• Airborne pollutants

Chemicals off-gassed from waste disposal open burn pits such as those used in the Persian Gulf war

The risk of toxic exposure varies over time and many veterans will not begin to display complications stemming from toxic exposure until years after the event.

Promise to Address Comprehensive Toxics (PACT)

In 2022, President Biden signed the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act (PACT) into law. Sergeant Robinson died from lung cancer more than a decade after being exposed to burn pits while serving in the Iraq war. While there was reason to believe that his cancer was a result of that exposure, the VA did not.

This law establishes "presumptive conditions" and "presumptive locations" triggering toxic substance exposure benefits for veterans and military families. In other words, once it is established that a veteran has certain toxic-exposure-related health conditions or served at one of the locations known to have been the site of toxic substances or environmental hazards there is a straightforward path to benefits. For example, twenty-three medical conditions, including cancers, are now officially connected to open burn pit exposure and provide automatic VA benefits eligibility.

Recently, the VA has begun automatic toxic exposure screening for those enrolled in VA health care. Nearly 40% of those screened have reported toxic exposure.

Another point of context, The Wounded Warrior Project (WWP) Feb. 2022 report, stated that "Nearly all WWP warriors (98%) reported exposure to hazardous or toxic substances during military service, and more than 7 in 10 were exposed to burn pits."

US Military Base Toxic Substances

There are several US military bases where toxic exposure leading to serious health concerns for military personnel and their families has been documented. This is a partial list of military bases and sites with known toxic exposure issues.

Naval Air Station Whidbey Island (Washington, United States): Established during WW II, this naval air station has a history of military personnel exposure to arsenic, lead, pesticide, PCB, and other toxic compounds.

Camp Lejeune (North Carolina, United States): Camp Lejeune is perhaps one of the most well-known instances of water contamination in the US military. During the 1950s to around the 1980s, this marine base’s water supply was contaminated with many compounds that included known carcinogens.

Fort McClellan (Alabama, United States): This installation was used mainly as a training center for chemical, biological, radiological, and nuclear (CBRN) warfare from 1952 to 1999. Fort McClellan housed many toxic substances which made their way into the surrounding soil and water supply including nerve agents and herbicides.

Marine Corps Base Camp Pendleton (California, United States): Camp Pendleton was the site of groundwater contamination with various compounds and other chemicals.

Karshi-Khanabad Air Base (Uzbekistan): Also known as K2, Karshi-Khanad air force base was one of many installations utilized during the wars in Iraq and Afghanistan that used burn pits to dispose of waste, metals, and fuels. This caused those stationed here and at other bases that utilized burn pits to be exposed to various airborne pollutants.

Johnston Atoll (Pacific Ocean): Johnston Atoll was used during the 20th century for chemical weapons disposal and nuclear weapons testing. Many of those stationed here were exposed to chemical and radioactive contamination.

Kadena Air Base (Okinawa, Japan): Kadena Air Base utilized firefighting foams that contained compounds associated with many health concerns such as per- and poly-fluoroalkyl substances (PFAS). PFASs have been found to cause cancer and immune system disorders.

There are a multitude of other bases and sites where veterans may have come into contact with toxic substances. This list is not intended to be comprehensive.

Click here for an interactive map of US military toxic exposure sites.

Mental Health Complications of Toxic Exposure

While the physical ramifications of toxic exposure have gained significant awareness in recent years thanks to things like the PACT Act and the VA’s new emphasis on screening for it, the psychological aspect of toxic exposure still tends to be a bit underrepresented.

The Mental Health and Environmental Exposures report from the Learning and Developmental Disabilities Initiative, November 2008, details medical evidence of the mental health threats of toxic chemical exposure. It has been implicated in depression, anxiety, phobias, PTSD and other mental health disorders. There isn't much research on mental health effects of toxic exposure using military subjects, but a study of veterans of the Iran-Iraq conflict found that "sulfur mustard (SM) exposure can have effect on mental health even 25 years after exposure."

It is crucially important that more light be shed on the link between military toxic exposure and mental health.

Toxic Exposure as a Traumatic Event

We may not think of toxic exposure as a traumatic event akin to combat or various forms of abuse, but it can absolutely be a traumatic experience for veterans. Exposure to toxic substances can be an event that causes fear, helplessness, and horror that can directly contribute to, or even cause, conditions such as depression, substance use disorders, anxiety, phobias, or post-traumatic stress disorder (PTSD).

Neurological Interruption

Toxic substances, especially ones such as nerve agents, can cause neurological disorders and disrupt the delicate balance of neurological systems in the brain. These changes in neurological function can lead to the development of mental health issues such as anxiety disorders and PTSD.

Impairment of Cognitive Function

Many of the chemicals that veterans may be exposed to can potentially impair their cognitive abilities which can make it more difficult to manage stress, solve problems, and regulate emotions. This can create a vicious cycle of poor mental health as these complications can be mutually reinforcing.

Social Implications

Veterans who develop depression, anxiety, phobias, or PTSD can see their social relationships and ability to interact in social situations impacted. This can cause them to become more socially withdrawn which can further exacerbate mental health concerns.

Increased Sensitivity to Environmental Triggers

The way toxic exposure can impact neurological function and cognitive health can make those with PTSD more susceptible to triggers, or factors that bring back the experience of their traumatic event. This can increase their anxiety, amplify their flashbacks, and increase their risk of developing other mental health conditions.

Relationship Between Physical and Mental Health

If toxic exposure does cause physical health concerns, they may not only affect the body. Those with decreased physical health may come under psychological duress due to lamenting their physical health and compromised ability to live a normal life due to organ damage, respiratory issues, or other chronic illnesses. This can result in the development of mental health illnesses like depression, anxiety disorders, and PTSD or compound already existing ones.

Disability Compensation and Assistance

Now that you have a better understanding of the link between military service, toxic exposure, and the development of anxiety, phobias, and PTSD, you’ll likely want to know what can be done if you or a loved one are a victim of military toxic exposure.

Advocacy is a great first step. Since the interplay between toxic exposure and mental health is often overlooked, recognizing the mental health impact on toxic-exposed veterans can help us understand the need for increasing the awareness of others, preventative measures, and comprehensive support systems.

It’s also important to make sure that service members fully document their exposure, maintain contact with veterans' health administration, and engage in routine mental health evaluations to monitor their well-being. For those impacted by military toxic exposure, one of the best ways to start is by beginning the VA claims process.

Veterans are encouraged to consult with health care providers, VA representatives, and legal experts who can help them navigate the complexities of seeking benefits and accessing assistance.

Veterans Suicide Prevention

Mental health challenges can lead to suicidal thoughts and actions and the suicide rate among U.S. veterans is disturbingly high.

The suicide rate for veterans is higher than that for non-veterans. The difference between these two populations remains even when you take into account gender difference in suicide. The majority of veterans are male and males represent 80% of suicide deaths. When you segregate out gender and military service 2018 results show that:

• U.S. veteran women's suicide rate is nearly double the rate for non-veteran women

• the suicide rate among veteran men is 1.2 times higher than among non-veteran men (33.8 versus 29.0 per 100,000)

The 2022 Wounded Warrior Project survey reports that nearly 1 in 4 post-9/11 veterans in their program had suicidal thoughts in the past year.

The U.S. Department of Veterans Affairs 2018-2024 strategic plan identified veteran suicide prevention as its highest clinical priority.

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