Guest Commentary

To stimulate discussion and debate, Coastal Review welcomes differing viewpoints on topical coastal issues. 

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Toxic exposure is a common occurrence in the military, affecting thousands of veterans, many years after service. Thus, providing compensation and free healthcare is a federal obligation to those who have served their country. Nevertheless, up to 2022, only a few diseases were presumed to be connected with military operations.

For most veterans, receiving compensation meant undergoing an extensive bureaucratic process to demonstrate exposure and prove causality in the development of their condition. With the implementation of the PACT Act, the Department of Veterans Affairs (VA) recognized more than 20 diseases as presumably caused by toxic exposure during service. However, while this list is constantly expanding, the list of toxic agents for which a presumption of causality exists under the PACT Act remained the same. This leads to paradoxical situations, where some veterans receive compensation while others still need to prove causality, albeit these people suffer from the same conditions.

VOCs’ toxicity and military exposure

Volatile Organic Compounds, or VOCs, are among the toxic agents that are only partially recognized by the PACT Act. These chemicals are common in industrial solvents, degreasers, and cleaners, as well as jet fuel, adhesives, and certain paints and coatings. Given their properties, VOCs such as trichloroethylene (TCE) and perchloroethylene (PCE) were extensively used by the U.S. military for decades in equipment maintenance, aircraft cleaning, and parts degreasing.

Although very efficient in these operations, VOCs quickly turn from liquids or solids into vapor, leading to a high probability of being inhaled by personnel operating with these substances. TCE and PCE are classified as chlorinated solvents, widely used in degreasing and cleaning metal parts. These substances present significant risks not only for military staff using them, but also for their families and local communities due to improper storage and leakage in and around military sites.

There is a strong body of literature built from epidemiological studies and research on human and animal models demonstrating that TCE has carcinogenic effects in various tissues, including kidneys, lungs, liver, testicles, and stomach. These effects are observed either as a result of ingestion or inhalation. Noncarcinogenic effects have also been reported for TCE, with serious effects in neural and cardiac tissue. Similar effects are observed in PCE exposure, indicating a strong potential for carcinogenic effects. Notably, PCE’s impact on neural tissue demonstrates stronger neurotoxicity, especially in children, where exposure is associated with reduced cognitive capacity.

To date, the Department of Defense (DoD) recognizes contamination with VOCs, for which compensation is provided, only in relation to contamination from Agent Orange, a pesticide used in Vietnam, burn pits, and Camp Lejeune. Although various other military bases are recognized to have VOCs pollution, affecting both veterans and their families, these areas are not considered part of presumptive toxic contact. Pressure from the public and extensive investigations carried out by the Environmental Protection Agency (EPA) forced the DoD to recognize Camp Lejeune as a site of exposure to dangerous VOCs, including TCE and PCE. Similar pressure may thus be necessary to have all sites recognized by expanding the PACT Act list of toxic agents impacting veterans for years on end.

Exposure in North Carolina veterans

More than 620.000 veterans live in North Carolina and many of them have been directly impacted by VOCs exposure while working for the military. Camp Lejeune is now a well-known documented site where veterans and their families suffered long-term health effects due to prolonged exposure to toxic chemicals in the water supply. At the time when contamination was documented here, increased media attention and pressure from the civic society led to the creation of a compensation fund for those affected. Today, exposure at Camp Lejeune is valid for automatic compensation under the PACT Act.

While support is offered for those affected at this site, many other locations in North Carolina are known to be contaminated. For example, the Military Ocean Terminal Sunny Point is currently under monitoring by the EPA, while PFAS levels here measured in 2024 exceed EPA’s new recommended limits of 4 parts per trillion in drinking water more than three times. Despite clear evidence of environmental risk, sites such as these remain excluded from presumptive coverage and lack VOCs monitoring and impact assessments. 

VA pressures, funding, procedural inconsistencies

Since 2022, the VA has processed over 1.7 million claims and granted more than 6.8 billion in compensation to veterans and their families. The costs of this program are therefore substantial. Any new agent introduced on the toxic list will likely increase these costs. Yet for any agent dismissed, thousands of veterans’ claims are denied, even following long battles to demonstrate causality. This is far from a just representation of how the VA’s mission aligns with supporting and protecting former military personnel.

Recognizing the full scope of toxic exposures, including compounds such as TCE and PCE, is essential to ensuring equitable access to benefits for all veterans and removing inconsistencies from this system. With the EPA’s recent ban on TCE and PCE, the continued lack of recognition by the DoD may become increasingly difficult to justify. As scientific evidence continues to demonstrate the health risks associated with VOCs, expanding the list of recognized agents would represent a necessary and evidence-based step toward improving the integrity and fairness of the veterans’ compensation system.

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Opinions expressed by the authors are not necessarily those of Coastal Review or our publisher, the North Carolina Coastal Federation.