unique circumstance challenges those who must determine a disability rating. While individual exposure levels cannot be accurately determined, DoD considers constrictive bronchiolitis (initially diagnosed as to be “bronchiolitis obliterans”) plausibly associated with exposure to the 2003 Mishraq State sulfur fire event. This health effect has been scientifically associated with high exposures to SO2 . Both sulfur dioxide and hydrogen sulfide are gases that can produce irritation and reddening of the nose and throat, eye irritation/pain, and coughing. At high levels, sulfur dioxide can burn the skin and can cause severe airway obstruction, hypoxemia, pulmonary edema, and even death. The firefighters involved with suppressing this fire experienced irritation, minor burns, and other effects such as blood-tinged nasal mucous. Some have been found to have long-term respiratory conditions such as “constrictive bronchiolitis.” Note: If the claim is for a respiratory condition possibly related to the sulfur fire exposure consider requesting tests for be conducted in addition to “bronchiolitis” other respiratory testing, while noting that many standard test results may be normal. This information is not meant to influence examiners rendering opinions concerning the etiology of any particular disability; but rather to ensure that such opinions are fully informed based on all known objective facts. Therefore, when rendering opinions requested by rating authorities for a disability potentially related to such exposure, please utilize this information objectively and together with the remaining evidence, including lay evidence, in the record. Veteran’s _____________________ Adjudication Authority 12. Exhibit 4: Fact Sheet Qarmat Ali Water Treatment Plant in Basrah, Iraq August 7, 2015 Change Date a. Fact Sheet: Fact Sheet for Claims of Exposure Based on the Qarmat Ali Water Treatment Qarmat Ali is shown below. Plant in Basrah, Iraq, Water Treatment Plant
unique circumstance challenges those who must determine a disability rating. While individual exposure levels cannot be accurately determined, DoD considers constrictive bronchiolitis (initially diagnosed as “bronchiolitis obliterans”) to be plausibly associated with exposure to the 2003 Mishraq State sulfur fire event. This health effect has been scientifically associated with high exposures to SO2 . Both sulfur dioxide and hydrogen sulfide are gases that can produce irritation and reddening of the nose and throat, eye irritation/pain, and coughing. At high levels, sulfur dioxide can burn the skin and can cause severe airway obstruction, hypoxemia, pulmonary edema, and even death. The firefighters involved with suppressing this fire experienced irritation, minor burns, and other effects such as blood-tinged nasal mucous. Some have been found to have long-term respiratory conditions such as “constrictive bronchiolitis.” Note: If the claim is for a respiratory condition possibly related to the sulfur fire exposure consider requesting tests for “bronchiolitis” be conducted in addition to other respiratory testing, while noting that many standard test results may be normal. This information is not meant to influence examiners rendering opinions concerning the etiology of any particular disability; but rather to ensure that such opinions are fully informed based on all known objective facts. Therefore, when rendering opinions requested by rating authorities for a disability potentially related to such exposure, please utilize this information objectively and together with the remaining evidence, including lay evidence, in the Veteran’s record. _____________________ Adjudication Authority 12. Exhibit 4: Fact Sheet Qarmat Ali Water Treatment Plant in Basrah, Iraq Change Date August 7, 2015 a. Fact Sheet: Qarmat Ali Water Treatment Plant Fact Sheet for Claims of Exposure Based on the Qarmat Ali Water Treatment Plant in Basrah, Iraq, is shown below.