Mishraq Sulfur-Plant Fire (Iraq 2003)

What Mishraq sulfur fire is

• Sulfur dioxide (SO2) — a severe respiratory irritant.
• Hydrogen sulfide (H2S).
• Sulfuric acid mist formed in the atmosphere.
• Fine particulate sulfur fallout across northern Iraq.

Who was exposed

• U.S. service members in northern Iraq (Mosul, Tikrit, Kirkuk) during summer 2003.
• Air crews flying through the SO2 plume.
• Units conducting fire suppression and base-camp setup downwind of the fire.

Recognized conditions & VA framework

• Constrictive bronchiolitis — heavily documented in Mishraq-exposed veterans.
• Reactive airway disease / occupational asthma.
• Chronic sinusitis and rhinitis.
• All PACT Act § 1119 presumptive respiratory conditions.

Evidence to gather

• DD-214 placing the veteran in northern Iraq in 2003.
• Unit records and OPORDs showing assignment in the affected area.
• Pulmonary function testing — spirometry and methacholine challenge.
• If clinically appropriate, lung biopsy is the gold standard for confirming constrictive bronchiolitis.
• Nexus opinion from a pulmonologist citing Mishraq exposure.

Claim path

1. For listed PACT Act conditions, file under § 3.320 — no nexus required.
2. For constrictive bronchiolitis (a histologic diagnosis), the PACT Act presumption applies for qualifying veterans; consider biopsy if symptoms suggest small-airway disease but spirometry is near-normal.

Authoritative reference

VA Public Health publishes its own overview of this exposure. Use it as a citation in your claim narrative: https://www.publichealth.va.gov/exposures/mishraq-sulfur-fire/index.asp

Where these claims break down

• ×Relying on normal spirometry alone — constrictive bronchiolitis often shows normal FEV1/FVC ratios while still causing severe exercise intolerance.
• ×Not specifically naming the Mishraq fire on the claim form — this strengthens the airborne-hazards narrative.

Frequently Asked Questions