This story, part of a series of reporting projects by Military.com on service member and veteran health, was supported by the Pulitzer Center. You can read our first story on missileer cancer concerns here.
It's the radiation that most people think about. Shut in 60 feet underground not far from the massive nuclear weapons, missileers keep careful watch of the projectiles designed to bring about Armageddon, doing small repairs and staying alert for long, sunless hours of duty.
But when more significant maintenance needs to be done, when something bigger breaks, support personnel such as Kimberly Cross are brought in at a moment's notice and for hours at a time to keep the missiles working. For those maintainers, it's the long list of hazardous substances and chemicals, sometimes oozing from equipment, that is the real risk.
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Cross would arrive for a job in an olive green T-shirt and battle dress uniform pants. She'd pull on her safety gear -- the same well-worn pair of oversized rubber gloves seemingly meant to fit the burly frame of a man, not her delicate and slim arms. That gear wouldn't do much when it came to radiation, but the maintainers knew other toxins lurked in the mass of electronic and hydraulic systems that would let the missiles fly.
On one service call at Grand Forks Air Force Base in North Dakota, Cross -- then a sergeant -- reached into a missile compartment to change a filter responsible for cooling the computer of a guidance and control system for a Minuteman III. A noncommissioned officer from quality control was breathing down her neck, though this was a task she'd aced many times before.
But something went wrong during the routine maintenance on that day in the late 1980s.
A viscous and toxic liquid, the consistency and neon yellow-green tint of Mountain Dew soda, began leaking and started to slowly run into her gloves and seep through her shirt.
It was sodium chromate, a well-known carcinogen that, according to the National Institutes of Health, can harm the respiratory tract, stomach, liver, kidneys and immune system.
Cross, who served as a maintenance technician from 1982 to 1990 and is now 67 years old, recalled to Military.com that the noncommissioned officer supervising told her that it wasn't worth doing the required paperwork to document the incident and take her to the emergency room. It would have required a helicopter to come to the remote missile site to ferry her to the closest hospital, and she was intimidated by the supervisor.
So, she washed up, changed her clothes and went back to work.
The expectation that maintainers would simply accept being doused in known, deadly chemicals and continue to carry out their duty was rampant. The lack of adequate protective gear was the norm.
"I was exposed to so much stuff," Cross said. "It's insane, but we were young and stupid. So, we didn't pay attention."
A dozen current and former enlisted men and women who spoke with Military.com described an overworked profession in which superiors were less concerned with the chemicals and toxic dangers in the launch facilities and more with getting the high-stress job done quickly. They spoke about ill-fitting, repeatedly reused and degraded, or seemingly inadequate personal protective equipment that put them at risk given the toxins they encountered. Many believe their jobs repairing intercontinental ballistic missiles contributed to prolonged illnesses and cancer diagnoses.
Military.com previously reported on the toxic exposure and cancer concerns of America's missileers, the officers who work in launch control and missile alert facilities responsible for firing the nation's intercontinental ballistic missiles in times of crisis. In these dated facilities, service members have come in contact with carcinogens such as polychlorinated biphenyls, or PCBs; lead paint; asbestos; and tainted water.
More than a decade ago, the Air Force overlooked past warning signs and research indicating potential cancer clusters that could have been connected to those workplace exposures.
But unlike missileers, who may not know whether they were directly in contact with those toxic substances, the enlisted airmen who maintained the missile systems know they've seen, smelled, touched and breathed in concerning chemicals. Many of the maintainers, who spoke to Military.com following the publication of the first story focusing on missileers, pointed out that they felt overlooked when it came to the historic issue of exposure on the job.
One former missileer, in hopes of securing Department of Veterans Affairs benefits, shared a list with Military.com he made containing 107 items alphabetized from acetone to zirconium showing the possible substances; where maintainers and missileers could have encountered them; and what their adverse health effects are.
The substance that saturated Cross' clothes, sodium chromate, is widely used in the cooling systems of America's Minuteman III missile systems, roughly 400 of them. In 2017, about four decades after the incident, Cross' doctor confirmed she had breast cancer, a diagnosis she believes can be attributed to her exposure not just to sodium chromate but a variety of well-documented toxic dangers and chemicals found in the silos she worked in and near.
Charles Hoffman, an Air Force Global Strike Command spokesman, said current maintainers are rigorously instructed on what toxins and chemicals they come in contact with in their jobs.
"Maintainers and missileers have been informed of the carcinogens and toxins through safety briefings and summaries. Initial work-center safety training is also mandatory, and each training session is required to be tailored to the specific hazards that each tech airman may encounter," Hoffman said. "There are a wide variety of resources available, and members are encouraged to reach out to their medical providers or community to receive the care or support needed if they feel they need care."
But former and current missile maintainers believe the culture and high tempo of keeping the missiles on alert forces many of them to take risks, even though they're aware of them.
Johnny Cole Murdock, a 30-year-old former missile maintainer who served at Minot Air Force Base, North Dakota, in 2018, was among the maintainers who pointed to inadequate protective gear, known as personal protective equipment, or PPE, as a key risk.
"The gloves and stuff that people are using have been there for a very long time, and I personally think it should be a one-use sort of thing," Murdock said.
Murdock remembered opening hard-shelled Pelican cases containing the gloves and face shield that needed to be worn when handling toxic chemicals. They often were dirty.
"The kits get used a lot, like multiple times, but you don't know how well and diligent they were about cleaning them," he said. "If they could have spilled something into the gloves, you don't really know because you weren't there."
Military officials say that, while there are hazards for service members working on and around missiles, they are risks that are well known, and appropriate precautions are in place.
"There's a lot of hazards out there for missile maintainers, but we've known about those hazards for years," Col. John Schantz, the commander of the 90th Maintenance Group at F.E. Warren Air Force Base, Wyoming, told Military.com in an interview.
Very careful guidelines are set to try to limit exposure to radiation for service members, frequently represented by the phrase "as low as reasonably achievable," or ALARA, which encourages workers to limit their exposure to those radioactive materials by being around them only when absolutely necessary and in controlled doses.
But maintainers say that no such firm guidance exists for the numerous other hazardous toxins that inundate missile sites.
"When you're out there, you're only concerned about the mission and putting the missiles back on alert," Murdock said.
Last year, Air Force Global Strike Command authorized a wide-ranging probe examining all three of the nation's intercontinental ballistic missile bases, as well as all jobs related to the mission, to determine their cancer risk. It came on the heels of a PowerPoint presentation raising cancer concerns published last year by a former missileer and a current Space Force officer.
That study is looking at all generations of those who have worked in the missile community, from Cross' generation down to those who served recently, such as Murdock. While early results indicate some higher rates of cancer, officials say more data is needed.
Independent groups such as the Torchlight Initiative have been collecting data, documents and personal stories from service members who have worked with America's nuclear missiles, too. Their work shows a troubling pattern of illness.
Torchlight's self-reported cancer registry included 601 people as of late May.
Of the 601 registrants listed, 121 of them identified as missile maintainers diagnosed with cancer. Among those diagnoses include 42 with prostate cancer; 16 with non-Hodgkin lymphoma; nine with bladder cancer; nine with colon or rectal cancer; nine with renal or kidney cancers; six with leukemia; six with thyroid cancer; two with breast cancer; and the rest with other various or even multiple illnesses.
"You're not thinking about, 'If I'm down here for a long amount of time, is it going to possibly give me cancer or like some sort of thyroid issues?'" Murdock said. "I knew the job sucked, but I was trying to be positive about it because, at the end of the day, I love America."
A Generational Problem
The ongoing official Air Force cancer study for the missile community has forced many enlisted maintainers to look back on their time in the service and reconsider the casualness and carelessness they and their superiors had toward unsafe conditions.
"Going into the hole and working down below ground when you crawl down the ladder, the first thing is you can smell it. I mean you can smell the lead paint," said Joe Whitesocks, a 22-year missile maintainer who served between 1973 and 1995. "You can smell the musty smell in the launch tube. I don't know how many times that the PCBs would be leaking, and our work order would say, 'Mop it up. Spray some water, wipe it off and put it back up on the truck.'"
Those orders reflected a broader relaxed approach to safety.
"When I was working in the missile business, there wasn't so much emphasis on warnings, cautions or notes: 'Make sure you do this," Whitesocks said. "'Make sure you wear this, make sure you wash your hands.' That wasn't really a big deal then."
The current Air Force Global Strike Command study is also looking at older Titan II and Minuteman II bases, the earlier variants of the ICBMs used as part of America's nuclear arsenal.
Most of them are scattered throughout the Midwest and western states ranging from Ellsworth Air Force Base, South Dakota; Davis-Monthan Air Force Base, Arizona; Whiteman Air Force Base, Missouri; McConnell Air Force Base, Kansas; Little Rock Air Force Base, Arkansas; and Grand Forks in North Dakota.
Most recently, in a memo to the missile community published in May, Air Force Global Strike Commander Gen. Thomas Bussiere said that older eras of enlisted service members and officers who worked with nuclear missiles were likely exposed to PCBs.
"While unable to sample decommissioned sites for the Peacekeeper and Titan weapon systems, a review of technical data showed that PCB-containing components were likely used in those alert and control facilities, given the construction time frame," Bussiere wrote.
That initial medical research highlighted Defense Department records from 2001 to the present, encompassing about 84,000 missile community members.
Those findings are the tip of the iceberg. Air Force Global Strike Command still needs data from Department of Veterans Affairs medical records, the DoD cancer registry or the VA cancer registry.
It "captures fewer than 25% of total cancer cases" that will likely be found by the study, the service said in a memo detailing the early findings.
Whitesocks is one of those cancer cases.
He was diagnosed with advanced prostate cancer and is finding it hard to stay optimistic that the Air Force will do its necessary research in time and that the VA will be able to get benefits and service-related connections to older generations of missile maintainers like him before they pass.
He compares it to the government's nightmare with Agent Orange -- a Vietnam War-era herbicide that was contaminated with dioxin during the production process -- that later was linked to leukemia, Hodgkin lymphoma and various types of cancers in service members. Only after decades of lobbying from veterans service organizations were many former service members able to get benefits, long after many of them were already severely sick or dead.
"It's just the same as all my friends that were in Vietnam, and all those maintenance guys and gals have been talking about it," Whitesocks said. "They're not going to do anything about this until a good percentage of us are gone."
The Air Force has acknowledged PCBs have been detected during testing since the start of its cancer study.
Last year, Malmstrom Air Force Base, Montana, and Minot in North Dakota both found levels of PCBs above the Environmental Protection Agency's threshold of 10 micrograms per 100 square centimeters. F.E. Warren in Wyoming also detected the carcinogen but below that threshold, the service said.
The launch facilities were not tested for PCBs, but Air Force officials, such as Schantz with the 90th Maintenance Group at F.E. Warren, told Military.com that maintainers have been the ones responsible for replacing and coming into contact with those old contaminated components within electrical systems and that they should have a working knowledge of how to handle them.
"Even before the missileer cancer studies started, we knew about the hazards of PCBs, and for many years, we've actually been swapping components out to get rid of PCBs in the missile field," Schantz told Military.com. "We know if there's a sticky, brown fluid coming out of a resistor, don't touch it. Don't put your sandwich on it, alright. Stay away from it, put the right gear on and handle it."
The maintainers who spoke to Military.com questioned whether they'd had access to the personal protective equipment that would have been adequate. Hoffman, the Air Force Global Strike Command spokesperson, told Military.com that the service's existing policies do not advise reusing single-use protective equipment and that maintainers are instructed about the fit of equipment regularly.
"PPE and equipment are provided in every size with some administering 'fit tests' to ensure that the proper wear and use is done [in accordance with] manufacturer recommendation," Hoffman said. "Cleanliness and serviceability for PPE is addressed in guidance and policies outlining how the units will maintain and store PPE."
The List Goes On
Meanwhile, the military failed for decades to properly account for PCBs at America's bases.
The Toxic Substances Act of 1976 banned many carcinogens such as asbestos and PCBs, materials used for the construction of missile systems and facilities. A 1994 Government Accountability Office report pointed out that, nearly two decades later, the military services, including the Air Force, weren't following the Environmental Protection Agency's guidelines nor were they doing enough to mitigate the carcinogens.
In 2001, after receiving word that three service members at Malmstrom had been diagnosed with lymphoma, the Air Force started an environmental study that revealed dangers to airmen ranging from diesel fuel, PCBs, contaminants from burnt paper tapes, biological risks from standing water and sewage backup, pesticides, herbicides, chlorophenols and carbon dioxide.
Tony Klingensmith served as a missile technician for 22 years from 1977 to 1999 and knows he's been in contact with PCBs. But he believes PCBs are just a small piece of the potential problem, given the number of toxic substances in the missile facilities.
"They're checking all the sites for particular PCBs," Klingensmith said. "Well, that may not be the cause of this; it could be something else. But they're checking sites now for evidence of like a smoking gun when it can be a list of a lot of things."
According to a 2007 environmental assessment report related to the deactivation of some missile sites at Malmstrom, "Hazardous materials utilized at [launch facilities] and [missile alert facilities] include petroleum, oils, and lubricants (POL); fuels, batteries, and ethylene glycol that are used for the diesel generators; sodium chromate that is utilized in facility chiller units; and refrigerant that is utilized in facility HVAC systems."
Klingensmith and other maintainers believe recent attention has gone to missileers, but that the risk of exposure is likely even greater for maintainers.
"To be fair, they [missileers] spent more time underground, but they also were not actually handling any of the materials," he said.
Klingensmith was diagnosed with advanced prostate cancer in 2019, despite having no family history or other warning signs of the cancer. It was one of the illnesses that missile community members may have a higher likelihood of contracting, the Department of the Air Force's early health results released in March indicated. When he was applying for VA benefits, Klingensmith suspected it was tied to his service and said he had the receipts to prove it.
To show that he believed he was exposed to toxic dangers on the job, he made the list containing 107 alphabetized items.
He listed materials such as the cadmium-plated hardware in the launch facilities and missile alert facilities, which is highly toxic and tied to lung, prostate, kidney, pancreatic, breast and urinary bladder cancers, according to the National Institutes of Health.
One of the items he detailed was sulfuric acid, which was used in launch facility emergency batteries and can cause breathing troubles if inhaled -- and possibly blindness.
Thorium, a radioactive material that was once present in old ceramic household items and is listed as a cancer-causing substance by the National Institutes of Health, was present in a magnesium alloy ring used in joint assembly.
Klingensmith said three others in his small circle of missile maintenance friends were diagnosed with advanced prostate cancer as well.
Current Air Force leaders such as Schantz say missile maintainers should know they're taking on an inherently dangerous job.
"For us, it's just making sure people are aware of the hazards, whether it's those PCB hazards, it's the other chemicals we deal with, all the way to the radiation hazards of working around nuclear weapons, and wearing the right PPE and taking all the right actions to make sure they keep themselves safe while they're doing a dangerous job," Schantz said.
Airmen were told in March about a wave of policy changes coming from Air Force Global Strike Command, including updates to the maintainer and missileer manuals and technical orders highlighting how to deal with toxic substances, as well as how bases clean for carcinogens.
Hoffman, the command spokesman, said that the service has recently completed those updates and changes to technical orders and civil engineer manuals.
Those "changes in policy and guidance have included warning statements, safety summaries, and briefings that are required to be reviewed before beginning any activities in the areas where the hazards are located," Hoffman said. "PPE requirements and redundant warning signs, labels and stickers have also been placed throughout the facilities where these hazards exist."
Past maintainers such as Murdock wish the military had made those changes when they were in the service.
Murdock left his job as a missile maintainer in the frigid plains of Minot in North Dakota in 2018 and moved back to his home state of Texas, eager for warmth and a new life.
A lifelong musician, he started pursuing a country music career when he returned to the Lone Star State. He began playing live shows and producing his own music to be released on the radio.
But in 2021, he started losing his voice. Singing, let alone speaking, became incredibly painful. After several visits to the doctor, he was diagnosed with hypothyroidism -- a condition most often seen in elderly women, not in a 30-year-old man in good health.
"One of the biggest things I've always wanted to do is just play music for a living, and then it's finally got to the point where I'm doing it and I'm starting to make progress," Murdock told Military.com. "But then it kind of gets smacked down because you can't be a singer if you can't sing, if having a normal conversation with people fatigues your voice to the point that it hurts."
Shortly after his diagnosis, he thought back to the foam floor at the bottom of the nuclear missile silo, which was like a massive sponge that released odors of fuel and chemicals. He thought about when he had to drill into the wall of the launch facility silo, knowing asbestos residue would fly out. He thought back to the dried sodium chromate crystallized on missile support systems that he'd breath in.
He's still proud of his service, even if it may cost him his post-service dreams. He's using his voice, though a bit battered from his illness, to help push for protections that might help other maintainers have a better chance at living their dreams and staying healthy.
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