Shortly after the ground war ended in March 1991, a Marine Corps detachment from the 2d Marine Division (2d MARDIV) searched an abandoned cement factory outside Kuwait City because intelligence indicated it might be a chemical munitions filling area. The Marines searched the area and took soil samples that were sent to the US for laboratory analysis.^[2,3] Despite repeated attempts to obtain analysis results, the Marines did not learn of the laboratory’s findings.^[4] This incident was recounted in interviews, military reports, and testimony before the Presidential Advisory Committee on Gulf War Veterans' Illnesses.^[5] The June 1997 MITRE Corporation draft report, "Iraqi Chemical Warfare: Analysis of Information Available to DoD," and at least one other book also discusses this incident.^[6,7] We initiated this investigation in response to these statements and reports.

This case narrative final report draws on information from various Marine Corps and Department of Defense Desert Storm command chronologies, records, and logs. Additionally, 25 veterans offered first-hand accounts of the events related to the samples taken at the cement factory. We interviewed many witnesses and subject matter experts about such issues as chemical warfare agents, chemical warfare agent detectors, chemical warfare agent sampling, mine warfare, and cement production processes. Section VI contains some insights on lessons learned from this incident.

The I Marine Expeditionary Force (I MEF) probably tasked the 2d MARDIV to conduct a reconnaissance of the cement factory. However, since we have no written record of that tasking, its details are unclear.^[8] The commander of the unit sent to investigate recalls, "Kuwaiti resistance had known the location of the Iraqi chemical brigade headquarters and there was thought to be chemical munitions in that vicinity as well."^[9] No other sources are known to have identified the cement factory as a possible chemical weapon storage or production facility. On February 28, 1991, the United States Central Command (USCENTCOM) sent a message to the Marine Central Command (MARCENT) about 17 suspected chemical and biological weapons storage sites in the MARCENT area of responsibility (Figure 2). The message directed MARCENT to perform inspections of each of these sites.^[10] However, the cement factory was not one of these sites.^[11]

Figure 2. MARCENT suspected sites

The cement factory is located approximately 15 kilometers southwest of Kuwait International Airport. It lies roughly between the Kuwait International Airport and an area the Marines called the ice cube tray, because of this area’s grid-like road system.^[12] Two other sources pinpoint the factory’s location, each giving a location within 700 meters of the other.^[13] (A third source, a Materiel Courier Receipt, incorrectly puts its location more than 30 kilometers south of the first two.)^[14]

The official 2d MARDIV Command Chronology places the date as March 12, 1991.^[15] Additionally, the USCENTCOM Nuclear, Biological, Chemical (NBC) Desk Log records the results of the mission on "12 March at 1620."^[16] The Materiel Courier Receipts for the samples are also dated March 12, 1991.^[17] However, one source of information conflicts with the March 12, 1991 reconnaissance date. The Fox vehicle is equipped with a mobile mass spectrometer (MM-1) that generates tapes of its sample analysis. The MM-1 stamps these tapes with a time-date stamp that must be set manually. The Fox vehicle tapes believed to have recorded the results of the cement factory reconnaissance show the date of the reconnaissance was March 14, 1991.^[18] However, it is possible the time-date stamp on the MM-1 of that Fox vehicle was set incorrectly.^[19] Therefore , since March 12, 1991, is the most consistent, attributable date in these sources, we presume the mission took place on this date.

In response to the suspicions Kuwaiti resistance expressed about the cement factory, the 2d MARDIV NBC officer decided to send a group of Marines there to conduct a reconnaissance and look for evidence of chemical weapons.^[20] The 2d MARDIV NBC officer selected his second-in-command NBC officer (henceforth called the group leader) to lead the reconnaissance. The reconnaissance group also consisted of several NBC non-commissioned officers (NCOs), a small security force, explosive ordnance disposal (EOD) specialists to identify potential munitions hazards, and two Fox NBC reconnaissance vehicles (hereafter called Fox 1 and Fox 2). In addition, a Kuwaiti officer accompanied the group.^[21,22]

Figure 3. Fox vehicles of the 2d MARDIV^[23]

We briefly describe the Fox NBC reconnaissance vehicle (Figure 3) to aid in understanding events at the cement factory. The source of this information is the Fox Vehicle Information Paper posted on our GulfLINK website.^[24]

The Fox vehicle has a two-step detection process. First, it makes an initial quick scan to alert for any possible chemical warfare agent presence, even at the expense of generating potential false alarms. The Fox is specifically designed to provide such alerts to provide maximum warning to US forces. The second step is a more time-consuming spectrum analysis that more precisely identifies what—if any—chemical warfare agents may be present.

The Fox’s MM-1 mobile mass spectrometer performs these alert and confirmation processes. The MM-1 detects chemical warfare agents by analyzing samples it collects through a sampling probe. The sampling probe collects samples by sniffing the surrounding air or taking samples from a silicone wheel lifted from the ground to a sampling port at the end of the probe.

Inside the sampling port, the sample is heated until it vaporizes. The vaporized sample molecules separate from one another while traveling up the probe to the MM-1. Because many different chemical compounds may be in the vaporized sample, it is important to separate them so they can be identified. The MM-1 can operate at two different temperature settings, High and Low. When the probe operates in the High setting (180� C) the molecules in the sample travel fast and there is less separation. When the probe operates in the Low setting (120� C) the molecules in the sample travel slower and there is more separation. Normally, the MM-1 operates in the High temperature mode. This allows for faster but less complete analysis of a sample. When the MM-1 alerts for a particular chemical, the MM-1 operator can change to the Low temperature to allow for a more detailed analysis of the sample.

Once inside the MM-1, the sample is broken into smaller charged pieces called ions. All chemicals—including chemical warfare agents—consist of unique combinations of ions. The MM-1 can detect and identify the chemical agents already programmed into its library by analyzing the ions in a sample. While performing initial, quick scans, the MM-1 looks only for ion combinations of chemicals that intelligence indicates are most likely to be in the area of operation. If the MM-1 finds one of these, it sounds an alert. The MM-1 must then compare all the chemicals in its library to the sample (called a spectrum analysis) to identify more precisely the chemical in the sample.

Every time the MM-1 performs a function—including an alert or a spectrum analysis—it can be recorded on a strip of paper tape resembling a grocery receipt. The MM-1 can print the results of a spectrum analysis in two ways: (1) print data about the chemical substance it has likely detected and a list of all the ions it detected while analyzing the sample, or (2) omit the list of ions and just print the data on the possible chemical substance. The first method is more time-consuming, but useful if any subsequent analysis of the tape is necessary. The second method is faster, but does not allow for subsequent, detailed analysis.

On March 12, the 2d MARDIV reconnaissance group drove to the cement factory’s main buildings. Iraq’s military had mined the area around the cement factory,^[25] thereby restricting movement around the compound. In addition, the Coalition had used bombs, cluster bomb units, and artillery shells against the facility. Some of these had not exploded.^[26] This unexploded ordnance, identified by the EOD specialists, presented conventional, high-explosive hazards to the group.

The cement factory facility included several small buildings dispersed over an area of four square kilometers (Figure 4).^[27] Fox 1 conducted a reconnaissance around the buildings and did not detect any chemical warfare agents. The group leader established a command post at an assembly point and briefed the reconnaissance group before they performed their inspections.^[28] The group then donned the maximum level of chemical protective equipment, Mission Oriented Protective Posture (MOPP) 4,^[29] and thoroughly searched every building. The group checked anything suspicious with an M256A1 Chemical Agent Detection Kit, M8 and M9 Detector Paper, or a chemical agent monitor.

Figure 4. Cement factory schematic

One building contained documents, possible offensive map overlays, and chemical defense protective equipment. According to the group leader, the Kuwaiti officer interpreting the documents and map overlays indicated Iraq had used the facility as a chemical brigade headquarters. Using all available detectors, the team was unable to detect the presence of any chemical warfare agents in the buildings. ^[30,31] However, the group did identify land mines and several other items of concern, discussed in the next two subsections.

1. Land Mines. The Marines found land mines in land mine packing crates throughout the cement factory compound. The EOD specialist riding with a Fox vehicle said they were Italian-made Valmara-59 anti-personnel mines (Figure 5).^[32,33] However, this specialist only saw the mine packing crates, not the mines. He recalled seeing hundreds of these crates, each of which he estimated to contain 4-8 mines.^[34] The Valmara-59 contains 0.576 kilograms of high-energy conventional explosive.^[35] One EOD specialist recalls warning the Fox vehicle commander this might indicate there were land mines filled with chemical warfare agents in the area.^[36] However, a US government mine expert states the Valmara-59 is a conventional mine only, and cannot be used with a chemical warfare agent.^[37] The senior EOD officer on the scene noted the mines lacked explosive charges and therefore assumed they were used for training purposes.^[38] Tab E contains more information about chemical mines.

Figure 5. Valmara-59 mine

Figure 6. Sampling liquid at the cement factory^[39]

2. Other Suspicious Items. The group tested several other items at the cement factory for chemical warfare agent. Among these were munitions resembling five-gallon drums the Marines thought might contain some type of chemical warfare agent. The Marines identified these munitions as smoke pots, munitions that generate smoke as an obscurant during combat operations.^[40] The Marines found 55-gallon drums filled with unidentified liquids. The group leader thought these drums might contain chemicals that could be mixed to make chemical warfare agents.^[41] The Marines also found two or three large liquid containers on trailers. They described these containers as slightly larger than the 500-gallon water trailers the US military uses to transport water in the field. Figure 6 shows a smaller trailer at the cement factory. An NBC specialist thought they resembled one-ton bulk chemical containers.^[42] The group tested the contents of all of these containers using M8 or M9 Chemical Agent Detection Paper. The results indicated no chemical warfare agent presence.^[43]

When none of the suspicious items in and around the buildings tested positive for chemical warfare agents, the group leader decided the facility was not a chemical weapons filling station. As the group leader prepared to depart, Fox 1 alerted for possible chemical warfare agents.^[44]

3. Fox 1 Alert and Sampling. The site where Fox 1 alerted was approximately 150 meters from the buildings.^[45] The contaminated area appeared to be a large, oily wet spot on the ground.^[46] An NBC gunnery sergeant with Fox 1 (in MOPP 4 and not in the vehicle)^[47] went to the oily spot. He took at least two soil samples, one from the contaminated area, and one from uncontaminated soil in the same general area.^[48]

The Fox 1 MM-1 alerted to two substances, cyclosarin (a G-series nerve agent), and phosgene (a choking agent). In response to these alerts, the Fox 1 MM-1 performed three spectrum analyses to confirm whether any chemical warfare agents were present.^[49] None of the spectrum analyses showed any presence of chemical warfare agents, although one did indicate the presence of the chemical xylyl bromide (later determined to be xylene). Section IV discusses these analyses in detail.

As the Fox 1 vehicle conducted these tests, the group leader monitored its activity from the assembly point about one-quarter to one-half mile away. The Marines at the assembly point were in MOPP 2. No one at the assembly point reported symptoms indicating any type of chemical warfare agent exposure.^[50]

4. Fox 2 Alert and Sampling. In an attempt to verify the Fox 1 findings, the group leader ordered Fox 2 to test the spot. When Fox 2 arrived, the group leader assigned it a general search area. As Fox 2 searched using the sampling wheel, the MM-1 alerted to a chemical substance.^[51] One of the Fox 2 crewmen stated that the Fox received initial warnings that appeared to be chemical warfare agents, but they could not be sure the area was truly contaminated. After attempting to verify the reading, the Fox 2 crew took at least five soil samples of both suspect and uncontaminated soil.^[52]

We have not found the tapes generated by the Fox 2’s MM-1. Therefore, we cannot be certain what substances the MM-1 alerted for, or of the results of any subsequent spectrum analyses it may have performed. Consequently, the information in this report concerning Fox 2 detections is based solely on the recollections of its crew.

Neither the Fox 2 wheelman nor the MM-1 operator remembers the cause of the MM-1 alert, but the wheelman does not think it was a chemical warfare agent.^[53] Likewise, the master sergeant who was with Fox 2 recalls the MM-1 alerted to trace amounts of something he cannot recall and to "fat, oil, wax," but did not alert to chemical warfare agents.^[54] However, the Fox 2 commander remembers the MM-1 showed some kind of contamination in the area, so he ordered reducing the temperature in the probe to increase the accuracy of the readings. He also recalled the MM-1 then alerted for two chemical warfare agents: sarin (a G-series nerve agent) and lewisite (a blister agent).^[55] Section IV discusses the possible detection of these agents.

5. Disposition of the Fox MM-1 Tapes.Since the Fox vehicle was still a new, experimental piece of equipment, doctrine and procedures for its use had not been fully developed by the time of the Gulf War. Consequently, Fox crews were not required to maintain any of the MM-1 tapes. Many of the crews routinely destroyed or discarded these tapes. Fortunately, the Fox 1 MM-1 operator preserved the Fox 1 tapes for his own records, keeping them even after he left the Marine Corps. He gave us copies of these tapes for this investigation. Unfortunately, however, the Fox 2 tapes have not been found. Some 2d MARDIV NBC personnel said these tapes were kept in a file cabinet at 2d MARDIV headquarters in Camp Lejeune, North Carolina. However, no tapes from the Fox 2 vehicle were ever located. Thus, it remains unclear for what substances Fox 2 alerted.

6. Additional Chemical Warfare Agent Tests and Indicators. During the sampling, the Fox crew is protected from outside contamination by pressurizing and sealing the vehicle.^[56] The Marines outside the Fox, near the sampling, were in MOPP 4. However, the Marines at the assembly point were in MOPP 2—not wearing a protective mask. None of these Marines reported any physical signs of nerve agent exposure, such as dimmed vision or runny noses. The group leader said he and other Marines specifically looked for signs of a chemical warfare agent release—such as clusters of dead animals—but found none.^[57] In March 1991, he told an interviewer he recalled testing the samples one last time: "We tested the soil samples again with the CAM [Chemical Agent Monitor] and the 256 [M256A1 Kit], M-8, and M-9 paper. They came back negative [showing no presence of a chemical warfare agent]."^[58]

7. Mission Completion. After completing the reconnaissance, the group returned to the 2d MARDIV headquarters. We have found no records that indicate that the 2d MARDIV sent any unit to inspect this area after March 12^th reconnaissance. The group leader speculated Iraq’s military may have used the cement factory as a chemical mine filling station and the Iraq unit that occupied the area may have been a defensive chemical brigade headquarters.^[59] This was based on the presence of mines, the liquid storage containers, and the oily spots on the ground where the Fox vehicles alerted. The group leader reported this to the 2d MARDIV NBC officer and then to the I MEF NBC officer. Additionally, he reported the situation to the operations and intelligence staff officers of the 2d MARDIV. The I MEF NBC officer reported the inspection to USCENTCOM, where it was recorded as follows:

CWO3 [Name redacted] called. MARCENT has located a suspected chem land mine filling site at QT751349. The Fox got a positive for GB [sarin] and [illegible, but probably lewisite]. They found containers that look like air tanks and mine crates. EOD advised the mines can be filled with HE [high explosive] or Chem [chemical warfare agent]. The area has been roped off and secured. I advised them to call 513^th MIB [Military Intelligence Brigade] and get a sampling team into the area.^[60]

Memories differ among the reconnaissance group members about the exact details of the sampling.^[61] Thus, we are unsure who took the samples or how many soil or liquid samples were taken. However, it is clear from the Materiel Courier Receipt (DD Form 1911) the 2d MARDIV NBC personnel forwarded seven soil samples for further analysis.^[62] We are also uncertain about what chemical warfare agents the Marines suspected were present in the samples. Three separate documents reflect what the Marines thought might have been present in the samples.

1. The USCENTCOM NBC Desk Log for March 12, 1991, shows the samples possibly contained sarin and lewisite.^[63]
2. The Technical Escort Unit trip report dated March 16, 1991, reflects that the samples were suspected to contain lewisite and GA. GA is also known as tabun and, like sarin and cyclosarin, is a G-series nerve agent.^[64]
3. The group leader reported on March 20, 1991, that the samples were suspected to have contained lewisite and sarin.^[65]

These reports present an anomaly: none mention the two chemical warfare agents found on the Fox 1 tapes (cyclosarin and phosgene), nor the chemical xylyl bromide. Although it is possible these reports reflect only what was printed on the Fox 2 tape, we cannot find any explanation for why the chemical warfare agents cyclosarin and phosgene are excluded.

1. Transporting the Soil Samples. The Joint Captured Materiel Exploitation Center (JCMEC), subordinate to the US Army 513^th Military Intelligence Brigade, was responsible for assessing captured equipment and exploiting this knowledge by supplying tactical information useful to battlefield commanders. This mission included acquiring information about Iraq’s chemical weapons.^[66] On the evening of March 12, 1991, the JCMEC dispatched a team to the 2d MARDIV headquarters to pick up the cement factory samples.^[67] The senior NCO in charge of the 2d MARDIV Fox vehicles had custody of the soil samples.^[68] Each was packaged in individual snap-top canisters,^[69] similar to 35mm film containers.

The group leader, the 2d MARDIV NBC officer, the gunnery sergeant in charge of the Fox vehicles and several other Marines turned over custody of the samples to JCMEC at the 2d MARDIV headquarters. Several Marines involved in the exchange remembered photocopied Fox tapes also were included with the samples.^[70] However, the Materiel Courier Receipt does not record them.^[71]

According to the JCMEC commander, all samples collected during the Gulf War thought to be positive for chemical warfare agent were delivered to the United States for analysis.^[72] Soldiers from the Technical Escort Unit (TEU), a US Army unit based in Edgewood, were responsible for transporting all such suspected chemical or biological samples to the United States. Since the seven samples the 2d MARDIV gave to JCMEC were thought to be positive, a TEU team took them from the JCMEC facility in Dhahran, Saudi Arabia, to the Chemical Research, Development, and Engineering Center (CRDEC)^[73] in Edgewood, Maryland.^[74] The Materiel Courier Receipt indicates the JCMEC NCO turned over the samples to a TEU soldier at the JCMEC facility in Dhahran, Saudi Arabia on March 13, 1991. Before leaving Dhahran, the TEU soldiers tested the outside of the sample container with an M18A1 Chemical Agent Detector kit and detected no chemical warfare agents.^[75] The samples arrived at CRDEC on March 17, 1991.

2. CRDEC Processing. A team of CRDEC chemists analyzed each sample.^[76] None of the chemists remember receiving any Fox MM-1 tapes.^[77] By March 27, 1991, CRDEC completed its analysis and prepared a report of its findings. Section IV reports the details of these findings.

3. Disseminating the Findings. On March 27, 1991, the CRDEC scientists sent a classified message reporting the findings to JCMEC.^[78] According to the 2d MARDIV group leader, the JCMEC never passed these findings on to the 2d MARDIV.^[79] Several days after the cement factory reconnaissance (probably around March 16-18), the 2d MARDIV group leader called the JCMEC office and inquired about the samples. The group leader is unsure exactly to whom he talked but believes it was an Army major. This person at JCMEC told the group leader that he did not have a need to know about the test findings.^[80] The group leader believed he did have a need to know if the Fox vehicles and crews were correct in suspecting chemical warfare agents at the cement factory. He asked the 2d MARDIV intelligence officer or one his assistants to call JCMEC. The group leader recalls JCMEC told the intelligence officer the same thing, "You don’t have a need to know."^[81,82] The I MEF NBC officer also recalls he had a similar exchange with a USCENTCOM officer, who likewise told the I MEF NBC officer he did not have a need to know.^[83,84,85]

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