In establishing related guidance on solid waste management in 1978, DOD has recognized that burning waste in open pits poses environmental and health hazards. However, burn pits—shallow excavations or surface features with berms used to conduct open-air burning—were often chosen as a method of waste disposal during recent contingency operations in the CENTCOM area of responsibility, which extends from the Middle East to Central Asia and includes Iraq and Afghanistan. In 2010 we reported that there were 251 active burns pits in Afghanistan and 22 in Iraq. Additionally, we reported that the military used burn pits to dispose of waste because of their expedience, and that waste management alternatives could decrease DOD’s reliance on the use of burn pits. We recommended that DOD implement relevant guidance related to burn pit operations, improve its adherence to relevant guidance on waste management, and analyze alternatives to its current practices. DOD generally concurred with the recommendations and took actions to address them. For example, the Army Materiel Command began focusing on solid waste management, including burn pits, and required contractors to segregate non-hazardous, hazardous, and recyclable materials; establish recycling systems; and maintain all solid waste operations in accordance with DOD guidance. According to DOD officials, while the Army considered alternative waste disposal methods such as deployable, ready-made incinerators as standard equipment to each Army unit, it ultimately decided against issuing them due to logistical issues. Further, the use of waste disposal alternatives other than burn pits is not always possible. For example, DOD officials have stated that there have been times when incinerators have not been used because of the challenges associated with obtaining permits and visas for the personnel who were contracted to operate and maintain them. In addition, DOD officials stated that using landfills as an alternative waste disposal option has not always been an option because of security concerns surrounding local landfills off base or space constraints for landfills on base. When alternatives are not available, military base commanders have resorted to the use of burn pits. Although burn pits help base commanders to manage waste, they also produce smoke and harmful emissions that military and other health professionals believe may result in acute and chronic health effects for those exposed. We previously reported that some veterans returning from the Iraq and Afghanistan conflicts have reported pulmonary and respiratory ailments, among other health concerns, that they attribute to burn pit emissions. Numerous veterans have also filed lawsuits against a DOD contractor alleging that the contractor mismanaged burn pit operations at several installations in both Iraq and Afghanistan, resulting in exposure to harmful smoke that caused these adverse health effects. We also previously reported on the difficulty of establishing a correlation between occupational and environmental exposures and health issues. For example, in 2012 we found that establishing causation between an exposure and an adverse health condition can be difficult for several reasons, including that for many environmental exposures, there is a latency period—the time period between initial exposure to a contaminant and the date on which an adverse health condition is diagnosed. When there is a long latency period between an environmental exposure and an adverse health condition, choosing between multiple causes of exposure may be difficult. In addition, in 2015 we found that the Army had recently published a study that evaluated associations between deployment to Iraq and Kuwait and the development of respiratory conditions post- deployment. However, the study was unable to identify a causal link between exposures to burn pits and respiratory conditions. Section 317 of the NDAA for Fiscal Year 2010 requires DOD to develop regulations prohibiting the disposal of covered waste in burn pits during contingency operations, except in circumstances where alternatives are not feasible. This provision also requires DOD to notify Congress of the decision to dispose of covered waste in burn pits, along with the circumstances, reasoning, and methodology leading to the decision. Additionally, for each subsequent 180-day period during which covered waste is disposed of in a burn pit, DOD must submit to Congress a justification for continuing to operate the burn pit. Further, even in the absence of a contingency operation and applicable guidance, DOD overseas environmental guidance exists prohibiting the use of burn pits, except in certain instances. In response to section 317, DOD issued department-wide guidance regarding the use of burn pits, environmental management, and occupational health. Specifically, in 2011 the Under Secretary of Defense for Acquisition, Technology and Logistics issued DOD Instruction 4715.19, which establishes policy, assigns responsibilities, and provides guidance regarding the use of burn pits during contingency operations. In 2016 DOD issued Instruction 4715.22, which establishes policy, assigns responsibilities, and provides direction for environmental management at contingency locations. Additionally, the guidance directs the Assistant Secretary of Defense for Energy, Installations, and Environment to establish Contingency Location Environmental Standards by February 2017. These standards are to define environmental standards for implementation at contingency locations in order to protect force health, minimize environmental impact, and sustain mission effectiveness. Two other DOD instructions, DOD Instruction 6055.05 and DOD Instruction 6055.01, provide guidance regarding risk management procedures associated with occupational or environmental factors. Specifically, DOD Instruction 6055.05 expands risk management procedures to anticipate, recognize, evaluate, and control health hazards associated with occupational and environmental exposures to chemical, physical, and biological hazards in DOD workplaces, including military operations and deployments. The guidance is aimed at protecting DOD personnel from accidental death, injury, and illness caused by hazardous occupational or environmental exposures. Further, it applies risk management strategies designed to achieve reductions in all mishaps, injuries, and illnesses, and compliance with DOD safety and health standards and policies. DOD Instruction 6055.01 provides guidance to protect DOD personnel from accidental death, injury, or occupational illness throughout all operations worldwide, with certain limitations. Specifically, this guidance reinforces the concept of applying risk management strategies to eliminate occupational injury or illness and loss of mission capability and resources, both on and off duty. Since 2008, CENTCOM has issued guidance relating to environmental assets within its area of responsibility. CENTCOM Regulation 200-1 requires bases within CENTCOM’s area of responsibility to have an environmental assessment program, structured to optimize environmental asset expertise, protection, enhancement, and security. This regulation requires CENTCOM environmental leads to develop policies and procedures for management and disposal of solid waste, hazardous waste, and medical waste, among others. CENTCOM Regulation 200-2 guides solid waste management practices throughout CENTCOM’s area of responsibility, including minimum requirements for operating and monitoring burn pits. This regulation also provides guidance for managing environmental concerns, such as hazardous materials and regulated medical and solid waste. It also includes requirements for base commanders to develop a solid waste management plan and strategy to transition to alternative waste disposal methods, such as an incinerator. On the basis of our assessment of DOD’s March 2016 burn pit report, we found that it generally addressed the requirements in section 313 of the NDAA for Fiscal Year 2015. According to DOD officials, to gather information for and develop its report, DOD tasked each of the military services, the Joint Staff, and the overseas combatant commands—U.S. Central Command, U.S. Africa Command, U.S. European Command, U.S. Pacific Command, and U.S. Southern Command—to provide information on the requirements in section 313, which included providing information on the policies and procedures related to the disposal of covered waste in burn pits during contingency operations. Section 313 contains seven specific reporting elements that DOD was required to address in its report. We determined, based on our assessment, that DOD’s report fully addressed four of the seven reporting requirements and partially addressed the remaining three. Table 1 summarizes our analysis of the extent to which DOD’s report addressed each of the specific requirements in section 313. Our assessment identified that reporting requirements 1, 3, and 5 are partially addressed in DOD’s report because we found that the responses to the reporting requirement lacked required detail and instead only identified relevant policy. For example, we assessed reporting requirement 3 to be partially addressed because DOD’s report included guidance used to distinguish categories of waste but did not include information about whether the categories were appropriately and clearly distinguished in environmental surveys and assessments. Similarly, we assessed reporting requirement 5 to be partially addressed because DOD reported on the notification process by which burning covered waste in a burn pit is requested and approved, and the process by which Congress is notified, but did not discuss how this notification process could be improved, if applicable. The DOD official responsible for compiling the report stated that because section 313 of the National Defense Authorization Act of Fiscal Year 2015 applies to the Office of the Secretary of Defense, which focuses primarily on strategic and policy-related issues, the requests for specific information contained in reporting requirements 1, 3 and 5 were outside its purview, and information with this degree of specificity could be provided only by lower-level commands. The Office of the Secretary of Defense tasked lower-level commands, including each of the military services, the Joint Staff, and the combatant commands, to provide information for the report. However, the tasking order sent to these lower- level commands contained the same wording as the mandate language in section 313 of the National Defense Authorization Act of Fiscal Year 2015, with little clarification of the level of detail that these entities should include in their responses. As a result, the level of information obtained and used to develop the report varied and partially addressed three of the seven requirements. While DOD issued guidance on burn pit use, as required by law, it is not clear how the guidance will be implemented in future contingency operations because the overseas combatant commands, except for CENTCOM, have not issued related policies and procedures for implementing this guidance. As previously stated, in response to section 317 of the National Defense Authorization Act of Fiscal Year 2010, in 2011 DOD issued DOD Instruction 4715.19.