In June 2015, when the the Department of Veterans Affairs’ (VA) Post-9/11 Era Environmental Health Program released its “Report on Data from the Airborne Hazards and Open Burn Pit (AH&OBP) Registry,” it signaled an important first step toward characterizing, to the greatest extent possible, the health risks posed by certain health hazards military personnel had encountered while deployed to the Middle East.
The reports of returning service members, along with several limited-scale investigations of their health and the environments they served in, increased the pressure on the federal government to learn more about these exposures, and to determine a course of action.
The AH&OBP Registry was mandated by a law signed by President Barack Obama in January 2013, after several years of anecdotal reports from service members and veterans suffering long-term health problems, including respiratory illnesses, recurrent headaches, and chronic fatigue. Many of these people had served near one of the hundreds of open-air pits used to dispose of waste – anything from Styrofoam to medical waste to entire vehicles – at installations in Iraq and Afghanistan. The military’s policy on these burn pits was updated in 2009 to prohibit the burning of toxic materials such as batteries, tires, and certain medical wastes.
The reports of returning service members, along with several limited-scale investigations of their health and the environments they served in, increased the pressure on the federal government to learn more about these exposures, and to determine a course of action. Both the Pentagon and the VA, however, voiced concerns about trying to extrapolate isolated findings to the experiences of more than 2 million post-9/11 veterans.
The VA requested that the Institute of Medicine (IOM) of the National Academy of Sciences study the problem and make recommendations for how to approach the issue of airborne environmental hazards in Iraq and Afghanistan. The IOM report was made public in 2011; it concluded, according to the VA, that there was “limited but suggestive evidence of an association between exposure to combustion products and reduced pulmonary function.” Nevertheless, the evidence gathered by IOM was insufficient to provide a clear association between these exposures and diseases such as cancer or respiratory, circulatory, or neurologic disorders.
After reviewing the IOM report, then-Secretary of Veterans Affairs Eric Shinseki directed the Veterans Health Administration to conduct a long-term prospective study on all adverse health effects that might be related to deployment in Iraq and Afghanistan, including health effects potentially related to exposure to airborne hazards and burn pits. The most recent step in these studies – the post-deployment data-gathering phase – has been the AH&OBP Registry, launched online last summer.
Post-Deployment Health: A Brief History
Health problems that may or may not be related to military deployment have been an issue for the military and veterans for more than a century, as service members have departed the familiar and relatively well-regulated environments of home to serve in the more fluid – and often chaotic – environments of war.
How does today’s post-9/11 program for gathering information and addressing veterans’ health concerns differ from those of the past? According to Dale Smith, professor of military medicine and history at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, it has to do with when, how, and what kind of information is gathered.