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- Title
Deployment to Military Bases With Open Burn Pits and Respiratory and Cardiovascular Disease.
- Authors
Savitz, David A.; Woskie, Susan R.; Bello, Anila; Gaither, Rachel; Gasper, Joseph; Jiang, Lan; Rennix, Christopher; Wellenius, Gregory A.; Trivedi, Amal N.
- Abstract
Key Points: Question: Is duration of deployment to military bases with open burn pits associated with an increased risk of diagnosed respiratory and cardiovascular disease? Findings: In this cohort study of 459 381 military veterans receiving health care from the Veterans Health Administration, deployment to bases with burn pits was associated with modestly increased odds of asthma, chronic obstructive pulmonary disease, hypertension, and ischemic stroke. Meaning: These findings suggest that prolonged deployment to military bases with open burn pits may increase the risk of developing adverse health outcomes and provide a model for additional studies of the health impact of environmental exposures during military service. This cohort study assesses the association of deployment to military bases where open burn pits were used for waste disposal and the subsequent risk of developing respiratory and cardiovascular diseases among US veterans receiving care from the Veterans Health Administration. Importance: Many veterans who served in Afghanistan and Iraq during Operations Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) were deployed to military bases with open burn pits and exposed to their emissions, with limited understanding of the long-term health consequences. Objective: To determine the association between deployment to military bases where open burn pits were used for waste disposal and the subsequent risk of developing respiratory and cardiovascular diseases. Design, Setting, and Participants: This retrospective observational cohort study used Veterans Health Administration medical records and declassified deployment records from the Department of Defense to assess Army and Air Force veterans who were deployed between 2001 and 2011 and subsequently received health care from the Veterans Health Administration, with follow-up through December 2020. Data were analyzed from January 2023 through February 2024. Exposure: Duration of deployment to military bases with open burn pits. Main Outcomes and Measures: Diagnosis of asthma, chronic obstructive pulmonary disease, interstitial lung disease, hypertension, myocardial infarction, congestive heart failure, ischemic stroke, and hemorrhagic stroke. Results: The study population included 459 381 OEF and OIF veterans (mean [SD] age, 31.6 [8.7] years; 399 754 [87.0%] male). Median (IQR) follow-up from end of deployment was 10.9 (9.4-12.7) years. For every 100 days of deployment to bases with burn pits, veterans experienced increased adjusted odds for asthma (adjusted odds ratio [aOR], 1.01; 95% CI, 1.01-1.02), chronic obstructive pulmonary disease (aOR, 1.04; 95% CI, 1.02-1.07), hypertension (aOR, 1.02; 95% CI, 1.02-1.03), and ischemic stroke (aOR, 1.06; 95% CI, 0.97-1.14). Odds of interstitial lung disease, myocardial infarction, congestive heart failure, or hemorrhagic stroke were not increased. Results based on tertiles of duration of burn pit exposures were consistent with those from the continuous exposure measures. Conclusions and Relevance: In this cohort study, prolonged deployment to military bases with open burn pits was associated with increased risk of developing asthma, COPD, and hypertension. The results also point to a possible increased risk in ischemic stroke. The novel ability to use integrated data on deployment and health outcomes provides a model for additional studies of the health impact of environmental exposures during military service.
- Subjects
AFGHANISTAN; UNITED States; IRAQ; RESPIRATORY disease risk factors; WASTE management; RESEARCH funding; SCIENTIFIC observation; MULTIPLE regression analysis; CARDIOVASCULAR diseases risk factors; RETROSPECTIVE studies; UNITED States. Air Force; EVALUATION of medical care; DESCRIPTIVE statistics; PSYCHOLOGY of veterans; ARMED Forces in foreign countries; ODDS ratio; LONGITUDINAL method; OCCUPATIONAL exposure; UNITED States. Army; CONFIDENCE intervals; DATA analysis software
- Publication
JAMA Network Open, 2024, Vol 7, Issue 1, pe247629
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2024.7629