Military operations produce a great deal of trash in an environment where standard waste management practices may be subordinated to more pressing concerns. As a result, ground forces have long relied on incineration in open-air pits as a means of getting rid of refuse. Concerns over possible adverse effects of exposure to smoke from trash burning in the theater were first expressed in the wake of the 1990–1991 Gulf War and stimulated a series of studies that indicated that exposures to smoke from oil-well fires and from other combustion sources, including waste burning, were stressors for troops. In January 2013, Congress directed the Department of Veterans Affairs (VA) to establish and maintain a registry for service members who may have been exposed to toxic airborne chemicals and fumes generated by open burn pits.

Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry analyzes the initial months of data collected by the registry and offers recommendations on ways to improve the instrument and best use the information it collects. This report assesses the effectiveness of the VA's information gathering efforts and provides recommendations for addressing the future medical needs of the affected groups, and provides recommendations on collecting, maintaining, and monitoring information collected by the VA's Airborne Hazards and Open Burn Pit Registry.

Contents

• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• COMMITTEE ON THE ASSESSMENT OF THE DEPARTMENT OF VETERANS AFFAIRS AIRBORNE HAZARDS AND OPEN BURN PIT REGISTRY
• Reviewers
• Preface
• Acronyms and Abbreviations
• Summary
  • FRAMEWORK AND ORGANIZATION
  • THE COMMITTEE'S INFORMATION-GATHERING AND ANALYSIS EFFORTS
  • ENVIRONMENTAL HEALTH REGISTRIES AS AN INFORMATION-GATHERING INSTRUMENT
  • THE AIRBORNE HAZARDS AND OPEN BURN PIT REGISTRY
  • ANALYSIS METHODS AND DESCRIPTIVE STATISTICS FOR THE REGISTRY DATA
  • ANALYSIS METHODS AND INTERPRETATION OF REGISTRY EXPOSURE DATA
  • ANALYSIS METHODS AND INTERPRETATION OF REGISTRY HEALTH OUTCOMES DATA
  • OTHER FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS
  • CLOSING OBSERVATIONS
  • REFERENCES
• 1. Introduction
  • THE COMMITTEE'S CHARGE AND APPROACH TO ITS TASK
  • INFORMATION GATHERING
  • ORGANIZATION OF THE REPORT
  • REFERENCES
• 2. Use of Registries in Environmental Health Research
  • USE OF REGISTRIES IN HEALTH RESEARCH
  • VA AND DOD ENVIRONMENTAL HEALTH REGISTRIES
  • LIMITATIONS OF REGISTRY DATA
  • IDENTIFICATION OF AN APPROPRIATE COMPARISON GROUP
  • DRAWING INFERENCES FROM REGISTRY DATA
  • SYNOPSIS AND CONCLUSIONS
  • REFERENCES
• 3. The Airborne Hazards and Open Burn Pit Questionnaire and Registry
  • SCIENTIFIC BASIS AND CONGRESSIONAL DIRECTIVE
  • DEVELOPING THE REGISTRY
  • RECRUITMENT AND ENROLLMENT
  • COMMUNICATIONS AND OUTREACH
  • QUESTIONNAIRE QUALITY
  • LINKING OTHER DATA TO REGISTRY DATA
  • SYNOPSIS AND CONCLUSIONS
  • REFERENCES
• 4. Analysis Methods and Descriptive Statistics
  • DATA REQUESTED AND RECEIVED
  • DATA ON AH&OBP REGISTRY PARTICIPANTS
  • ANALYSIS METHODS
  • PARTICIPATION RATES
  • REPRESENTATIVENESS
  • OVERVIEW OF QUESTIONNAIRE RESULTS
  • SYNOPSIS AND CONCLUSIONS
  • REFERENCES
• 5. Analysis and Interpretation of Exposures Data
  • INTRODUCTION
  • EXPOSURE INFORMATION COLLECTED BY THE AH&OBP REGISTRY
  • THE COMMITTEE'S ANALYSIS OF AH&OBP EXPOSURE INFORMATION
  • EXPOSURE METRICS FOR MULTIVARIATE ANALYSES
  • SYNOPSIS AND CONCLUSIONS
  • REFERENCES
• 6. Analysis and Interpretation of Registry Health Outcome Data
  • HEALTH OUTCOMES COLLECTED BY THE QUESTIONNAIRE
  • HEALTH CONDITIONS USED IN ANALYSES
  • ANALYSES OF EXPOSURES AND HEALTH OUTCOMES
  • OVERALL INTERPRETATION OF REGISTRY DATA ANALYSIS
  • SYNOPSIS AND CONCLUSIONS
  • REFERENCES
• 7. Findings, Conclusions, and Recommendations
  • OPENING OBSERVATIONS
  • THE AIRBORNE HAZARDS AND OPEN BURN PIT REGISTRY QUESTIONNAIRE
  • ANALYSIS METHODS AND DESCRIPTIVE STATISTICS FOR THE REGISTRY DATA
  • ANALYSIS METHODS AND INTERPRETATION OF REGISTRY EXPOSURE DATA
  • ANALYSIS METHODS AND INTERPRETATION OF REGISTRY HEALTH OUTCOMES DATA
  • OTHER FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS
  • CLOSING OBSERVATIONS
  • REFERENCES
• APPENDIXES
  • Appendix A. Public Law 112-260
  • Appendix B. Workshop Agenda
  • Appendix C. Airborne Hazards and Open Burn Pit Registry Self-Assessment Questionnaire
  • Appendix D. Data Requested
  • Appendix E. Multivariate Model Results
  • Appendix F. Biographical Sketches of Committee Members and Staff

Suggested citation:

National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press. doi: 10.17226/23677.