Veterans who served during the Gulf War Era (1990 to present) have long believed that exposure to airborne hazards and burn pits has adversely affected their health. The Veterans Administration (VA) and the Department of Defense (DoD) are paying attention to service members’ concerns. Specifically, the Individual Longitudinal Exposure Record (ILER) is a collaboration between the VA and DoD designed to create an individual electronic record of exposures for each service member beginning with entry into military service and spanning across their military career.
ILER is expected to contain a wide variety of information which will be useful to VA and DoD healthcare providers, epidemiologists and researchers, and VA disability evaluation and benefits determinations specialists. Data being collected and compiled includes:
- Time of deployments
- Locations and events during deployments
- All-hazard occupational data
- Environmental hazards that were known or found later
- Any monitoring performed in the areas of deployments
- Medical encounter information such as diagnosis, treatment and laboratory data
- Medical concerns to be addressed regarding possible exposures
One goal of ILER is to integrate the various environmental health registries utilized by the VA currently, including the Agent Orange Registry, Gulf War Registry, Airborne Hazards and Open Burn Pit Registry, Ionizing Radiation Registry, Toxic Embedded Fragment Surveillance Center, and Depleted Uranium Follow-Up Program.
Clearly, ILER is an intensive effort designed to build an important medical history for service members. An improved medical history should facilitate quality, exposure-related health care. It should also improve the disability claims process by decreasing processing time and implementing more accurate decisions. In addition, the exposure information included in a veteran’s medical history under ILER serves to relieve her from “burden of proof” disability evaluations and benefits determinations.
Research to date indicates that veterans who served in Southwest Asia during the Persian Gulf War and/or after September 19, 2001 as well as those who served in Afghanistan and Uzbekistan during the Persian Gulf War are concerned about a number of airborne hazards:
- Smoke and fumes from open burn pits
- Sand, dust and particulate matter
- General air pollution common in certain countries
- Fuel, aircraft exhaust, and other mechanical fumes
- Smoke from oil well fires
While exposure to some of these hazards could result in temporary adverse health conditions, other long-term medical issues may arise as a result of exposure to such environmental toxins. Obviously, health effects related to hazardous exposure depend on a number of factors, each of which could impact a veteran’s risk level for short or long-term medical issues. Factors to consider include the following:
- Types of waste burned
- Proximity, amount of time, and frequency of exposure
- Wind direction and other weather-related factors
- Presence of other airborne or environmental hazards in the area
- Other injuries or illnesses experienced during military service, such as blast or noise injuries
Open burn pit exposure is a hot topic in the military community. Open-air combustion of trash and other waste in burn pits was common in Iraq, Afghanistan and other areas of the Southwest Asia theater of military operations. Although the DoD has closed most of the burn pits in these areas others remain open. Service members are understandably concerned about this type of hazardous exposure since waste products commonly put in open-air burn pits include:
- chemicals and paint
- medical and human waste
- metal and aluminum cans
- munitions and unexploded ordnance
- petroleum and lubricant products
- plastics, rubber, wood and food waste
Since its implementation in 2019 as a pilot program, the VA has begun to focus on particulate matter exposure with an emphasis on chronic respiratory conditions, including asthma, rhinitis and sinusitis. Exposure to smoke created by burning the type of materials outlined above may result in irritation and burning of the eyes or throat, coughing, breathing difficulties, skin itching or rashes, each of which could result in temporary or long-term medical conditions depending on the factors mentioned earlier. Rulemaking to consider adding respiratory conditions to the list of chronic disabilities based on association with military service in Southwest Asia, Afghanistan and Uzbekistan during the Gulf War Era is underway, and veterans are encouraged to participate in the rulemaking process.