Exposures of Concern to Veterans of Operation Enduring Freedom/ Operation Iraqi Freedom

1
Exposures of Concern to Veterans of
Operation Enduring Freedom/Operation Iraqi
Freedom

• Ron Teichman, MD, MPH, FACP, FACOEM

2
Operation Enduring Freedom

• Referred to as OEF
• Primary theater of combat is Afghanistan
• Began October 7, 2001

3
Operation Iraqi Freedom

• Referred to as OIF
• Primary theater of combat is Iraq
• Many troops in Kuwait, Saudi Arabia, etc.
• Began March 20, 2003

4
Perspective

• Total number of US service members deployed
  1,700,000
• Total number of US service members separated,
  i.e., Veterans 1,016,213
• Received some health care from VA 454,121
  45 of returnees
• 95 outpatient, 5 inpatient

5
Perspective contd.

• VHA sees approximately 5,500,000 Veterans per
  year
• 454,121 OEF/OIF Veterans seen over 7.5 years
• OEF/OIF Veterans seen over 7.5 years
  approximately 8 of Veterans seen in a single year

6
Seamless Transition

• The transfer of personnel from the Department of
  Defense to the Department of Veterans Affairs
• DoD DVA
• Service Member to Veteran
• Post-Deployment Health Assessment upon return
  (PDHA)
• Post-Deployment Health Re-Assessment in 3-6
  months (PDHRA)

7
Percentage of OEF/OIF service members who
endorsed Exposure Concerns on PDHA and PDHRA
(9/07-10/08)

• Active component
• Pre-Deployment n245,378 0.0
• Post-Deployment n224,511 16.2
• Reassessment n189,933 21.2
• Reserve component
• Pre-Deployment n85,843 0.0
• Post-Deployment n75,174 24.9
• Reassessment n96,886 34.8
• Frequency of exposure concerns rise after 3-6
  months
• MSMR Vol. 15 / No. 7 Sept. 2008

8
Proportion of service members who endorse
exposure concerns on post-deployment health
assessments (1/04-8/08)

• MSMR Vol. 15 / No. 7 Sept. 2008 MSMR Vol. 15 /
  No. 7 Sept. 2008

MSMR Vol. 15 / No. 7 Sept. 2008
9
Top five Concerns of Veterans from Afghanistan
and Iraq

• Sand
• Noise
• Smoke from trash
• Vehicle exhaust
• JP8 or other fuel
• MSMR Vol. 12 / No. 8 Nov. 2006

10
Frequency of OEF/OIF service member exposure
concern reported on the PDHRA (9/05-8/06)
MSMR Vol. 12 / No. 8 Nov. 2006
11
Top ten environmental exposures of concern
OEF/OIF

• Smoke from burning trash or feces (44.6)
• Sand and dust storms (41.5)
• Gasoline, Jet Fuel, Diesel Fuel (21.1)
• Depleted Uranium (19.0)
• Paint, solvents, other petrochems (15.2)
• Oil well fire smoke (14.9)
• Contaminated food and water (14.4)
• Anthrax Vaccine (14.2)
• Multiple Vaccinations (13.9) 89gt3
• Vehicular Exhaust (10.3)
• Seen at NJ WRIISC, n612. 1889 concerns, range
  0-15

12
Top ten environmental exposures of concern Gulf
War

• Protective gear/alarms (82.5)
• Diesel, kerosene, other petrochems (80.6)-3
• Oil well fire smoke (66.9)-6
• Local food (64.5)-7
• Insect bites (63.7)
• Harsh weather (62.5)-2
• Smoke from burning trash or feces (61.4)-1
• Within 1 mile of missile warfare (59.9)
• Repellants and pesticides (47.5)
• Paint, solvents (36.5)-5
• From Schneiderman, Lincoln, Wargo, et. al., APHA,
  12-14-05

13
Prevalence () of exposures common to Vietnam,
Persian Gulf and Bosnia-Kosovo
14

• Thank you