In a recent study published in JAMA network openresearchers examined the connection between time spent on military bases that used open fires and the likelihood of veterans being diagnosed with respiratory or heart problems.

The study found that prolonged deployment on bases using open fire pits is related to a rather increased risk of developing chronic obstructive pulmonary disease (COPD), asthma, ischemic stroke, and hypertension, suggesting potential antagonistic health effects related to environmental aspects during military service.

Test: Deployment to military bases with open burns and respiratory and circulatory system diseases. Senior Airman Julianne Showalter, public domain, via Wikimedia Commons, en.wikipedia.org/wiki/Burn_pit. Accessed: April 29, 2024

Background

During quite a few operations in Iraq and Afghanistan, america military used open burns to eliminate quite a lot of materials, including medical, hazardous and solid waste.

Despite restrictions imposed by the Department of Defense (DOD) in 2009 and efforts to adopt alternative waste disposal methods, fire pits remained in use until more sustainable options were introduced.

Despite concerns expressed by the general public and veterans themselves, few studies have examined the lasting health effects of burn exposure.

Although deployments during Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) have been linked to an increased risk of respiratory disease, isolating the impact of burn exposure is attributable to the complex mixture of emissions and other air pollutants encountered during military operations.

Concerning the study

This study was designed to judge how deployment to open burn bases affects veterans’ long-term cardiovascular and respiratory health.

The cohort study examined Air Force and Army veterans who were deployed to the OIF or OEF between 2001 and 2011 and registered with the Veterans Health Administration (VHA) for post-deployment health care.

The study used declassified deployment records linked to VHA health data to evaluate the association between deployments to bases that used open burn pits and long-term cardiovascular and respiratory health effects amongst veterans.

A cohort of veterans meeting the inclusion criteria was created, excluding Navy and Marine Corps veterans attributable to data unavailability and veterans with incomplete deployment history prior to 2005.

Burn exposure and rectal history were determined from Department of Defense records, and health outcomes were assessed from health records maintained by the VHA through 2020.

The evaluation took into consideration covariates including obesity, smoking, demographic aspects, service industry and income level.

Statistical evaluation included multivariable logistic regressions to look at associations between burn exposure and disease outcomes, after adjusting for covariates.

Sensitivity analyzes addressed methodological issues, including exclusions and potential sources of confounders.

Results

The study included 459,381 Air Force and Army veterans deployed to OIF or OEF between 2001 and 2011. Follow-up data was collected from the VHA through the top of 2020.

The cohort, primarily male (87%) and racially diverse (white veterans made up 67% of the population), was on average 31.6 years old after they entered VHA care. Over 94% of veterans had a history of military service.

Participants demonstrated various socioeconomic indicators, including high rates of obesity (34%) and cigarette smoking (43%).

The vast majority of cohort members (86%) had been deployed to bases with burn pits not less than once, and the typical duration of exposure was 244 days.

Evaluation of the association between duration of burn exposure and various health outcomes showed a small increase in the chance of asthma (1%) and COPD (4%) per 100 days of exposure, with moderate dose-response associations across exposure tertiles.

Hypertension was also related to burn exposure, with a slight increase in the chances of ischemic stroke observed, although accuracy was limited. No association with interstitial lung disease was observed.

Sensitivity analyzes showed minimal effects on association measures after exclusions and adjustments for covariates.

Adjusting the model for implementation time explained many of the differences in associations between adjusted and unadjusted outcomes, excluding hypertension, which showed an increased association only after controlling for all covariates.

Conclusions

A cohort study found that longer periods of exposure to open burns were related to small increases within the rates of COPD, hypertension, and asthma amongst OIF and OEF veterans.

These associations were modest; Nevertheless, given the massive variety of veterans who could potentially be affected by the disease, the authors say that even a small increase in risk needs to be considered clinically significant.

Previous studies have had limitations in assessing the consequences of burn exposure. This study, with an extended median follow-up of 10.9 years and a bigger sample size, provided essential insights.

Although there have been limitations, including potential bias and lack of detailed data on burn exposure, these findings highlight the necessity for continued assessment of health risks related to burn exposure amongst veterans.

These findings highlight the importance of considering potential long-term health impacts when providing health care and advantages to veterans, in addition to the worth of declassified deployment data in examining military-related health outcomes.