Abstract
Many occupational health nurses provide care for military Veterans, National Guard, or Reserve Component members. Military personnel are potentially exposed to airborne hazards and open burn pits (AHOBP) (e.g., desert environment, vehicle exhaust, or industrial activities associated with certain environments) while deployed (National Academies of Sciences, Engineering, and Medicine [NASEM], 2020). Open burn pits, once a common practice used to dispose of waste in operational theaters, are currently prohibited by legislation. The Secretary of Defense is the approval authority for exceptions, and this approval cannot be delegated below the Secretary level (National Defense Authorization Act [NDAA], 2022).
Studies have been conducted on deployed personnel over the past 20 years to evaluate the effects these exposures had on service member’s health status (e.g. NASEM, 2020). There are conflicting reports on the health outcomes related to exposure to burn pit emissions and other airborne hazards. Some published reports conclude that there are higher rates of self-reported pulmonary symptoms, asthma, sinusitis, and rare, unexpected conditions among service members deployed to Southwest Asia, while other publications report finding no elevation in disease or symptom-reporting (NASEM, 2020). Nevertheless, it is recommended that post-deployment pulmonary evaluation should focus on common diseases such as asthma and airway hyperreactivity (Morris et al., 2020).
Congress has mandated a number of approaches to mitigate AHOBP hazards and health outcomes. In January 2013, Congress passed a law that required the Department of Veterans Affairs (VA) to establish the AHOBP Registry to gather data, identify associated health concerns, and conduct research on the potential health effects due to airborne hazards exposures (Dignified Burial and Other Veterans’ Benefits Improvement Act, 2013). There are specific eligibility requirements to the registry, such as timeframe, location/region of deployment, and type of operations. Members do not have to be symptomatic or newly diagnosed with a respiratory illness to participate. Those eligible for the registry are also eligible for an examination through a VA medical center at no cost.
On August 10, 2022, President Biden signed the Honoring our Promise to Address Comprehensive Toxics (PACT) Act into law, which further expanded efforts to address these concerns. The PACT act directs a number of changes to include expansion of veteran eligibility and access to VA healthcare, increasing the number and types of service-connected medical conditions that entitle Veterans for disability compensation and improve exposure research and treatment options (Honoring our PACT Act, 2022). In addition to other outreach efforts to educate Veterans on AHOBP, Congress has also mandated that the Department of Defense (DoD) medical providers complete mandatory training on the potential health effects of burn pits to increase awareness of these exposures (NDAA, 2022). This training is available to DoD occupational health nurses.
To learn more about the registry, eligibility, and optional examination, occupational health nurses can refer their employees with concerns to the following website: https://www.publichealth.va.gov/exposures/burnpits/registry.asp. To further educate themselves on the clinical aspects of AHOBP and other deployment exposures, occupational health nurses can access training with free educational credits at the following link: https://www.warrelatedillness.va.gov/WARRELATEDILLNESS/education/provider-training/index.asp. By understanding the potential exposures to burn pits or other airborne hazards and resources available to Veterans, occupational health nurses can appropriately counsel their employees on services available through VA facilities and refer members as necessary.
