Proposed Iraq/Afghanistan War-Lung Injury (IAW-LI) Clinical Practice Recommendations: National Academy of Sciences’ Institute of Medicine Burn Pits Workshop

Szema, Anthony M.; Mirsaidi, Niely; Patel, Bhumika; Viens, Laura; Forsyth, Edward; Li, Jonathan; Dang, Sophia; Dukes, Brittany; Giraldo, Jheison; Kim, Preston; Burns, Matthew P.

doi:10.1177/1557988315619005

Cited by 23 publications

(19 citation statements)

References 33 publications

(25 reference statements)

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“…[7]. Children living close to Ground Zero showed a reduction of peak expiratory flow rates and had to be treated repeatedly for respiratory issues associated with asthma [7]. Given the existing evidence associated with trash burning and chemical burns, we can conclude that there is a strong relation between respiratory difficulty and burn pit exposure in Iraq and Afghanistan.…”

Section: Health Problems Associated With Burn Pitsmentioning

confidence: 96%

“…In addition, many IAVs have been exposed to improvised explosive devices (IEDs). The fumes of an IED explosion could cause metal particulates to be inhaled and bonded to the iron in IAVs' lungs [7]. IAVs hit with IEDs may have TBIs that can lead to pulmonary injury from barotrauma.…”

Section: Variables That Contribute To Respiratory Issuesmentioning

confidence: 99%

“…Vocal cord dysfunction (VCD) can be suspected in IAVs who have not responded to asthma treatment. When an abnormal flow-volume loop with truncation of the inspiratory limb is found while conducting a pulmonary function test (PFT), a direct laryngoscopy can help in diagnosing VCD [7]. Another study found a consistent and significant pattern of prevalence of chronic obstructive pulmonary disease (COPD) and asthma in IAVs between 2003 to 2011 [6].…”

Section: Health Problems Associated With Burn Pitsmentioning

confidence: 99%

“…Researchers at Augusta University in Georgia worked on a new study called "Deployed Veterans Have Higher Proportionate Cancer Mortality from Exposure to Open-Air Burn Pits" and discovered that more exposure to burn pits was correlated with higher risk of developing cancers and other ailments [15]. [7]. Children living close to Ground Zero showed a reduction of peak expiratory flow rates and had to be treated repeatedly for respiratory issues associated with asthma [7].…”

Section: Health Problems Associated With Burn Pitsmentioning

confidence: 99%

“…One of these registries is BurnPits360.org, a voluntary nonprofit civilian website that tracks health symptoms of service members after their deployment to the Middle East. The awareness raised by this registry led to the Open Burn Pits Registry Act, resulting in the VA's creation of the Airborne Hazard and Open Burn Pit (AH&OBP) registry [7]. The Burn Pits 360 registry does not require any special login, and all the questions are displayed on its first page.…”

Section: Burn Pit Registriesmentioning

confidence: 99%

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Critical Analysis of the Healthcare Response to Burn-Pit-Related Illnesses for Post-9/11 Iraq and Afghanistan Veterans

Lim¹,

Tayyeb²

2019

OJEM

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A serious concern among post-9/11 Iraq and Afghanistan veterans (IAV) are health conditions from military and environmental exposure while serving. Many veterans are becoming suddenly ill and experiencing symptoms that have been associated with exposure to burning trash or "burn pits" set up to destroy waste produced by the military. IAVs are exhibiting respiratory conditions and other numerous health issues from exposure to burn pits during deployments. From the US military operations to the Middle East, 70% of the military personnel reported respiratory illnesses, with 17% experiencing symptoms serious enough to require medical care. Despite growing concerns, little research has been conducted on the health conditions of returning veterans. Many veterans have difficulty gaining appropriate access to care, unable to travel long distances to Veterans health facility, or have to deal with long wait times to see a provider. As a result, many veterans utilize civilian emergency rooms and healthcare facilities. Most healthcare facilities are not familiar with military-related health conditions. To address and prevent delays in care, it is helpful to have a veteran-specific screener questionnaire at the point of healthcare access. Getting a better understanding of the background and history of veterans can aid in accurately triaging this community and lead to better health care outcomes. Collecting and maintaining data regarding health issues that can arise from burn pit exposures can help direct the care of this specific community of veterans. In seeking to improve the understanding of IAV health issues from exposure to burn pits, the aim of this article is to help educate and raise awareness, and assist health care professionals to better triage and direct the care or resources necessary to help this underserved and at-risk community of our veterans.

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Section: Health Problems Associated With Burn Pitsmentioning

confidence: 96%

Section: Variables That Contribute To Respiratory Issuesmentioning

confidence: 99%

Section: Health Problems Associated With Burn Pitsmentioning

confidence: 99%

Section: Health Problems Associated With Burn Pitsmentioning

confidence: 99%

Section: Burn Pit Registriesmentioning

confidence: 99%

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Critical Analysis of the Healthcare Response to Burn-Pit-Related Illnesses for Post-9/11 Iraq and Afghanistan Veterans

Lim¹,

Tayyeb²

2019

OJEM

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Association of Agricultural, Occupational, and Military Inhalants With Autoantibodies and Disease Features in US Veterans With Rheumatoid Arthritis

Ebel

Lutt

Poole

et al. 2021

Arthritis & Rheumatology

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Objective. To determine the association of inhalant exposures with rheumatoid arthritis (RA)-related autoantibodies and severity in US veterans. Methods. Participants in the Veterans Affairs Rheumatoid Arthritis (VARA) registry were mailed surveys assessing occupational, agricultural, and military inhalant exposures. Demographic characteristics, disease activity, functional status, and extraarticular features were obtained from the VARA registry, while HLA-DRB1 shared epitope (SE) status, anti-cyclic citrullinated peptide (anti-CCP) antibodies, and rheumatoid factor (RF) were measured using banked DNA/ serum from enrollment. Associations between inhalant exposures and RA-related factors (autoantibodies, severity, and extraarticular features) were assessed using multivariable linear and logistic regression models adjusted for age, sex, race, and tobacco use and stratified by SE status. Adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. Results. Questionnaires were returned by 797 of 1,566 participants (50.9%). Survey respondents were older, more often White or male, and less frequently smokers, and had lower disease activity compared to nonrespondents. Anti-CCP positivity was more common among veterans exposed to burn pits (OR 1.66 [95% CI 1.02, 2.69]) and military waste disposal (OR 1.74 [95% CI 1.04, 2.93]) independent of other factors. Among participants who were positive for SE alleles, burn pit exposure (OR 5.69 [95% CI 2.73, 11.87]) and military waste disposal exposure (OR 5.05 [95% CI 2.42, 10.54]) were numerically more strongly associated with anti-CCP positivity. Several inhalant exposures were associated with the presence of chronic lung disease, but not with the presence of RF or the level of disease activity. Conclusion. Military burn pit exposure and military waste disposal exposure were independently associated with the presence of anti-CCP antibodies in RA patients. These findings are consistent with emerging evidence that various inhalant exposures influence autoantibody expression and RA risk.

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A Man with Metal Lungs

Szema

Kostrubiak

2017

Unusual Diseases With Common Symptoms

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Proposed Iraq/Afghanistan War-Lung Injury (IAW-LI) Clinical Practice Recommendations: National Academy of Sciences’ Institute of Medicine Burn Pits Workshop

Cited by 23 publications

References 33 publications

Critical Analysis of the Healthcare Response to Burn-Pit-Related Illnesses for Post-9/11 Iraq and Afghanistan Veterans

Critical Analysis of the Healthcare Response to Burn-Pit-Related Illnesses for Post-9/11 Iraq and Afghanistan Veterans

Association of Agricultural, Occupational, and Military Inhalants With Autoantibodies and Disease Features in US Veterans With Rheumatoid Arthritis

A Man with Metal Lungs

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