The Environmental Epidemiology Service (EES) conducts original research studies on the health of Veterans, including research on potential exposures to environmental hazards during military service.
EES also maintains databases and registries of Veterans’ exposures and health care utilization, which provide unique data for much of the research.
Learn about featured research studies on:
- Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) Veterans
- Gulf War Era Veterans
- Vietnam Veterans
- Veterans of U.S. Nuclear Weapons Tests
Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) Veterans
The MIND Study (Markers for the Identification, Norming, and Differentiation of TBI and PTSD)
Investigators: Julie Chapman, Psy.D.; Aaron Schneiderman, Ph.D., M.P.H., R.N.
The upcoming MIND Study will be an in-depth follow-up of a sample of participants from the National Health Study for a New Generation of U.S. Veterans who have experienced a traumatic brain injury (TBI), symptoms of TBI, or post-traumatic stress disorder (PTSD). Researchers plan to identify sub-groups who have symptoms of TBI and/or PTSD and a comparison group of Veterans. These Veterans will be invited to one of the three VA War Related Illness and Injury Study Centers (WRIISCs) to be a part of the MIND Study. Participants will receive further physical evaluation and diagnostic testing that will explore differential diagnoses between TBI and PTSD and build objective and consistent diagnostic criteria.
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National Health Study for a New Generation of U.S. Veterans
Investigators: Aaron Schneiderman, Ph.D., M.P.H., R.N.; Han Kang, Dr.P.H.; Clare Mahan, Ph.D.; Steven Coughlin, Ph.D.; Stephanie Eber, M.P.H.; Shannon Boyer, M.P.H.; Matthew Reinhard, Psy.D.
This 10-year follow-up study is one of the largest scientific research studies ever undertaken on the health of recent Veterans. Thirty thousand OEF/OIF Veterans and 30,000 Veterans who served elsewhere during the same time period have been contacted and invited to participate.
Researchers are comparing chronic medical conditions, PTSD and other psychological conditions, general health perceptions, reproductive health, pregnancy outcomes, functional status, mortality, health care utilization, behavioral risk factors and VA disability compensation between the Veterans who served in OEF/OIF and the Veterans who served elsewhere. This study will provide the basis to begin answering questions on the long-term effects of deployment to OEF/OIF and provide important knowledge for improving the health of recent Veterans and future military personnel deployed in combat theaters. Learn more about the National Health Study for a New Generation of U.S. Veterans.
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Gulf War Era Veterans
Longitudinal Health Study of Gulf War Era Veterans
The Longitudinal Health Study of Gulf War Era Veterans compares changes periodically in the health status of 1990-1991 deployed Gulf War Veterans to Veterans not deployed to the Gulf.
Estimates of Cancer Prevalence in Gulf Veterans Using State Registries
Investigators: Aaron Schneiderman, Ph.D., M.P.H., R.N.; Han Kang, Dr.P.H.; Clare Mahan, Ph.D.; Samuel Simmens, Ph.D.; Heather Young, Ph.D.
Although there were relatively few combat casualties in the 1990-1991 Gulf War, many Veterans were subjected to a wide variety of natural and man-made environmental exposures, some of which are considered potential human carcinogens. Because of concerns about increased cancer risks among these Veterans, Congress asked VA to address the question of potential cancer risk among Gulf War Veterans.
Researchers evaluated the hypothesis that 1990-1991 Gulf War Veterans are at an increased risk of developing specific cancers compared to non-Gulf War Veterans. The objectives of the study were:
- to assess and compare the prevalence, distribution, and characteristics of cancer among approximately 620,000 Gulf War Veterans to 750,000 non-Gulf War Veterans; and
- to assess demographic, military, and in-theater exposure characteristics associated with the cancer.
Gulf War and non-Gulf War Veterans with a diagnosis of cancer from 1991 to 2003 were identified through record linkage of the Veterans’ database with files supplied by state cancer registries. Researchers combined the state data, completed initial analyses, and published results.* Only lung cancer showed a statistically significant relative excess among Gulf War Veterans compared with non-Gulf War Veterans (adjusted proportional incidence ratios, 1.15; 95% confidence interval, 1.03-1.29). When adjusted for race, age, and sex, the overall proportion of cancers among Gulf War and non-Gulf War Veterans was similar (odds ratio, 0.99; 95% CI, 0.96-1.02). With the exception of lung cancer, there was little evidence of excess risk of cancer associated with Gulf War deployment.
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Post War Mortality from Neurologic Diseases in Gulf War Veterans
Investigators: Aaron Schneiderman, Ph.D., M.P.H., R.N.; Han Kang, Dr.P.H.; Shannon Boyer, M.P.H.; Tim Bullman, M.S.; Mitchell Wallin, M.D., M.P.H.
We are investigating the risk of post-war mortality from neurological disease among 620,000 Gulf War Veterans and 750,000 non-Gulf War Veterans. Gulf War Veterans may be at increased risk for adverse health outcomes, including neurological disorders, as a result of their Gulf War service. Specifically, there is concern that Gulf War Veterans may be at increased risk for amyotrophic lateral sclerosis, multiple sclerosis, Parkinson’s disease, or brain cancer. These risks may be related to potentially hazardous environmental exposures during the war, such as oil well fire smoke, chemical and biological warfare agents, prophylactic agents against chemical and biological warfare, multiple vaccinations, depleted uranium, pesticides, and endemic infectious diseases.
Since our last follow-up in 1997, there have been few changes in mortality rates among Gulf War and non-Gulf Veterans. Controlling for oil well fire smoke exposure, Army Gulf War Veterans who were potentially exposed to nerve agents at Khamisiyah had a higher mortality rate from brain cancer compared to Army Veterans who were not considered exposed. The risk of death due to motor vehicle accidents is still higher among female Gulf War Veterans compared to female non-Gulf War Veterans, though no longer statistically significant among male Gulf War Veterans. We are continuing to follow the health outcomes of these Gulf War and non-Gulf Veterans, and recently expanded the time frame for investigating post-war mortality from 1991-2004 to 1991-2008.
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Vietnam Veterans
Long Term Health Outcomes of Women’s Service During the Vietnam Era
Investigators: Han Kang, Dr.P.H.; Amy Kilbourne, Ph.D.; Kathryn Magruder, M.P.H., Ph.D.; Rachel Kimerling, Ph.D.; Susan Frayne, M.D., M.P.H.; Avron Spiro III, Ph.D.; Joan Furey, R.N., M.A.; Yasmin Cypel, Ph.D.; Clare Mahan, Ph.D.; Matthew Reinhard, Psy.D.; Kathy Swanson, C.S.P., R.Ph., M.S.; Ciaran Phibbs, Ph.D.; Tracey Serpi, Ph.D.; Amyre Barker, M.P.H.
This is the most comprehensive study to date of the mental and physical health of women Vietnam Veterans. It will estimate the prevalence of PTSD and other mental and physical health conditions in these women, and examine the relationship between PTSD and other conditions. Researchers will study approximately 10,000 women who served in the military during the Vietnam War, including those who served in Vietnam, those who served near Vietnam, and those who served in the United States. This study will include four research phases conducted over a 5-year period: one year of cohort development, two years of mail survey and telephone interview administration, one year of medical record abstraction, and one year of data analysis.
The study will be used to shape future research on women Veterans, and to plan for appropriate services for women Veterans and the aging Veteran population. It is being coordinated by VA’s Cooperative Studies Program and involves researchers from across the country. More information about this study is available on the Vietnam-Era Women Veterans Study Web page and on the press release Secretary Shinseki Announces Study of Vietnam-Era Women Veterans.
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Veterans of U.S. Nuclear Weapons Tests
Cancer Mortality among Military Personnel at U.S. Nuclear Weapons Tests
Investigators: John D. Boice Jr., Sc.D.; Han K. Kang, Dr.P.H.; A. Bertrand Brill, M.D., Ph.D.; John Till, Ph.D.; Clark Heath, M.D.; Robert Tarone, Ph.D.; Kenneth Kopecky, Ph.D.; Richard Toohey, Ph.D.
This mortality follow-up study will assess the risk of cancer among 120,000 United States military personnel who participated during one of seven aboveground atmospheric weapons tests at the Nevada Test Site and the Pacific Proving Grounds between 1946 and 1958. Over 200,000 military personnel participated in U.S. atmospheric nuclear weapons tests from 1945 until the Limited Nuclear Test Ban Treaty in 1963.
A unique aspect of this study is the use of a comprehensive dose reconstruction program to estimate radiation doses to specific organs for epidemiologic evaluation. This was not possible in previous research studies. Particular attention will be paid to deaths from leukemia, and from cancers of the thyroid, salivary gland, breast, liver, and bone; i.e., cancers that have been reported to be in excess among U.S. and U.K. atmospheric nuclear weapons test participants.
The results from this study will be of service to Cold War Veterans and their families by providing them with an understanding of the risks they may have incurred when serving our Nation. It will also provide an important scientific understanding of the level of lifetime risks possible from low-level exposures during occupational circumstances, medical imaging examinations, environmental cleanups, nuclear waste disposal, and dirty bomb attacks.
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