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Military Exposures & Your Health - 2023 - Issue 10


In this issue:

Toxic Exposure Screening

As a Veteran, during your military service, you may have been exposed to environmental hazards, such as open burn pits or Gulf War-related exposures. To learn more about your exposures, you can have a toxic exposure screen (TES) during a routine health care appointment, which will allow your exposures to be documented in your record. The TES includes a series of questions that take about 5-10 minutes, and the potential exposures to various hazards are recorded. This screening is not meant for diagnostic purposes but can address concerns about your health and deployment. Following the screen, you will receive information about benefits, environmental health registry exams and clinical resources to address any concerns.

If you have any questions about the TES, you can contact your local VA health care team via Secure Message or call 1-800-MyVA411 and press 8. You can also inquire about the TES during your next VA health care appointment or contact your local VA facility and ask to be screened by the TES Navigator if you want to be screened sooner. It is important to note that you will be screened at least once every five years, even if you do not have any concerns at present. We recommend that you take advantage of this opportunity better understand your health.

Community Forums for Veterans who served at Karshi-Khanabad Air Base

Karshi-Khanabad (K2) Air Base was a former Soviet-era air base the U.S. Army and Air Force used from 2001-2005 in support of missions into Afghanistan. VA, the Department of Defense (DoD), and the Centers for Disease Control and Prevention's Agency for Toxic Substances and Disease Registry (ATSDR) have begun offering a series of online community forums to provide information on the latest VA research and services for K2 Veterans.

On June 29, 2023, VA held the first online community forum. VA invited K2 Veterans to the forum via postal letters. VA, DoD, and ATSDR gave presentations on topics such as the K2 Surveillance Program, K2 legislation, and the Depleted Uranium Follow-Up Program. Community forum presentations are available online. Over the next 8-10 years, VA, DoD, and ATSDR will offer more online community forums with updates for K2 Veterans. Follow the K-2 webpage to learn more and for information about future forum dates.

VA holds annual Military Environmental Exposures Training Conference

VA’s Health Outcomes Military Exposures (HOME) is committed to educating health care providers about military environmental exposures and their impact on health. As a part of this effort, HOME held its annual Military Environmental Exposures Training Conference July 11-13th, 2023, in St. Louis, MO. This conference provided essential training for VA staff to develop and sustain skills needed to evaluate Veterans with military environmental exposure concerns. Attendees included VA health care providers and staff who care for Veterans with exposure concerns, including environmental health clinicians and coordinators, primary care physicians, and other health care providers.

At the conference, attendees received up-to-date information on the requirements and best practices for implementing and conducting military environmental exposure assessments and environmental health registry exams. Additionally, attendees were provided with an overview of the PACT Act, the toxic exposure screen, and the roles and responsibilities of environmental health coordinators and clinicians. This year, all attendees were required to complete the VA/American College of Preventive Medicine’s Military Environmental Exposures Level 1 Certification and obtain an Individual Longitudinal Exposure Record account prior to attending the conference. The certification provided foundational knowledge to effectively identify and treat military environmental exposures that are of concern to Veterans.

The conference included lectures, case studies, breakout sessions, scientific poster displays, and a comprehensive question-and-answer session to test the knowledge of attendees.

The PROject for Military Exposures and Toxin History Evaluation in U.S. service members (PROMETHEUS)

By Jerry Lee, PhD; Michael Borack; Terra Vincent-Hall, PhD, DABT; Warren Casey; and Craig Shriver

Service-related exposures to contaminants or other environmental hazards continue to be a major concern for service members, beneficiaries, and Veterans of all generations. On May 4, 2022, the Department of Defense’s (DoD’s) Cancer Moonshot Roundtable held a discussion entitled, “A Conversation on Cancer Health Equity and Military-relevant Environmental Exposures,” to support President Biden’s 2022 reignition of the Cancer Moonshot initiative to end cancer as we know it. The roundtable explored new technologies to measure the impact of potential environmental exposures on the health of service members.

Hosted by Dr. Craig Shriver, Director of the John P. Murtha Cancer Center Research Program at the Uniformed Services University in Bethesda, MD, the roundtable included experts from the National Institute of Environmental Health Sciences (NIEHS), Uniformed Services University, VA, and the Lawrence J. Ellison Institute for Transformative Medicine. Half of the participants were service members at different parts of their cancer survivorship journey. They all advocated for the development of a process for monitoring and studying the short- and long-term effects of such exposures, including respiratory illnesses, autoimmune disorders, and cancers. On September 12, 2022, motivated by the roundtable’s input and his charge to the White House Cancer Moonshot Cancer Cabinet to bring together multi-federal and public-private partnerships, President Biden announced the launch of the PROject for Military Exposures and Toxin History Evaluation in US service members (PROMETHEUS) during his remarks celebrating the 60th anniversary of President Kennedy’s Moonshot Address.

The PROMETHEUS program will extend the Applied Proteogenomics OrganizationaL Learning and Outcomes (APOLLO) program network, which is a flagship tri-agency effort among DoD, VA, and National Cancer Institute (NCI) started in 2016 by then Vice President Biden’s Cancer Moonshot Task Force. Led by Dr. Shriver, the APOLLO network already connects and extends ongoing studies being conducted at the DoD Murtha Cancer Center, DoD Joint Pathology Center (JPC), DoD Serum Repository, VA Million Veteran Program (MVP), VA Precision Oncology Program, NCI Genomic Data Commons, NCI Proteomic Data Commons, NCI The Cancer Imaging Archive, and VA Precision Oncology Data Commons. The PROMETHEUS program will add scientific data from the NIEHS Translational Toxicology Division, VA Health Outcomes Military Exposures, DoD/VA Individual Longitudinal Exposure Record (ILER), and public-private partners to continue the development of short- and long-term goals.

At the most recent PROMETHEUS retreat in July 2023, working groups and research teams shared ongoing progress to collect, store, and maintain biological samples to be used with clinical research and care data from service members and Veterans. Using scientific and clinical methods, the research teams will evaluate the effects of environmental exposures during military service. The program aims to transform the way exposure-related scientific data are used to improve health and health care for military service members, beneficiaries, Veterans, and civilians.*

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*Disclaimer: The contents of this article are the sole responsibility of the author(s) and do not necessarily reflect the views, opinions or policies of Uniformed Services University of the Health Sciences, The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., the Department of Defense or the Departments of the Army, Navy, or Air Force. Mention of trade names, commercial products, or organizations does not imply endorsement by the U.S. Government.

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