The National Academies Press

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1 Introduction
Pages 11-26

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From page 11... ... That committee suggested that the first tier be focused on determining whether proximity to burn pit operations at Joint Base Balad increased the risk of adverse health outcomes, using data such as dates of deployment, duties on base, and location of housing relative to the burn pit, and taking into account wind-dispersion models to assess individual exposure to Joint Base Balad burn pit emissions. The second tier would address whether the installation of incinerators at Joint Base Balad between 2008 and 2010 had reduced the incidence of disease or intermediate outcomes by evaluating chronic health outcomes in those deployed before and those deployed after the burn pit was shut down, factoring in the increased use of incinerators over those 2 years. Read the entire page →
From page 12... ... Appendix A of this report provides an excerpt of the law calling for the current study. The law directed the Secretary of VA to coordinate with DoD to establish and maintain an open burn pit registry for eligible individuals who may have been exposed to toxic airborne chemicals and fumes caused by open burn pits. Read the entire page →
From page 13... ... The committee will supervise the conduct of an analysis of the first ~6 months of data collected by the AH&OBPR using de-identified datasets provided by VA, summarize information on the cohort, and compare its demographic characteristics with the characteristics of all those who were deployed during the Gulf con flicts. The committee will also solicit veteran input and provide methodological recommendations on how to best ascertain and monitor the health effects of the exposure of members of the Armed Forces to toxic airborne chemicals caused by open burn pits and other potential airborne hazards during deployment. Read the entire page →
From page 14... ... . Of particular relevance for the current report, the previously mentioned report Long-Term Health Consequences of Exposure to Burn Pits in Iraq and Afghanistan summarized the health effects associated with exposures to 51 pollutants that were detected in air samples taken at Joint Base Balad in Iraq in 2007 and 2009 (IOM, 2011) Read the entire page →
From page 15... ... . It did find limited or suggestive evidence of an association between exposure to combustion products and reduced pulmonary function in the study populations, but it was unable to determine whether the long-term health effects are likely to result from service members exposed to emissions from burn pits -- specifically the one in operation at Joint Base Balad -- because high ambient concentrations of particulate matter from both natural and anthropogenic sources likely modified the effects, but could not be accounted for or adjusted in the analyses. Read the entire page →
From page 16... ... , and provided the committee with an understanding of what data were gathered with respect to burn pit emissions and exposures. The intent of his study was to create an exposure-zone map using spatially interpolated particulate air sampling point data from Joint Base Balad and exposure contours from dispersion model outputs. Read the entire page →
From page 17... ... Recent Epidemiologic Studies of Military Personnel Exposed to Burn Pits The committee's statement of task directed it to use established and previously published epidemiologic studies to provide recommendations regarding the most effective and prudent means of addressing the medical needs of eligible individuals with respect to conditions that are likely to result from exposure to burn pit emissions. To accomplish this, a targeted review was conducted of epidemiologic studies published since the last National Acad 8 Later called Joint Base Balad. Read the entire page →
From page 18... ... (2010) study examined medical encounters of Army and Air Force personnel 36 months after deployment to Joint Base Balad or Camp Taji (with burn pits) Read the entire page →
From page 19... ... Follow up to AFHSC locations in Iraq with Southeast Asia theater conditions (ICD-9 codes OIF deployment (both bases et al., 2010 burn pits (15,908 at Joint of operations. Read the entire page →
From page 20... ... of a burn pit (N = 21 cases; study and 2007–2008 Base Balad, Camp Taji, 15 unexposed and 6 at Joint Lupus analyses adjusted for Millennium Cohort Study or Camp Speicher) Base Balad) Read the entire page →
From page 21... ... Sharkey et al., 2015 Military personnel Exposure limited Medical encounters for No camps with statistically This study adds 12 months deployed between January to deployment to respiratory symptoms significantly increased of follow-up to the study Retrospective cohort 2005 and June 2007: bases with burn pits, (ICD-9: 460–519) , acute IRRs compared with U.S.- conducted by AFHSC et al. Read the entire page →
From page 22... ... . Rates for bases with burn pits and without burn pits were also significantly elevated for both asthma and respiratory symptoms (as well as for Joint Base Balad, Camp Taji, and Camp Arifjan, individually) Read the entire page →
From page 23... ... . The investigators found that deployed personnel exposed to documented burn pits in the combined Joint Base Balad, Camp Taji, and Camp Speicher sites were not at an elevated risk of lupus or rheumatoid arthritis (Jones et al., 2012) Read the entire page →
From page 24... ... The 2011 IOM report indicated that there was "limited/suggestive evidence of an association between exposure to combustion products and reduced pulmonary function," but evidence was inadequate/insufficient for other health outcomes mostly based on studies in firefighters and incinerator workers or communities around incinerators. While the new evidence is less than sufficient, it does not show that service members are at an increased risk of health effects associated with burn pits in particular, although other hazards may be important contributors to respiratory symptoms and disease. Read the entire page →
From page 25... ... Chapter 6 turns to the AH&OBP Registry's health outcomes data, focusing on those conditions and diseases that the committee believes are most relevant to assessing the potential health effects of exposures to burn pits and other airborne hazards. It presents descriptive statistics for these outcomes, describes the approaches used to analyze the data, and concludes with a discussion of how this information may be used to assess associations between health outcome and exposures. Read the entire page →
From page 26... ... 2012. The effects of exposure to documented open-air burn pits on respiratory health among deployers of the Millennium Cohort Study. Read the entire page →

From page 11...

... That committee suggested that the first tier be focused on determining whether proximity to burn pit operations at Joint Base Balad increased the risk of adverse health outcomes, using data such as dates of deployment, duties on base, and location of housing relative to the burn pit, and taking into account wind-dispersion models to assess individual exposure to Joint Base Balad burn pit emissions. The second tier would address whether the installation of incinerators at Joint Base Balad between 2008 and 2010 had reduced the incidence of disease or intermediate outcomes by evaluating chronic health outcomes in those deployed before and those deployed after the burn pit was shut down, factoring in the increased use of incinerators over those 2 years.

1 Introduction Pages 11-26

1 Introduction
Pages 11-26