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Military Health Care Personnel Learn about Environmental Exposures

Image of Military Health Care Personnel Learn about Environmental Exposures. Soldiers from the 84th Combat Engineer Battalion use a bulldozer and excavator to manuever trash and other burnable items around in the burn pit at the landfill here. The bulldozer is primarily used to keep refuse constantly burning, and the excavator to push dirt over chutes to make the land useable in the future. (Courtesy Photo)

More than 450 military and civilian personnel from across the Military Health System attended a recent “Understanding and Evaluating Military Environmental Exposures” webinar offered by the Defense Health Agency’s Continuing Education Program Office within the Education and Training Directorate.

The attendees, including those unable to attend the live session, can earn continuing education or continuing medical education credits by completing the Home Study course offered by CEPO starting May 15.

Attendees learned how to identify common environmental exposures, the purpose of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry, and how health care providers conduct medical evaluations of service members with environmental exposure concerns. Participants also learned the importance of the Individual Longitudinal Exposure Record, an individual, electronic record of exposures designed in collaboration between VA and the Department of Defense.

“The special feature webinar is one of several recent outreach and education efforts undertaken by DOD to promote awareness and understanding of military exposures among health care providers and service members and is a reflection of the ongoing collaboration between DOD and VA,” said Steve Jones, director of force readiness and health assurance policy with the Office of the Deputy Assistant Secretary of Defense for Health Readiness Policy & Oversight.

Dr. Jesse Monestersky, an occupational and environmental medicine branch physician at the Defense Centers for Public Health-Aberdeen, in Aberdeen, Maryland, told attendees the MHS’ goal is to deliver a seamless continuum of care for service members when they leave the military.

“The value of the targeted primary care encounter for active duty service members is to get their health concerns related to burn pit and other environmental exposures addressed and have it documented in their military medical record,” Monestersky said.

“Service members are required to get additional exposure-related exams by the VA for disability compensation determination when no longer on active duty. The documentation proves invaluable to the examiner during the disability claim process when reviewing their medical records.”

Larry Vandergrift, the project manager of the Individual Longitudinal Exposure Record, said the tool enables clinicians, epidemiologists, researchers, and claims adjudicators to obtain exposure documentation.

“ILER is a web-based application that provides the DOD and the VA the ability to link an individual to exposures improving the efficiency, effectiveness, and quality of health care,” Vandegrift said. “It supports epidemiological research by determining whether deployment-related exposures are associated with post-deployment health outcomes and supports clinical care and public health activities by searching for individuals and associating them to known exposure events.”

Dr. Eric Shuping, operations director of the VA’s Health Outcomes of Military Exposures office talked about the multiple registries the office oversees and clarified the overarching purpose of the registries.

“The purpose of the redesigned registry is to conduct surveillance of the entire cohort and to update the cohort on any new findings,” Shuping said. “The entire Defense Manpower Data Center roster of veterans and service members who deployed to the Southwest Asia theater of operations—from August 2, 1990 to present—will be migrated into the Veterans Integrated Registries Platform.”

The VA’s Post-Deployment Health Services currently manages six congressionally mandated registries: Agent Orange, Gulf War Registry, Ionizing Radiation Registry, Toxic Embedded Fragments, Depleted Uranium, and Airborne Hazards and Open Burn Pit Registry.

More than 970,000 veterans are enrolled in these registries. In 2022, the Airborne Hazards and Open Burn Pit Registry had 67,519 new participants, an all-time high.

U.S. Air Force Master Sgt. Lonnie Kemp, noncommissioned officer in charge of the bioenvironmental engineering office with the 124th Medical Group, 124th Fighter Wing in Boise, Idaho, said he attended the training to get a better understanding of how medical providers view environmental exposures, ensuring he can provide airmen within his unit the most current information regarding their health and life after service.

“The 124th Fighter Wing continuously strives to provide the best opportunities and care for our airmen as it relates to their physical health, mental health, welfare, and safety,” Kemp said. “This training, and others like it, positively impacts our capability to meet that goal.”

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