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El. knyga: Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry

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  • Formatas: 252 pages
  • Išleidimo metai: 28-Mar-2017
  • Leidėjas: National Academies Press
  • Kalba: eng
  • ISBN-13: 9780309451185
Kitos knygos pagal šią temą:
Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit RegistryDidesnis paveikslėlis
  • Formatas: 252 pages
  • Išleidimo metai: 28-Mar-2017
  • Leidėjas: National Academies Press
  • Kalba: eng
  • ISBN-13: 9780309451185
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Military operations produce a great deal of trash in an environment where standard waste management practices may be subordinated to more pressing concerns. As a result, ground forces have long relied on incineration in open-air pits as a means of getting rid of refuse. Concerns over possible adverse effects of exposure to smoke from trash burning in the theater were first expressed in the wake of the 19901991 Gulf War and stimulated a series of studies that indicated that exposures to smoke from oil-well fires and from other combustion sources, including waste burning, were stressors for troops. In January 2013, Congress directed the Department of Veterans Affairs (VA) to establish and maintain a registry for service members who may have been exposed to toxic airborne chemicals and fumes generated by open burn pits.





Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry analyzes the initial months of data collected by the registry and offers recommendations on ways to improve the instrument and best use the information it collects. This report assesses the effectiveness of the VA's information gathering efforts and provides recommendations for addressing the future medical needs of the affected groups, and provides recommendations on collecting, maintaining, and monitoring information collected by the VA's Airborne Hazards and Open Burn Pit Registry.

Table of Contents



Front Matter Summary 1 Introduction 2 Use of Registries in Environmental Health Research 3 The Airborne Hazards and Open BurnPit Questionnaire and Registry 4 Analysis Methods and Descriptive Statistics 5 Analysis and Interpretation of Exposures Data 6 Analysis and Interpretation of Registry Health Outcome Data 7 Findings, Conclusions, and Recommendations Appendix A: Public Law 112-260 Appendix B: Workshop Agenda Appendix C: Airborne Hazards and Open Burn Pit Registry Self-Assessment Questionnaire Appendix D: Data Requested Appendix E: Multivariate Model Results Appendix F: Biographical Sketches of Committee Members and Staff
Acronyms And Abbreviations xv
Summary 1(10)
1 Introduction
11(16)
The Committee's Charge And Approach To Its Task
12(1)
Information Gathering
12(12)
Prior National Academies Reports Regarding Burn Pit Exposures and Health Outcomes
14(1)
Registry Data Analysis Efforts
15(1)
Summary of the Committee's Workshop
15(2)
Recent Epidemiologic Studies of Military Personnel Exposed to Burn Pits
17(7)
Organization Of The Report
24(1)
References
25(2)
2 Use Of Registries In Environmental Health Research
27(16)
Use Of Registries In Health Research
27(2)
VA And Dod Environmental Health Registries
29(3)
VA Environmental Health Registries
29(2)
DoD Environmental Health Registries
31(1)
Limitations Of Registry Data
32(3)
Selective Participation and Bias
33(1)
Misclassification Bias
34(1)
Recall Bias
34(1)
Self-Report Bias
35(1)
Identification Of An Appropriate Comparison Group
35(2)
Potential Comparison Groups
36(1)
Drawing Inferences From Registry Data
37(1)
Synopsis And Conclusions
38(1)
References
39(4)
3 The Airborne Hazards And Open Burn Pit Questionnaire And Registry
43(30)
Scientific Basis And Congressional Directive
43(2)
Developing The Registry
45(6)
Personnel and Expertise
45(2)
Questionnaire Development
47(1)
Optional In-Person Exam
48(2)
Open Comment Period and Pilot Testing
50(1)
Recruitment And Enrollment
51(2)
Eligibility
51(1)
Process for Participation
52(1)
Communications And Outreach
53(2)
Questionnaire Quality
55(11)
Registry Questionnaire Basic Characteristics
56(1)
Questionnaire Design
56(2)
Evaluation of Questions
58(8)
Linking Other Data To Registry Data
66(1)
Synopsis And Conclusions
67(2)
References
69(4)
4 Analysis Methods And Descriptive Statistics
73(32)
Data Requested And Received
73(1)
Data On AH&OBP Registry Participants
73(4)
Characterizing Eligibility
74(2)
Unavailable Data
76(1)
Analysis Methods
77(1)
Assuring Quality Control of Analyses
78(1)
Participation Rates
78(3)
Representativeness
81(10)
Demographic and Military Characteristics Comparisons
82(1)
Comparisons of Differences Between Respondents and Total Eligible Population
82(7)
Effect of Nonresponse
89(2)
Overview Of Questionnaire Results
91(7)
Questions with Limited Variability in Responses
92(1)
Questions with High Rates of Nonresponse
93(5)
Synopsis And Conclusions
98(4)
References
102(3)
5 Analysis And Interpretation Of Exposures Data
105(24)
Introduction
105(5)
Sources and Nature of Exposures
106(2)
Limitations of Exposure Information
108(2)
Exposure Information Collected By The AH&OBP Registry
110(3)
Location-Specific Deployment Exposures
111(1)
General Military Occupational Exposures
111(1)
Environmental Exposures and Regional Air Pollution
111(1)
Limitations of AH&OBP Registry Questionnaire Exposure Information
112(1)
The Committee's Analysis Of AH&OBP Exposure Information
113(9)
Descriptive Statistics
114(4)
Committee-Created Exposure Variables
118(4)
Composite Exposure Potential
122(1)
Exposure Metrics For Multivariate Analyses
122(3)
Changes in Burn Pit Exposure Over Time
124(1)
Synopsis And Conclusions
125(1)
References
126(3)
6 Analysis And Interpretation Of Registry Health Outcome Data
129(28)
Health Outcomes Collected By The Questionnaire
129(5)
Strategies for Assessing Self-Reported Health Information
131(3)
Health Conditions Used In Analyses
134(8)
Descriptive Statistics for Health Outcomes
135(7)
Analyses Of Exposures And Health Outcomes
142(10)
Methods
142(1)
Results
142(9)
Unexpected Patterns of Association
151(1)
Overall Interpretation Of Registry Data Anaysis
152(1)
Synopsis And Conclusions
153(3)
References
156(1)
7 Findings, Conclusions, And Recommendations
157(8)
Opening Observations
157(1)
The Airborne Hazards And Open Burn Pit Registry Questionnaire
158(1)
Analysis Methods And Descriptive Statistics For The Registry Data
159(1)
Analysis Methods And Interpretation Of Registry Exposure Data
160(1)
Analysis Methods And Interpretation Of Registry Health Outcomes Data
160(2)
Other Findings, Conclusions, And Recommendations
162(2)
Closing Observations
164(1)
References
164(1)
APPENDIXES
A Public Law 112-260
165(4)
B Workshop Agenda
169(2)
C Airborne Hazards and Open Bum Pit Registry Self-Assessment Questionnaire
171(32)
D Data Requested
203(18)
E Multivariate Model Results
221(10)
F Biographical Sketched of Committee Members and Staff
231
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