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

  • Formatas: 292 pages
  • Išleidimo metai: 22-Dec-2022
  • Leidėjas: National Academies Press
  • Kalba: eng
  • ISBN-13: 9780309694261
Kitos knygos pagal šią temą:
  • Formatas: 292 pages
  • Išleidimo metai: 22-Dec-2022
  • Leidėjas: National Academies Press
  • Kalba: eng
  • ISBN-13: 9780309694261
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Beginning with the 19901991 Gulf War, more than 3.7 million U.S. service members have been deployed to Southwest Asia, where they have been exposed to a number of airborne hazards, including oil-well fire smoke, emissions from open burn pits, dust and sand, diesel exhaust, and poor-quality ambient air. Many service members, particularly those who served in Iraq and Afghanistan, have reported health problems they attribute to their exposure to emissions from open-air burn pits on military installations.





In 2013, Congress directed the Department of Veterans Affairs (VA) to establish and maintain the Airborne Hazards and Open Burn Pit (AH&OBP) Registry to "ascertain and monitor" the health effects of such exposures. This report serves as a follow-up to an initial assessment of the AH&OBP Registry completed by an independent committee of the National Academies in 2017. This reassessment does not include any strength-of-the-evidence assessments of potential relationships between exposures to burn pits or airborne hazards and health effects. Rather, this report assesses the ability of the registry to fulfill the intended purposes that Congress and VA have specified for it.



Table of Contents



Front Matter Summary 1 Introduction 2 Methods and Approach 3 Airborne Hazards and Open Burn Pit Registry Development and Operations 4 Other Information Sources on Airborne Hazards 5 Use for Etiologic Research 6 Use for Population Health Surveillance 7 Use to Improve Clinical Care 8 Use for Informing VA Policies and Processes 9 Use for Supporting Communications and Outreach 10 Future Use of the AH&OBP Registry Appendix A: Public Law 112-260 Appendix B: Public Meeting Agendas Appendix C: Committee Member and Staff Biographies
Acronyms And Abbreviations xix
Summary 1(10)
Committee's Approach and Overall Recommendations
1(3)
AH&OBP Registry Questionnaire and Data Analysis
4(1)
Use for Etiologic Research
5(1)
Use for Population Health Surveillance
6(1)
Use to Improve Clinical Care
7(1)
Informing VA Policies and Processes
8(1)
Supporting Communications and Outreach
9(1)
Closing Observations
10(1)
1 Introduction
11(10)
National Academies' Reports on Airborne Hazards
13(2)
Legislative Changes to the AH&OBP Registry Since 2017
15(3)
Committee's Statement of Task
18(1)
Organization of the Report
18(2)
References
20(1)
2 Methods And Approach
21(44)
Interpretation of the Statement of Task
21(2)
Information Gathering
23(4)
Considerations of Exposure Registry Data
27(2)
Descriptive Review of AH&OBP Registry Data
29(32)
References
61(4)
3 Airborne Hazards And Open Burn Pit Registry Development And Operations
65(38)
Development
65(7)
Eligibility and Enrollment
72(5)
Annual Maintenance and Costs
77(1)
Indicators of Questionnaire Data Quality
78(17)
Initial Assessment Recommendations
95(4)
Synopsis
99(1)
References
100(3)
4 Other Information Sources On Airborne Hazards
103(30)
VA Exposure Registries
104(4)
World Trade Center Health Registry
108(3)
Individual Longitudinal Exposure Record
111(9)
Epidemiologic Cohorts of Service Members and Veterans
120(6)
Application to the Committee's Statement of Task
126(1)
References
126(7)
5 Use For Etiologic Research
133(32)
Causal Estimation
134(1)
Current Use of AH&OBP Registry Data
134(4)
Characteristics of an Exposure Registry to be Used in Etiologic Research
138(11)
Alternative Sources for Conducting Etiologic Research on Airborne Hazards Exposures
149(6)
Initial Assessment Recommendations
155(3)
Synopsis
158(2)
References
160(5)
6 Use For Population Health Surveillance
165(20)
Definition and Requirements for Effective Public Health Surveillance
165(7)
Current Use of the AH&OBP Registry for Surveillance
172(1)
Assessment of the AH&OBP Registry as a Population Health Surveillance System
173(4)
Alternative Sources for Population Health Surveillance Or Monitoring
177(2)
Synopsis
179(2)
References
181(4)
7 Use To Improve Clinical Care
185(24)
Overview of VA Health Care
186(1)
Use of the AH&OBP Registry to Improve Health Care
186(14)
Approaches to Improve Access to and Use of Health Care Services
200(2)
Initial Assessment Recommendations
202(1)
Synopsis
203(2)
References
205(4)
8 Use For Informing Va Policies And Processes
209(8)
Informing Policy
209(2)
Informing Processes
211(3)
Synopsis
214(1)
References
215(2)
9 Use For Supporting Communications And Outreach
217(22)
Initial Assessment Committee's Findings
218(1)
HOME'S Communication and Outreach Activities
219(3)
Communications and Outreach From VA to Potential Registry Participants
222(2)
Communications and Outreach from VA to Registry Participants
224(1)
Communications and Outreach from VA and DoD to their Health
Care Providers and Other Communicators
225(1)
Communications from Registry Participants to VA
226(2)
Communication and Outreach from VA to Other Stakeholders
228(1)
The World Trade Center Health Registry
228(1)
Initial Assessment Recommendation
229(1)
Synopsis
229(2)
References
231(3)
Annex: Health Outcomes Military Exposures Broad Communications Plan
234(5)
10 Future Use Of The Ah&Obp Registry
239(20)
Use for Etiologic Research
240(2)
Use for Population Health Surveillance
242(2)
Use to Improve Clinical Care
244(2)
Use for Supporting VA Policies and Processes
246(1)
Use for Supporting Communications and Outreach
247(3)
Integrated Assessment of the AH&OBP Registry
250(3)
Final Observations
253(4)
References
257(2)
APPENDIXES
A Public Law 112-260
259(4)
B Public Meeting Agendas
263(4)
C Committee Member and Staff Biographies
267