The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #65568

Andrew E Lincoln, ScD, MS¹, Matthew J McAtee, BA², Aaron I. Schneiderman, PhD, RN¹, and Han K Kang, DrPH¹. (1) War-Related Illness & Injury Study Center (WRIISC), U.S. Department of Veterans Affairs, 50 Irving Street, NW (MS 11), Washington, DC 20422, 202-745-8000 X6207, Andrew.Lincoln@med.va.gov, (2) Directorate of Health Risk Management, US Army Center for Health Promotion and Preventive Medicine, 5158 Blackhawk Road, Aberdeen Proving Ground, MD 21010

Objective Of The Project: The primary objective of the Study of Health Outcomes & Environmental Surveillance (SHOES) in Bosnia/Kosovo is to develop a prototypical data repository linking environmental exposures data, troop location data, military service records, and DoD & VA healthcare utilization records to answer research questions about the health effects of recent peacekeeping operations on veterans. This will be one of the first large-scale studies of a veteran cohort to combine advancements in environmental exposure assessment, geographic information systems (GIS), and health and illness experience to investigate the short-term and long-term effects of the environment during deployment on armed forces personnel.

Research Plan: An historic cohort study of over 60,000 veterans from the Bosnia/Kosovo operations who are no longer on active duty will be followed to assess their healthcare utilization within DoD and VA systems. This study will assess health risks associated with having participated in Operations Joint Endeavor and Joint Guardian by comparing the cause-specific morbidity and mortality of Bosnia/Kosovo participants to that of nondeployed veteran controls.

Methodology: Data include demographics, deployment history, immunizations, and inpatient hospitalizations and outpatient visits. Environmental surveillance data for the base camps include more than 3400 air, water, and soil samples. Troop tracking data has been added to identify the basecamps where personnel were stationed to enable more detailed exposure assessments. Analyses of exposure effects include hierarchical models with Bayesian and GIS-based methods used to perform uncertainty and sensitivity analyses of misclassification (exposure/outcome) and confounding.

Learning Objectives:

• At the conclusion of the session, the participant (learner) in this session will be able to:
• 1. Identify key elements of a prototypical data repository to answer research questions about the health effects of recent peacekeeping operations on veterans.
• 2. Appreciate the range of environmental pollutants experienced by veterans of the Bosnia/Kosovo peacekeeping operations and any associations with short- and long-term health effects.
• 3. Recognize the capability of SHOES to explore topical health issues and validate the consistency of health effects experienced by Bosnia/Kosovo veterans with those of veterans from other recent military campaigns.

Keywords: Veterans' Health, Environmental Exposures

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.