Online Program

Using Metabolomics, Exposure Biomarkers, and Health Outcomes to Assess Environmental Toxin Exposure in Deployed Service Members

Monday, November 2, 2015 : 9:26 a.m. - 9:40 a.m.

Patricia Rohrbeck, DrPH, MPH, CPH, Division of Epidemiology & Analysis, Armed Forces Health Surveillance Center, Silver Spring, MD
Kevin Haines, MS, Division of Integrated Biosurveillance, Armed Forces Health Surveillance Center, Silver Spring, MD
Timothy Mallon, MD, MPH, FACOEM, Department of Preventive Medicine and Biometrics, Uniformed Services University, Bethesda, MD
Background: Environmental exposures during deployments pose health risks to U.S. service members. This study used exposure biomarkers as a surrogate for environmental sampling data. Sera from the DoD Serum Repository were linked to Defense Medical Surveillance System data to identify risk of health outcomes after burn pit exposure(s). 

Methods: There were two cohorts: 1) 200 exposed members deployed to Iraq/Afghanistan, and 2) 200 members who never deployed. Pre- and post-deployment sera in the exposed were matched to the controls. Phase 1 validated the use of sera to detect environmental exposure biomarkers using high-resolution mass spectrometry. Phase 2 compared pre- and post-deployment serum biomarker levels. Phase 3 serum sample results were linked to health outcomes data for the cohorts.

Results:  Serum sample analysis detected cytokines, interleukins, micro-RNA levels, dioxins and PAH protein adducts and altered B(a)P metabolic pathway intermediates.  In phase 2, serum from cases and controls showed similar results for B(a)P metabolism and a strong association between microRNA levels and PAHs.  In phase 3, burn pit air sampling data, serum biomarker levels were linked with health data. Serum cotinine levels were used to adjust for smoking status. Regression analysis was used to identify increased risk for pulmonary and cancer outcomes.

Discussion: The study examined biomarkers as surrogates for environmental data in determining health risk of respiratory illness and cancers due to burn pit emissions. Elucidating the link between burn pit exposures and health outcomes has significant public health policy implications regarding medical treatment and compensation for affected service members.

Learning Areas:

Chronic disease management and prevention
Environmental health sciences
Occupational health and safety
Public health biology
Public health or related research

Learning Objectives:
Describe the procedure for assessing environmental toxin exposure using serum biomarkers. Identify environmental toxin exposures through high-resolution mass spectrometry. Evaluate the utility of serum samples to detect environmental exposure biomarkers.

Keyword(s): Environmental Health, Chemical Exposures & Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a US Air Force public health officer for the past 13 years and have experience in deployment health and environmental monitoring as part of my job. I conducted research on health outcomes after burn pit emissions exposure and air quality in Kabul, Afghanistan.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.