Online Program

Assessing Environmental Exposures Associated with Open Pit Burning in Deployed U.S. Service Members

Monday, November 2, 2015

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: Deployment environmental exposures may pose long-term health risks for US Service Members. Breathing zone air sampling data is usually not collected because of logistical problems related to collection in a war zone. We attempted to validate metabolomics and inflammatory biomarkers in serum as surrogates of exposure because breathing zone samples are rarely available. Chemicals identified adjacent to burn pits in Iraq and Afghanistan and responses to chemical exposures were studied in stored sera of deployed forces.

Methods: The study utilized serum from the DoD Serum Repository and medical encounter data from the Defense Medical Surveillance System. Pre- and post-deployment stored sera from 200 exposed Service Members deployed to Balad, Iraq, and Bagram, Afghanistan, and sera from 200 Service Members who never deployed were studied and compared. Serum samples were analyzed for differences in environmental chemicals and inflammatory and metabolomics biomarkers. Results were linked to medical encounter data to identify adverse health effects. 

Results: Serum sample analyses detected inflammatory biomarkers, micro-RNAs, dioxins, polycyclic aromatic hydrocarbons (PAHs) and a Benzo(a)Pyrene altered metabolic pathway.  Burn pit air sampling data and serum biomarker levels were related.  Among the exposed, cardiovascular inflammatory markers decreased, micro-RNA levels were altered in response to PAH levels and the Benzo(a)Pyrene metabolic pathway intermediates were altered. Serum cotinine levels were used to adjust for smoking.

Discussion: This study described the association of serum biomarkers with breathing zone air sampling data to assess the utility of serum biomarkers as surrogates for air sampling data in the future.  In the absence of breathing zone air sampling data, biomarkers may permit researchers to assess health risks of environmental exposure(s) and long-term health outcome(s), such as respiratory illness and cancers.  

Learning Areas:

Basic medical science applied in public health
Environmental health sciences
Occupational health and safety
Public health or related organizational policy, standards, or other guidelines
Public health or related research

Learning Objectives:
Describe the utility of sera as surrogates to assess environmental exposures. Identify differences in environmental chemicals and inflammatory and metabolomics biomarkers. Demonstrate the impact of altered metabolic pathways on respiratory and cancer outcomes.

Keyword(s): Environmental Health, Air Pollution & Respiratory Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked in the US Air Force as a public health officer for the past 13 years and managed community health and deployment medicine programs. Some of my research focused on respiratory health outcomes after burn pit exposure and in areas with low air quality.
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.