Burn Pit Registry: Assisting the VA to Support Veterans

During the post-9/11 wars, open burn pits were used to dispose of waste at military bases in Iraq and Afghanistan. The incineration of large quantities of waste—items that contained such things as medical supplies, paint, plastic bottles, rubber, batteries, human waste, and even entire Humvees—emitted toxic smoke that, if exposed to it, could potentially cause health effects. To better understand the possible effects of exposure to burn pits and airborne hazards during military service, the Department of Veterans Administration (VA) established the Airborne Hazards and Open Burn Pit Registry in 2014.

Since then, studies on burn pit exposures and ways to enhance the registry have been conducted. Westat’s Joseph Gasper, Ph.D., an Associate Director, has served as Project Director on 4 studies focused on the registry and as Co-Investigator of a Brown University study, funded by the Department of Defense (DoD), on the impact of burn pit exposure on veterans’ respiratory and cardiovascular health. Here he discusses the work Westat is doing in this field and how it will help veterans.

Q: How has Westat been involved in efforts to improve the registry over the past several years?

A: In 2015, Westat supported the VA in conducting analysis of the initial data from the registry. We developed a tracking report to profile participants as the registry grows, assessed the quality of the data, and conducted an analysis of the association between burn pit exposure and health outcomes by linking the registry to DoD deployment data and VA health care records. Our analysis was published in the Journal of Occupational and Environmental Medicine: Burn Pit Emissions Exposure and Respiratory and Cardiovascular Conditions Among Airborne Hazards and Open Burn Pit Registry Participants.

Later, we supported the National Academies of Sciences, Engineering, and Medicine (NASEM) in conducting an independent scientific assessment of the registry that was mandated by Congress. We conducted analyses of the registry data for the NASEM committee’s report. Now we are supporting NASEM in conducting a 5-year reassessment of the registry that involves conducting an analysis of the data collected since the initial assessment.

At the same time, we are working with the VA to conduct an evaluation of the registry questionnaire that veterans complete to improve its design.

Q: How will you collect data for the VA study?

A: We convened an expert panel of survey methodologists to provide feedback on the questionnaire. Using cognitive interviews, we will gather input on specific questions that may be prone to measurement error. We will also conduct usability testing to see how veterans’ interact with and gain information from the registry’s website.

Q: As Co-Investigator of the impact study of burn pit exposure on veterans’ health, what are you seeking to learn?

A: This study, which is heading into its 4th year, will significantly advance our understanding of the possible long-term impacts of burn pit exposures on respiratory and cardiovascular health. It involves combining information on potential burn pit exposure based on location and time of deployment to health outcomes among half a million veterans receiving care through the VA. We will be integrating data on deployment history from DoD, its data on burn pit operations and dates for military bases, and medical records from the VA. The methods for linking these data will serve as a model for future studies on the potential long-term health consequences of deployment.

Q: How is Westat uniquely positioned to carry out this work?

A: We have conducted high-profile exposure studies in the past, including our work on Agent Orange in the 1970s, the Camp Lejeune Mortality Study that concerned possible exposure to contaminated drinking water, and the Vietnam Era Health Retrospective Observational Study. We are also a national leader in survey methodology and questionnaire development so we bring both subject matter and methodological expertise to bear on these important studies.

Our work analyzing burn pit exposure data and health outcomes as well as testing survey methods has helped the VA better understand the health needs and concerns of veterans with the ultimate goal of providing better care to veterans.