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Newly Reported Lupus and Rheumatoid Arthritis in Relation to Deployment Within Proximity to a Documented Open-Air Burn Pit in Iraq

Jones, Kelly A. MPH; Smith, Besa MPH, PhD; Granado, Nisara S. MPH, PhD; Boyko, Edward J. MD, MPH; Gackstetter, Gary D. DVM, PhD, MPH; Ryan, Margaret A.K. MD, MPH; Phillips, Christopher J. MD, MPH; Smith, Tyler C. MS, PhD

Section Editor(s): Teichman, Ron MD, MPH; Guest Editor

for the Millennium Cohort Study Team

Journal of Occupational and Environmental Medicine: June 2012 - Volume 54 - Issue 6 - p 698–707
doi: 10.1097/JOM.0b013e3182529799
Original Articles

Objective: To assess the relationship between possible exposure to smoke from documented open-air burn pits and newly reported lupus and rheumatoid arthritis among Millennium Cohort participants who have deployed in support of operations in Iraq and Afghanistan.

Methods: Prospectively assessed self-reported lupus and rheumatoid arthritis among deployers who completed both 2004–2006 and 2007–2008 questionnaires.

Results: After exclusions, more than 18,000 participants were deployed, including more than 3000 participants deployed within a 3-mile radius of a documented burn pit. After adjustment, proximity within 3 miles of a burn pit was not significantly associated with rheumatoid arthritis or lupus in general; however, one location was associated with lupus, although few cases were at this site (n = 2).

Conclusions: Results indicate deployers potentially exposed to documented burn pits in the combined three-camp analysis were not at an elevated risk of lupus or rheumatoid arthritis.

From the Department of Deployment Health Research (Ms Jones, and Drs T. Smith, B. Smith, Granado, and Phillips), Naval Health Research Center, San Diego, Calif; Seattle Epidemiologic Research and Information Center (Dr Boyko), Department of Veterans Affairs Puget Sound Health Care System, Seattle, Wash; Analytic Services, Inc. (ANSER) (Dr Gackstetter), Arlington, Va; Occupational Health Department (Dr Ryan), Naval Hospital Camp Pendleton, Camp Pendleton, Calif; and Department of Community Health (Dr T Smith), School of Health and Human Services, National University, La Jolla, Calif.

Address correspondence to: Kelly A. Jones, MPH, Naval Health Research Center, Deployment Health Research - Dept 164, 140 Sylvester Road, San Diego, CA 92106 (

This research represents Naval Health Research Center report 11–39, supported by the Department of Defense, under work unit no. 60002. Support for this work was provided by the Military Operational Medicine Research Program (MOMRP), a program of the US Army. VA Puget Sound Health Care System provided support for Dr. Boyko's participation in this research.

The content and views expressed in this publication are the sole responsibilities of the authors and do not necessarily reflect the views or policies of the Department of Defense or the Departments of the Army, Navy, Air Force, Department of Veterans Affairs, or the US Government. Mention of trade names, commercial products, or organizations does not imply endorsement by the US Government.

The authors acknowledge that research protocol (“Prospective Studies of US Military Forces: The Millennium Cohort Study”, NHRC.2000.0007) received applicable institutional review board review and approval. We certify that all individuals who qualify as authors have been listed; each has participated in the conception and design of this work, the analysis of data, the writing of the document, and the approval of the submission of this version; that the document represents valid work; that if we used information derived from another source, we obtained all necessary approvals to use it and made appropriate acknowledgements in the document; and that each takes public responsibility for it. Nothing in the presentation implies any Federal/DOD/DON endorsement.

In addition to the authors, the Millennium Cohort Study Team includes Paul J. Amoroso, Gregory C. Gray, Tomoko I. Hooper, Michelle Linfesty, James R. Riddle, Sheila Medina-Torne, and Timothy Wells.

The authors have no financial interest in this work.

©2012The American College of Occupational and Environmental Medicine