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Prospective Assessment of Chronic Multisymptom Illness Reporting Possibly Associated with Open-Air Burn Pit Smoke Exposure in Iraq

Powell, Teresa M. MS; Smith, Tyler C. MS, PhD; Jacobson, Isabel G. MPH; Boyko, Edward J. MD, MPH; Hooper, Tomoko I. MD, MPH; Gackstetter, Gary D. DVM, MPH, PhD; Phillips, Christopher J. MD, MPH; Smith, Besa MPH, 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 682–688
doi: 10.1097/JOM.0b013e318255ba39
Original Articles

Objective: To investigate the relationship between chronic multisymptom illness (CMI) and possible exposure to an open-air burn pit at three selected bases among those deployed to operations in Iraq and Afghanistan.

Methods: Chronic multisymptom illness (reporting at least one symptom in at least two of the following symptom constructs: general fatigue; mood and cognition problems; and musculoskeletal discomfort) was assessed, differentiating by potential burn pit exposure, among deployers who completed 2004 and 2007 Millennium Cohort questionnaires.

Results: More than 21,000 Cohort participants were deployed in support of the current operations, including more than 3000 participants with at least one deployment within a 3-mile radius of a documented burn pit. After adjusting for covariates, no elevated risk of CMI was observed among those exposed.

Conclusions: There was no increase in CMI symptom reporting in those deployed to three selected bases with documented burn pits compared with other deployers.

From the Deployment Health Research Department (Ms Powell, Ms Jacobson, Dr Phillips, Dr B. Smith, Dr T. Smith), 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; Department of Preventive Medicine and Biometrics (Dr Hooper), Uniformed Services University of the Health Sciences (USUHS), Bethesda, Md; and Analytic Services, Inc (ANSER) (Dr Gackstetter), Arlington, Va.

Address correspondence to: Teresa M. Powell, MS, Naval Health Research Center, Deployment Health Research–Dept 164, 140 Sylvester Road, San Diego CA 92106, mail to:

This research represents Naval Health Research Center report 11–36, 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 the resources to support Dr. Boyko's participation in this research.

The content and views expressed in this publication are the sole responsibility of the authors and do not necessarily reflect the views or policies of the Department of Defense or the Departments of the Army, Navy, or 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 manuscript implies any Federal/DOD/DON endorsement.

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

The authors have no financial interest in this work.

©2012The American College of Occupational and Environmental Medicine