Our Veterans face 40% All Cause Mortality, and 80% increase in lung cancer risk for deploying to Afghanistan and Iraq

   If you have not already, please pick up a copy of The Hardest Place. The following is not taken from the book nor discussed. However, this book is heralded as the gold standard for what has been taken place in our battles there, and what our men and women have had to overcome and face.

The following was done as part of my research into the Health Related Quality of Life of our Veterans.

The events of September 11th, 2001 have had a great impact on the social determinants of health for over 2.7 Million Veteran Americans due to climate change as well as the toll of combat deployments (Wenger et al. 2018). This great impact did not happen on U.S. Soil. It has taken place over the last 18 years in two specific regions, with the worst air pollution and heat stress imaginable and without proper adaptive measures; Iraq and Afghanistan. In Baghdad, Ar-Ramadi, Al Taqqadum, and Al Fallujah Iraq as well as Peshawar, Jalabad, Kabul, and Kandahar Afghanistan; the mean PM 2.5 (μg/m3) is the highest that can be recorded at over 110 PM 2.5(μg/m3). https://maps.who.int/airpollution/. These are the key areas where the conflicts of the past 18 years have taken place. The World Health Organization details these levels as being 4 times what is considered appropriate. PM2.5 references particulate matter in the air we breathe. The particulate is so fine it is 2.5 microns or less, less than the thickness of a human hair. It stays aloft in the air longer and is much easier to affect the human respiratory and cardiovascular system (Nayebare et al. 2018). A 16 year long-term study was conducted in the United States to assess the effect of PM 2.5(μg/m3). The PM 2.5 Measure starts at 10 (μg/m3) and goes up to 110. For every 10 (μg/m3) the PM 2.5 level increases, there is a direct correlation to increased risk of all-cause, cardiopulmonary, and lung cancer mortality by 4%, 6%, and 8% respectively for those exposed.

The average deployment is one year for military members. As stated prior, 2.7 Million service members have been deployed but the total number of deployments is 5.4 Million, meaning the average service member deploys multiple times equaling almost two years. Over 600,000 members of our armed forces have up to three or more deployments (Wenger et al. 2018). In Iraq and Afghanistan, where the silicate sand is like baby powder, the breathable air holds known pollutants like black carbon; nitrogen dioxide (NO2), carbon-monoxide (CO), sulfur dioxide (SO2), ozone (O3), methane (CH4), volatile organic compounds (VOCs) and hydrocarbons (HCs) (Nayebare et al 2018). In these areas with 110 PM 2.5(μg/m3) those mortality numbers translate to over 40%, 60%, and 80% respectively, for increased risk in cancer (Pope et al. 2002).  

What does this mean? In Kabul with a PM 2.5 recorded at 110...you increase your risk of death by all causes of disease by 40%, You increase your risk of Heart Disease and other Coronary issues by 60%, and you increase your chance of lung cancer by 80% for every year you spend in this environment. Let that sink in. Gotta love those burn pits.

Those veterans still had to do their jobs, run operations, conduct physical fitness, and training on a weekly basis. Our bodies and minds are linked and the climate effects the way you make decisions even in the best of circumstances. Your ability to think and reason clearly drops just during a short heatwave in the United States (Cedeno et al. 2018). How many injuries, casualties, or simply wrong turns were made due to poor decisions as a result of the climate in Iraq and Afghanistan? Now, we have a large amount of our brothers and sisters that have come from low income backgrounds faced with the high possibility of cancer due to exposure. There has been much recent discussion concerning who will pay for the health of those exposed to dangerous particulate. Who will pay? The impact of a one, two, or three year exposure at 110 PM 2.5(μg/m3) is not yet known. But one must ask, given the information, what will the health outcomes be for our millennial Veterans?

References:

Cedeno Laurent JG, Williams A, Oulhote Y, Zanobetti A, Allen JG, Spengler JD. Reduced cognitive function during a heat wave among residents of non-air-conditioned buildings: An observational study of young adults in the summer of 2016. PLoS Med. 2018;15(7):e1002605. doi: 10.1371/journal.pmed.1002605 [doi].

Lutz, Amy. 2008. “Who Joins the Military?: A Look at Race, Class, and Immigration Status.” Journal of Political and Military Sociology 36 (2): 167-188. This was published through Syracuse University, department of Sociology. Syracuse is highly ranked in its Veteran and Military focused education platforms and programs. It is a highly regarded institution in terms of studying and supporting those who served.

Nayebare SR, Aburizaiza OS, Siddique A, et al. Ambient air quality in the holy city of Makkah: A source apportionment with elemental enrichment factors (EFs) and factor analysis (PMF). Environmental Pollution. 2018;243:1791-801. https://www.sciencedirect.com.proxy1.library.jhu.edu/science/article/pii/S0269749118317615. doi: //doi-org.proxy1.library.jhu.edu/10.1016/j.envpol.2018.09.086.

Pope CA, Burnett RT, Thun MJ, et al. Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. JAMA. 2002;287(9):1132-1141. doi: joc11435 [pii]. This was a comprehensive long-term study on the effects of air pollution on U.S. Populations. The Journal of the American Medical Association ‘JAMA’ is a highly regarded peer reviewed journal.

Wenger, Jennie W., Caolionn O'Connell, and Linda Cottrell, Examination of Recent Deployment Experience Across the Services and Components. Santa Monica, CA: RAND Corporation, 2018. https://www.rand.org/pubs/research_reports/RR1928.html. This research was sponsored by the Office of the Deputy Chief of Staff, G-8, Army Quadrennial Defense Review Office, and conducted by the Personnel, Training, and Health Program within the RAND Arroyo Center. The RAND Corporation is a nonprofit institution that helps improve policy and decision making through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.

https://maps.who.int/airpollution/ Accessed 7/27/2019. Measuring PM 2.5(μg/m3) rate per geographical location, World Health Organizations.

https://youtu.be/HT5FTrIZN-E: Accessed 7/26/2019. Testimony of 9/11 First Responders by Jon Stewart. United States Congressional Hearing on Funding Healthcare Costs for disease and illness related to inhaling dangerous acute particulate.