A58-22 Prevalence of Respiratory Diagnoses Within the Redesigned Airborne Hazards and Open Burn Pit Registry

Rationale

Beginning with the 1990-1991 Gulf War and continuing through troop withdrawal from Afghanistan in August of 2021, more than 4.5 million U.S. service members were deployed to Southwest Asia theater of military operations. Many service members deployed to Iraq and Afghanistan, reported respiratory health issues they attribute to airborne hazard exposure, chief among them emissions from open-air burn pits. The US Department of Veterans Affairs (VA) established the Airborne Hazards and Open Burn Pit Registry (AHOBPR) in 2014 to monitor health effects among veterans and service members who were possibly exposed to airborne hazards. The AHOBPR was redesigned in 2024 and expanded to all those deployed to the region. This cohort profile is the first to describe the prevalence of respiratory conditions in a subset of VA users drawn from the redesigned AHOBPR.

Methods

The cohort consists of Veterans enrolled in the redesigned registry. From the 2,814,982 AHOBPR Veterans with a presence in the Electronic Health Records, VA users were identified with at least one outpatient visit in at least two of the last four years (10-01-2021 through 07-31-2025). From this cohort, 155,461,724 unique diagnostic events were extracted from inpatient and outpatient care settings. Each code was classified within the ICD-10 hierarchy (chapter, block, three-character category, full code). Analyses were restricted to respiratory system codes (J00-J99), with each patient counted once per block to estimate diagnosis prevalence across each patient.

Results

The cohort includes (n = 1,766,634) Veterans, with participants who are 86.2% male, 73.9% white and a mean age of 42 years. Respiratory conditions are the most reported, comprising of 39% (n∼689K) of the cohort’s reported conditions. Within the respiratory related ICD-10 subcategories, other diseases of the upper respiratory tract reported highest prevalence (27.3%). This is followed by chronic lower respiratory diseases (10.3%) and acute upper respiratory infections (10.2%) as seen in Table 1. Patients may appear in multiple subcategories, reflecting multimorbidity within respiratory diagnoses.

Conclusion

The redesigned AHOBPR serves as a crucial tool for better understanding the health effects of potential exposures among veterans. Strengths include automatic inclusion criterion based on Department of Defense records and broader participant criteria. This information is instrumental in developing targeted interventions to improve the health outcomes of veterans affected by airborne hazards.

This abstract is funded by: AIMES (Airborne Hazards and Burn Pits Center of Excellence Center for Innovations in Quality, Effectiveness and Safety Military Exposures Surveillance)