The VA action plan for the new registry seems to reflect that broader mission. As announced in the Federal Register, the plan acknowledges “the need for further study of the long-term health effects of exposure to airborne hazards (such as pollution and burn pit emissions) in Iraq and Afghanistan.”

The VA and Department of Defense will work together to assess the long-term health effects related to exposure to burn pit emissions, identify early markers of respiratory disease and develop new cohort studies and adapt ongoing studies such as the Millennium Cohort Study and the National Health Study for a New Generation of U.S. veterans to support burn pit exposure research and “assess potential long-term effects related to burn pit emissions in the context of other ambient exposures.”

The VA notes on its website that Iraq and Afghanistan war veterans “may have been exposed to a range of environmental and chemical hazards that carried potential health risks.” Among the airborne exposures listed are sand, dust and particulates, sulfur fire, burn pits, chromium and infectious diseases.

While Torres and others say they hope to see respiratory illnesses among those who deployed to Iraq and Afghanistan added to the list of presumptive service-related conditions, Sullivan said he fears that the cost associated with presumptive status may suppress research.

“Research on illnesses associated with exposures in Iraq and Afghanistan is happening in a highly volatile political mix. If you say these conditions are deployment related, that leads to a cascade of benefits that have vast financial implications,” he said.

“The research needs to be separated from the political to the extent possible, so we can determine which exposures cause which illnesses, identify ways to stop exposure in the future, invest in protecting those who will be deployed and treat those who have been deployed,” he added. If a critical factor is simply exposure to the dust of Southwest Asia, the medical and financial challenges of treating and protecting forces will be substantial, Sullivan pointed out.

1 King MS, Eisenberg R, Newman JH, Tolle JJ, Harrell FE, et al. Constrictive bronchiolitis in soldiers returning from Iraq and Afghanistan. N Engl J Med. 2011;365:222-230.