Hoover Christian, Trivedi Amal N, Bello Anila, Culpepper William J, Gasper Joseph, Gaither Rachel, Jiang Lan, Rennix Christopher, Schneiderman Aaron, Wellenius Gregory A, Woskie Susan R, Savitz David A
Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
Harvard TH Chan School of Public Health, Boston, Massachusetts, USA.
Occup Environ Med. 2025 Feb 12;81(12):632-634. doi: 10.1136/oemed-2024-109704.
Five million US Veterans had possible exposure to open burn pits used for waste disposal through service in Iraq (2003-2011) and Afghanistan (2001-2014). Burn pits generate toxic exposures that may be associated with adverse health outcomes. We examined all-cause and cause-specific mortality in relation to deployment to bases with open burn pits.
We analysed a cohort of 474 634 Veterans who received some healthcare from the Veterans Health Administration, linked to Department of Defense deployment records to identify assignments to bases with burn pits. In multivariable logistic regression models, we assessed the association between duration of deployment to bases with burn pits and all-cause mortality and cause-specific mortality from the six most common causes among this population of Veterans.
Duration of deployment to bases with burn pits was modestly related to all-cause mortality, with adjusted ORs of 1.07 (95% CI 0.99 to 1.15), 1.08 (95% CI 1.00 to 1.16) and 1.16 (95% CI 1.06 to 1.27) across tertiles, but not associated with mortality due to cancer, heart disease or chronic liver disease/cirrhosis. Positive associations were also found for unintentional injuries, suicide and stroke.
These data are suggestive of an association between duration of deployment to bases with burn pits and overall mortality, but not from cancer or heart disease. Unexpected associations with injury and suicide call for a more detailed evaluation. Conclusions are restricted by the broad aggregations of causes of death, a limited number of deaths in this relatively young cohort and the lack of more detailed information on exposure to burn pits.
500万美国退伍军人在2003年至2011年于伊拉克及2001年至2014年于阿富汗服役期间，可能接触过用于废物处理的露天焚烧坑。焚烧坑会产生有毒暴露，可能与不良健康后果相关。我们研究了与部署到设有露天焚烧坑的基地相关的全因死亡率和特定原因死亡率。
我们分析了一组474634名从退伍军人健康管理局接受过某种医疗保健服务的退伍军人队列，并与国防部部署记录相链接，以确定被分配到设有焚烧坑基地的情况。在多变量逻辑回归模型中，我们评估了在设有焚烧坑的基地的部署时长与该退伍军人人群中六种最常见原因导致的全因死亡率和特定原因死亡率之间的关联。
在设有焚烧坑的基地的部署时长与全因死亡率有适度关联，三分位数的调整后比值比分别为1.07（95%置信区间0.99至1.15）、1.08（95%置信区间1.00至1.16）和1.16（95%置信区间1.06至1.27），但与癌症、心脏病或慢性肝病/肝硬化导致的死亡率无关。还发现与意外伤害、自杀和中风存在正相关。
这些数据表明在设有焚烧坑的基地的部署时长与总体死亡率之间存在关联，但与癌症或心脏病无关。与伤害和自杀的意外关联需要更详细的评估。结论受到死亡原因的广泛汇总、这个相对年轻队列中死亡人数有限以及缺乏关于接触焚烧坑更详细信息的限制。
