Bello Anila, Savitz David A, Rennix Christopher, Jiang Lan, Trivedi Amal N, Wellenius Gregory A, Woskie Susan R
Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, 61 Wilder Street, O'Leary Library, Suite 540D, Lowell, MA, 01854, USA.
Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
Environ Health. 2025 Jul 1;24(1):40. doi: 10.1186/s12940-025-01195-2.
Open-air burning was a prevalent waste management method at many U.S. military bases during the wars in Afghanistan and Iraq. Past studies of the health impacts of burn pit exposure have relied on exposure assessments that did not account for waste segregation practices introduced in the later years of the wars, such as removing hazardous and medical waste before open burning and the use of incinerators.
We developed a refined exposure assessment that accounts for waste management practices on military bases and evaluated the impact of waste segregation and incineration on cardiovascular and respiratory health outcomes among veterans deployed during these conflicts.
The study cohort consisted of 459,381 Army and Air Force veterans who were deployed between 2005 and 2011 and received health care through the Veterans Health Administration (VHA) after deployment. The 109 most populated military bases in Afghanistan and Iraq were classified into four waste disposal categories by year: unsegregated, segregated, incineration, and no burning or incineration. Individual exposure was defined as the total number of days spent at bases based on the Department of Defense deployment histories. Health outcomes were determined through VHA healthcare records, from the end of deployment through the end of follow-up in 2020. Logistic regression was performed to investigate the association between deployment to bases with varying waste management practices and the risk of respiratory and cardiovascular diseases.
Deployment to bases using burn pits with unsegregated waste was associated with elevated risks of hypertension and asthma, whereas deployment to bases that segregated waste or used incinerators was not. Prolonged deployment (highest duration tertile of > 240 days) to bases with unsegregated waste burning was associated with a 16% higher risk of hypertension (aOR 1.16, 95% CI 1.13-1.19) compared to those never stationed at such bases. There was a clear deployment duration-response association for hypertension, but this was not observed for asthma.
The observed increased risk of hypertension and asthma among military veterans deployed to bases that used open burning of unsegregated waste - but not among those deployed to bases that segregated waste or used incinerators - highlights the importance of considering waste management methods in future studies examining the health effects of burn pit exposures among military veterans.
在阿富汗和伊拉克战争期间，露天焚烧是美国许多军事基地普遍采用的废物管理方法。过去关于接触燃烧坑对健康影响的研究依赖于暴露评估，这些评估没有考虑到战争后期引入的废物分类做法，例如在露天焚烧前清除危险和医疗废物以及使用焚化炉。
我们开发了一种精细的暴露评估方法，该方法考虑了军事基地的废物管理做法，并评估了废物分类和焚烧对这些冲突期间部署的退伍军人心血管和呼吸系统健康结果的影响。
研究队列包括459381名陆军和空军退伍军人，他们在2005年至2011年期间被部署，并在部署后通过退伍军人健康管理局（VHA）接受医疗保健。阿富汗和伊拉克人口最多的109个军事基地按年份分为四类废物处理类别：未分类、分类、焚烧以及无燃烧或焚烧。根据国防部的部署历史，将个人暴露定义为在基地度过的总天数。通过VHA医疗记录确定健康结果，从部署结束到2020年随访结束。进行逻辑回归以研究部署到具有不同废物管理做法的基地与呼吸道和心血管疾病风险之间的关联。
部署到使用未分类废物的燃烧坑的基地与高血压和哮喘风险升高相关，而部署到进行废物分类或使用焚化炉的基地则不然。与从未驻扎在此类基地的人相比，长时间（最长持续时间三分位数>240天）部署到进行未分类废物焚烧的基地与高血压风险高16%相关（调整后比值比1.16，95%置信区间1.13 - 1.19）。高血压存在明显的部署持续时间 - 反应关联，但哮喘未观察到这种关联。
在部署到使用未分类废物露天焚烧的基地的军事退伍军人中观察到高血压和哮喘风险增加，但在部署到进行废物分类或使用焚化炉的基地的退伍军人中未观察到，这凸显了在未来研究军事退伍军人接触燃烧坑对健康影响时考虑废物管理方法的重要性。
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