Public Health
Military Exposures & Your Health - 2024 - Issue 13
In this issue:
- Your Military History: What to Tell Your Health Care Provider
- Diagnostic Testing and Military Environmental Exposures
- VET-HOME: Using Telehealth to Provide Environmental Health Registry Exams
Your Military History: What to Tell Your Health Care Provider
Any time you meet with a health care provider, you have limited time to share information and discuss your health concerns. Sharing your military history during your appointment can help providers address your specific health concerns. Here are some tips on what to tell your provider about your military history.
Share if you were deployed, and where and when you served. Let your provider know if you deployed since not all Veterans did. If you were deployed, you should tell your provider where you served and when. This will help your provider identify what exposures you may have experienced.
For deployed Veterans, your provider may give you a toxic exposure screen to start the conversation about exposures and your health. This screening includes a series of questions that take about 5-10 minutes. This screening is not meant for diagnostic purposes but can address concerns about your health and deployment.
In addition, your provider may suggest that you have an environmental health registry evaluation. Registry evaluations are free assessments offered to Veterans who were deployed to certain countries during specific times. If you’ve already had any environmental health registry exams, let your provider know to avoid being referred to a registry exam that you’ve already undergone. Also, if you’ve already had an exam and have new concerns, sharing those concerns with your provider can help them address them. Registry exams are used for research and are not needed for ongoing care or benefits.
Share where you were stationed for garrison training. You should share the location of your basic training and duty station, as well as the time frame for your training. Based on where and when you trained, you may have been exposed to certain environmental factors that you should be aware of and may want to discuss with your provider.
Share your military occupational specialty (MOS) and your job duties. You may have had certain environmental exposures based not just on your job title but also the kind of day-to-day work you performed while in the military.
Share your non-military work and life history. Your non-military work and life history may reveal possible environmental exposures outside of military service that you may want to talk about during your medical appointment. You should tell your provider about any civilian work experience or home exposures (such as secondhand smoke or hobbies) that might lead to exposures. It may also help your provider to identify any ongoing exposures, for example, if you were a mechanic in the military, and you are still a mechanic.
Keep your providers updated. You will not need to repeat your entire history with every follow-up appointment, but you should keep your provider updated if anything has changed. For example, you should let your provider know if you have changed jobs or if there is something new in your life that may impact your health or create a change in your symptoms. Remember to have recommended screenings and inform your providers about any results.
It important to share your military and exposure experiences not just with your VA health care providers, but also with your civilian health care providers. If a civilian provider needs help addressing specific military concerns, they can refer you to the nearest VA and use VA’s Exposure Ed app. Exposure Ed is a free VA-designed mobile app that assists health care providers with making an informed discussion about a Veteran’s individual exposure-related concerns and potential impacts on their health.
Diagnostic Testing and Military Environmental Exposures
What is Diagnostic Testing?
Diagnostic testing allows health care providers to identify medical problems. Your health care provider may ask you about your work history, deployments, and family medical history to determine if diagnostic testing is appropriate. Diagnostic testing may include things like blood tests, swabs, x-rays, or other procedures.
Can Testing Show If I Have Been Exposed to Toxic Substances?
Most of the time, testing to detect toxic substances is not used for medical care. There are several reasons for this:
- The body eliminates the substance over time. Your kidneys and liver break down toxic substances so they can be eliminated in exhaled breath, urine, or stool. Some substances, like vinyl chloride, are eliminated from the body so quickly that they may not be detected by testing if significant time has passed since the exposure occurred.
- Inability to determine timing and source of exposure. Testing cannot tell when or how you were exposed to a substance. Some chemicals are very common in the environment. For instance, there are thousands of per- and polyfluoroalkyl substances (also known as PFAS or “forever chemicals”) in the environment. While a test for PFAS can detect abnormal levels of PFAS in the body, they cannot determine the timing or source(s) of your PFAS exposure.
- Uncertainty of health impact. Exposure to a toxic substance does not necessarily predict harmful health outcomes. Testing cannot determine whether the exposure will cause harm. Not all smokers get lung cancer, for instance. Factors such as family history and general health also influence the risk of developing health problems.
Can I Be Tested for Presumptive Conditions?
During an environmental health registry evaluation or other health care appointment, you may be concerned about an exposure that you have had and worry that you will get one or more of the presumptive medical conditions for that exposure in the future. It is normal to want to be tested for all possible health conditions.
However, it is important to remember that just because a condition is presumed to be related to an exposure in a certain location at a certain time, it does not mean that you will experience or even be at high risk of getting that condition. It just means that VA will assume that if you do develop the condition, that it was caused by your military service, and you will not be required to prove that relationship to receive VA benefits.
What Are the Pros and Cons of Testing?
Diagnostic testing may lead to finding a medical issue early. Spotting a problem early can lead to disease prevention and treatment. Early treatment can lead to better health outcomes as well as peace of mind for you and your loved ones.
On the other hand, there are some downsides to testing. Some tests use radiation, and certain procedures may cause harm. Occasionally, a test might suggest that you have a condition, when in fact, you do not. This may lead to more unnecessary tests and treatments. Sometimes a medical condition that is not causing any harm may be found. This may lead to unnecessary treatment and worry for you and your family.
How Do I Decide About Being Tested?
The decision to test should be made together by you and your health care provider, based on your individual situation. Factors to consider include family history, environmental exposures, existing health conditions, and guidelines from professional medical groups. Talking with your health care provider is the best place to start.
VET-HOME: Using Telehealth to Provide Environmental Health Registry Exams
Veterans Exposure Team-Health Outcomes Military Exposures (VET-HOME) is a new VA program using telehealth to provide eligible Veterans with an environmental health registry evaluation. Environmental health registry evaluations are free assessments offered to Veterans who were deployed to certain countries during specific times.
Environmental health registry evaluations include an exposure history, in which special attention is paid to any symptoms or abnormalities potentially related to military environmental exposures, and a review of a physical exam is performed. (Note: Registry evaluations are not required for VA disability compensation or other VA benefits.)
VET-HOME clinicians trained in military environmental exposures conduct all VET-HOME telehealth registry evaluations. VET-HOME offers early morning and late afternoon appointments to accommodate Veterans anywhere in the United States or U.S. territories. Additionally, Veterans can choose to receive an in-person evaluation by contacting the environmental health coordinator at their local VA facility.
Initially, VET-HOME's top priority will be completing Airborne Hazards and Open Burn Pit Registry and Ionizing Radiation Registry evaluations, but they will also offer other environmental health registry evaluations starting in 2025 as time and resources permit.
Veterans can schedule an airborne hazards telehealth registry evaluation by contacting the VET-HOME team at 833-633-8846 or online at https://vethome.va.gov.
Learn more about VET-HOME at https://www.publichealth.va.gov/VET-HOME/index.asp.
