Objective:

To examine associations between open burn pit exposure and neurological disorders among U.S. veterans.

Background:

Open burn pit exposure has emerged as a significant environmental hazard among military service members. Prior work has established a dose-dependent association between incident headache and open burn pit exposure. Yet, the relationship between open burn pit exposure and other neurological disorders has not been thoroughly examined. 

Design/Methods:

This retrospective cohort study linked the Airborne Hazards and Open Burn Pit Registry with the Department of Defense (DoD) and the Veterans Health Administration (VHA) electronic health records (EHR) to evaluate potential exposure to open burn pits from April 1, 2014, through October 31, 2022. Veterans with preexisting neurological disorders were excluded. Neurological outcomes were obtained from ICD-9 and ICD-10 codes from the EHR. Separate multivariable logistic regression models were used to determine the association between open burn pit status and neurological disorders, adjusting for sociodemographic characteristics, branch of service, and TBI history. Analyses were exploratory and adjustments for multiple testing were not performed.

Results:

Among 245,124 veterans, 138,214 reported being near an open burn pit and had burn pit-related duties, and had at least one neurological disorder (70.1%), including headache, epilepsy, movement disorders, stroke, neuroinflammatory disorders, neuromuscular disorders, dementia, and vertigo. Most of the sample was under 30 years old (M=27.8, SD= 7.7), male (90.0%), and White non-Hispanic (60.4%). In multivariable analyses, participants who were near an open burn pit with burn pit duties had higher odds of any neurological disorder (OR, 1.37; 95% CI: 1.25-1.49), any headache disorder (OR, 1.58; 95% CI: 1.45-1.73), and other vertigo (OR, 1.26; 95% CI: 1.14-1.41).

Conclusions:

Open burn pit exposure increases the odds of developing common and disabling neurological disorders among veterans. Focused research and continued surveillance on the long-term neurological impact of deployment-related exposures are necessary.