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Suggested Citation:"Appendix E: Multivariate Model Results." National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press. doi: 10.17226/23677.
×
Suggested Citation:"Appendix E: Multivariate Model Results." National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press. doi: 10.17226/23677.
×

TABLE E-1 Multivariate Model Results of Burn Pit Exposure Variables and Respiratory and Cardiovascular Health Outcomes

Asthma (N = 36,446) Emphysema, Chronic Bronchitis, or COPD (N = 35,383) Any Respiratory Symptoms (N = 39,271) Functional Limitation Due to Lung Problem (N = 37,903)
OR LCL UCL P OR LCL UCL P OR LCL UCL P OR LCL UCL P
Near Burn Pit
Q 2 1.1 1.0 1.2 0.24 1.0 0.9 1.2 0.53 1.2 1.1 1.3 * 1.1 1.0 1.2 *
Q 3 1.2 1.1 1.4 * 1.3 1.1 1.4 * 1.3 1.2 1.5 * 1.2 1.1 1.4 *
Q 4 1.3 1.2 1.6 * 1.5 1.3 1.8 * 1.8 1.6 2.0 * 1.4 1.3 1.6 *
Burn Pit Duty
Q 2 1.3 1.1 1.4 * 1.5 1.3 1.6 * 1.4 1.3 1.5 * 1.2 1.1 1.3 *
Q 3 1.2 1.1 1.3 * 1.3 1.2 1.4 * 1.4 1.3 1.5 * 1.3 1.2 1.4 *
Q 4 1.4 1.2 1.5 * 1.6 1.4 1.7 * 1.8 1.7 2.0 * 1.4 1.3 1.5 *
Smoke Hours
Q 2 1.1 1.0 1.2 0.07 1.3 1.2 1.5 * 1.3 1.2 1.4 * 1.2 1.1 1.3 *
Q 3 1.2 1.1 1.3 * 1.6 1.5 1.8 * 1.7 1.6 1.8 * 1.5 1.4 1.6 *
Q 4 1.5 1.3 1.6 * 2.0 1.8 2.2 * 2.3 2.1 2.4 * 1.9 1.8 2.1 *
Suggested Citation:"Appendix E: Multivariate Model Results." National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press. doi: 10.17226/23677.
×
Hypertension (N = 36,770) CAD, MI, or Angina Pectoris (N = 35,740)
OR LCL UCL P OR LCL UCL P
Near Burn Pit
Q 2 1.0 0.9 1.1 0.74 1.1 0.9 1.4 0.40
Q 3 1.2 1.1 1.3 * 1.3 1.0 1.7 0.04
Q 4 1.2 1.1 1.4 * 1.6 1.2 2.2 *
Burn Pit Duty
Q 2 1.2 1.1 1.3 * 1.3 1.0 1.6 0.02
Q 3 1.1 1.0 1.2 * 1.0 0.8 1.2 1.00
Q 4 1.3 1.2 1.4 * 1.4 1.1 1.7 *
Smoke Hours
Q 2 1.1 1.1 1.2 * 1.3 1.1 1.6 *
Q 3 1.3 1.2 1.4 * 1.4 1.1 1.7 *
Q 4 1.4 1.3 1.5 * 1.8 1.5 2.2 *

NOTES: The first quartile is the reference group. CAD = coronary artery disease; COPD = chronic obstructive pulmonary disease; LCL = lower confidence level; MI = myocardial infarction; OR = odds ratio; P = p-value; Q2 = second quartile; Q3 = third quartile; Q4 = fourth quartile; UCL = upper confidence level.

* Denotes p-value <0.01.

Suggested Citation:"Appendix E: Multivariate Model Results." National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press. doi: 10.17226/23677.
×

TABLE E-2 Model Estimates of Plausible and Implausible Levels of Burn Pit Exposure on Respiratory and Cardiovascular Health Outcomes

Asthma (N = 36,446) Emphysema, Chronic Bronchitis, or COPD (N = 35,383) Any Respiratory Symptoms (N = 39,271) Functional Limitation Due to Lung Problems (N = 37,903)
OR LCL UCL P OR LCL UCL P OR LCL UCL P OR LCL UCL P
Plausible Near Burn Pit
Q 2 1.0 0.9 1.1 0.68 0.9 0.8 1.0 0.20 1.1 1.0 1.2 * 1.0 1.0 1.1 0.26
Q 3 1.0 0.9 1.1 0.64 1.0 0.9 1.1 0.93 1.2 1.1 1.2 * 1.1 1.0 1.2 0.06
Q 4 1.0 0.9 1.1 0.65 0.9 0.8 1.0 0.01 1.3 1.2 1.4 * 1.1 1.0 1.2 0.28
Implausible Near Burn Pit
Q 2 1.0 0.9 1.1 0.51 1.0 1.0 1.1 0.35 1.0 1.0 1.1 0.51 1.1 1.0 1.2 *
Q 3 1.0 1.0 1.1 0.31 1.2 1.1 1.3 * 1.0 0.9 1.0 0.51 1.1 1.0 1.1 0.04
Q 4 1.0 0.9 1.1 0.88 1.1 1.0 1.2 0.18 0.8 0.7 0.9 * 0.9 0.9 1.0 0.17
Plausible Burn Pit Duty
Q 2 1.4 1.2 1.5 * 1.5 1.3 1.6 * 1.4 1.3 1.5 * 1.2 1.1 1.4 *
Q 3 1.2 1.1 1.3 * 1.2 1.1 1.3 * 1.4 1.3 1.5 * 1.2 1.2 1.3 *
Q 4 1.3 1.1 1.4 * 1.4 1.3 1.5 * 1.7 1.6 1.8 * 1.4 1.3 1.5 *
Implausible Burn Pit Duty
Q 2 0.9 0.8 1.0 0.07 1.0 0.9 1.1 0.92 0.9 0.8 0.9 * 0.9 0.9 1.0 0.04
Q 3 0.8 0.8 0.9 * 0.9 0.8 1.0 * 0.7 0.7 0.8 * 0.8 0.7 0.8 *
Q 4 0.8 0.7 0.9 * 0.7 0.6 0.8 * 0.5 0.5 0.6 * 0.7 0.6 0.8 *
Plausible Smoke Hours
Q 2 1.1 1.0 1.2 0.19 1.3 1.2 1.4 * 1.3 1.2 1.4 * 1.2 1.1 1.3 *
Q 3 1.2 1.1 1.3 * 1.6 1.4 1.7 * 1.6 1.5 1.7 * 1.5 1.4 1.6 *
Q 4 1.3 1.2 1.4 * 1.7 1.5 1.9 * 2.1 1.9 2.2 * 1.8 1.6 1.9 *
Suggested Citation:"Appendix E: Multivariate Model Results." National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press. doi: 10.17226/23677.
×
Hypertension (N = 36,770) CAD, MI, or Angina Pectoris (N = 35,740)
OR LCL UCL P OR LCL UCL P
Plausible Near Burn Pit
Q 2 0.8 0.8 0.9 * 0.7 0.6 0.9 *
Q 3 0.9 0.9 1.0 0.13 0.7 0.6 0.9 *
Q 4 0.8 0.8 0.9 * 0.6 0.5 0.8 *
Implausible Near Burn Pit
Q 2 1.0 1.0 1.1 0.37 1.0 0.8 1.2 0.98
Q 3 1.1 1.1 1.2 * 1.3 1.0 1.5 0.02
Q 4 1.2 1.1 1.3 * 1.3 1.1 1.6 0.01
Plausible Burn Pit Duty
Q 2 1.2 1.1 1.3 * 1.3 1.1 1.6 0.01
Q 3 1.0 1.0 1.1 0.31 0.9 0.8 1.1 0.35
Q 4 1.1 1.1 1.2 * 1.1 0.9 1.4 0.21
Implausible Burn Pit Duty
Q 2 1.0 1.0 1.1 0.47 1.0 0.8 1.2 0.94
Q 3 1.0 0.9 1.0 0.28 1.0 0.8 1.2 0.76
Q 4 1.0 0.9 1.0 0.28 0.9 0.7 1.1 0.19
Plausible Smoke Hours
Q 2 1.1 1.0 1.2 0.01 1.3 1.1 1.5 0.01
Q 3 1.2 1.1 1.3 * 1.3 1.1 1.6 *
Q 4 1.3 1.2 1.4 * 1.5 1.2 1.8 *

NOTES: The first quartile is the reference group. CAD = coronary artery disease; COPD = chronic obstructive pulmonary disease; LCL = lower confidence level; MI = myocardial infarction; OR = odds ratio; P = p-value; Q2 = second quartile; Q3 = third quartile; Q4 = fourth quartile; UCL = upper confidence level.

* Denotes p-value <0.01.

Suggested Citation:"Appendix E: Multivariate Model Results." National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press. doi: 10.17226/23677.
×

TABLE E-3 Multivariate Model Results of Respiratory and Cardiovascular Health Outcomes by Exposure Category and Level

Asthma Emphysema, Chronic Bronchitis, or COPD Any Respiratory Symptoms Functional Limitation Due to Lung Problem
OR LCL UCI P OR LCL UCL P OR LCL UCL P OR LCL UCL P
Burn Pits
1 1.1 0.9 1.3 0.31 1.2 1.0 1.5 0.03 1.1 1.0 1.2 0.05 1.1 1.0 1.3 0.07
2 1.3 1.1 1.5 * 1.5 1.2 1.7 * 1.3 1.2 1.4 * 1.4 1.2 1.6 *
3 1.5 1.3 1.7 * 1.6 1.3 1.9 * 1.5 1.4 1.7 * 1.6 1.4 1.8 *
4 1.4 1.2 1.6 * 1.7 1.4 2.0 * 1.5 1.4 1.7 * 1.4 1.3 1.6 *
5 1.5 1.3 1.8 * 2.1 1.8 2.4 * 2.0 1.8 2.2 * 1.8 1.6 2.0 *
6 1.8 1.6 2.1 * 2.5 2.1 2.9 * 2.8 2.5 3.0 * 2.3 2.0 2.5 *
Diesel/Exhaust/Fuel
1 1.2 1.1 1.4 * 1.2 1.1 1.4 * 1.2 1.1 1.3 * 1.1 1.0 1.3 0.01
2 1.3 1.2 1.5 * 1.5 1.3 1.7 * 1.4 1.3 1.5 * 1.2 1.1 1.3 *
3 1.4 1.2 1.6 * 1.5 1.3 1.7 * 1.7 1.5 1.8 * 1.4 1.3 1.6 *
4 1.5 1.3 1.7 * 1.6 1.4 1.8 * 1.8 1.6 2.0 * 1.5 1.4 1.7 *
5 1.6 1.4 1.9 * 2.0 1.7 2.3 * 2.2 2.0 2.5 * 1.7 1.5 1.9 *
6 1.6 1.4 1.9 * 2.1 1.8 2.5 * 2.4 2.1 2.8 * 1.8 1.6 2.0 *
Suggested Citation:"Appendix E: Multivariate Model Results." National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press. doi: 10.17226/23677.
×
Construction
3 1.1 1.0 1.2 0.05 1.3 1.2 1.4 * 1.4 1.3 1.5 * 1.2 1.2 1.3 *
6 1.3 1.2 1.4 * 1.5 1.4 1.6 * 1.7 1.6 1.8 * 1.4 1.3 1.5 *
Dust
1 1.1 0.9 1.3 0.64 0.9 0.8 1.1 0.51 1.1 1.0 1.3 0.09 1.1 0.9 1.2 0.48
2 1.1 0.9 1.4 0.19 1.1 0.9 1.4 0.19 1.3 1.2 1.5 * 1.2 1.0 1.4 0.01
3 1.3 1.1 1.6 * 1.4 1.2 1.7 * 1.7 1.5 1.9 * 1.4 1.2 1.7 *
4 1.4 1.2 1.7 * 1.7 1.4 2.0 * 2.0 1.8 2.3 * 1.6 1.4 1.9 *
5 1.6 1.3 2.0 * 1.9 1.5 2.3 * 2.6 2.3 3.0 * 1.9 1.6 2.2 *
6 1.8 1.4 2.2 * 2.5 2.0 3.1 * 3.2 2.7 3.8 * 2.3 1.9 2.7 *
Combat
1 1.1 0.9 1.4 0.27 1.2 0.9 1.4 0.20 1.0 0.8 1.1 0.49 1.1 0.9 1.3 0.22
2 1.4 1.2 1.6 * 1.7 1.5 2.0 * 1.5 1.3 1.6 * 1.4 1.2 1.5 *
3 1.4 1.2 1.6 * 1.6 1.4 1.9 * 1.5 1.4 1.7 * 1.4 1.3 1.6 *
4 1.6 1.4 1.8 * 2.0 1.8 2.4 * 1.8 1.7 2.0 * 1.5 1.4 1.7 *
5 1.7 1.5 2.0 * 2.4 2.0 2.7 * 2.1 1.9 2.3 * 1.8 1.7 2.0 *
1.9 1.7 2.2 * 2.9 2.5 3.3 * 2.8 2.5 3.1 * 2.1 1.9 2.4 *
Suggested Citation:"Appendix E: Multivariate Model Results." National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press. doi: 10.17226/23677.
×
Hypertension CAD, MI, or Angina Pectoris
OR LCL UCL P OR LCL UCL P
Burn Pits
1 1.1 1.0 1.2 0.25 1.0 0.7 1.5 0.89
2 1.2 1.1 1.4 * 1.1 0.8 1.6 0.48
3 1.2 1.1 1.4 * 1.0 0.7 1.4 1.00
4 1.3 1.1 1.4 * 1.4 1.0 1.9 0.07
5 1.4 1.2 1.5 * 1.4 1.0 1.9 0.05
6 1.6 1.4 1.8 * 1.8 1.3 2.4 *
Diesel/Exhaust/Fuel
1 1.1 1.0 1.2 0.01 1.5 1.1 2.0 *
2 1.2 1.1 1.3 * 1.7 1.3 2.3 *
3 1.3 1.2 1.4 * 1.9 1.4 2.5 *
4 1.2 1.1 1.3 * 1.4 1.0 1.9 0.03
5 1.4 1.3 1.6 * 2.1 1.5 2.9 *
6 1.6 1.4 1.8 * 2.5 1.7 3.5 *
Suggested Citation:"Appendix E: Multivariate Model Results." National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press. doi: 10.17226/23677.
×
Construction
3 1.2 1.0 1.4 0.04 1.2 1.0 1.4 0.04
6 1.6 1.3 1.9 * 1.6 1.3 1.9 *
Dust
1 0.9 0.8 1.1 0.31 1.0 0.6 1.5 0.92
2 1.1 1.0 1.2 0.21 1.2 0.8 1.8 0.42
3 1.2 1.1 1.4 * 1.4 0.9 2.2 0.11
4 1.3 1.2 1.5 * 1.5 1.0 2.3 0.05
5 1.4 1.2 1.7 * 2.0 1.3 3.1 *
6 1.7 1.4 2.0 * 2.3 1.5 3.7 *
Combat
1 1.1 1.0 1.3 0.17 1.4 0.9 2.2 0.10
2 1.3 1.2 1.4 * 1.3 0.9 1.7 0.11
3 1.3 1.1 1.4 * 1.6 1.1 2.3 0.01
4 1.5 1.3 1.6 * 1.8 1.3 2.4 *
5 1.6 1.5 1.8 * 2.0 1.4 2.6 *
6 1.7 1.6 1.9 * 2.1 1.5 2.8 *

NOTES: The unexposed group is the reference group. CAD = coronary artery disease; COPD = chronic obstructive pulmonary disease; LCL = lower confidence limit; MI = myocardial infarction; OR = odds ratio; P = p-value; UCL = upper confidence limit.

* Denotes p-value <0.01.

Suggested Citation:"Appendix E: Multivariate Model Results." National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press. doi: 10.17226/23677.
×

TABLE E-4 Multivariate Model Results of Composite Exposure Potential Measure and Respiratory and Cardiovascular Health Outcomes

Composite Exposure Asthma (N = 36,446) Emphysema, Chronic Bronchitis or COPD (N = 35,383) Any Respiratory Symptoms (N = 39,271) Functional Limitation Due to Lung Problem (N = 37,903)
OR LCL UCL P OR LCL UCL P OR LCL UCL P OR LCL UCL P
Q 2 1.2 1.1 1.3 * 1.4 1.2 1.5 * 1.4 1.3 1.5 * 1.3 1.2 1.4 *
Q 3 1.5 1.4 1.6 * 1.7 1.6 1.9 * 1.9 1.7 2.0 * 1.5 1.4 1.7 *
Q 4 1.7 1.5 1.8 * 2.3 2.1 2.6 * 2.7 2.5 2.9 * 2.0 1.8 2.1 *

Composite Exposure Hypertension (N = 36,770) CAD, MI, or Angina Pectoris (N = 35,740)
OR LCL UCL P OR LCL UCL P
Q 2 1.2 1.1 1.3 * 1.2 1.0 1.6 0.07
Q 3 1.4 1.3 1.5 * 1.5 1.3 1.9 *
Q 4 1.7 1.6 1.8 * 2.1 1.7 2.6 *

NOTES: The first quartile is the reference group. CAD = coronary artery disease; COPD = chronic obstructive pulmonary disease; LCL = lower confidence level; MI = myocardial infarction; OR = odds ratio; P = p-value; Q2 = second quartile; Q3 = third quartile; Q4 = fourth quartile; UCL = upper confidence level.

* Denotes p-value <0.01.

Suggested Citation:"Appendix E: Multivariate Model Results." National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press. doi: 10.17226/23677.
×
Page 221
Suggested Citation:"Appendix E: Multivariate Model Results." National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press. doi: 10.17226/23677.
×
Page 222
Suggested Citation:"Appendix E: Multivariate Model Results." National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press. doi: 10.17226/23677.
×
Page 223
Suggested Citation:"Appendix E: Multivariate Model Results." National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press. doi: 10.17226/23677.
×
Page 224
Suggested Citation:"Appendix E: Multivariate Model Results." National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press. doi: 10.17226/23677.
×
Page 225
Suggested Citation:"Appendix E: Multivariate Model Results." National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press. doi: 10.17226/23677.
×
Page 226
Suggested Citation:"Appendix E: Multivariate Model Results." National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press. doi: 10.17226/23677.
×
Page 227
Suggested Citation:"Appendix E: Multivariate Model Results." National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press. doi: 10.17226/23677.
×
Page 228
Suggested Citation:"Appendix E: Multivariate Model Results." National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press. doi: 10.17226/23677.
×
Page 229
Suggested Citation:"Appendix E: Multivariate Model Results." National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press. doi: 10.17226/23677.
×
Page 230
Next: Appendix F: Biographical Sketches of Committee Members and Staff »
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Military operations produce a great deal of trash in an environment where standard waste management practices may be subordinated to more pressing concerns. As a result, ground forces have long relied on incineration in open-air pits as a means of getting rid of refuse. Concerns over possible adverse effects of exposure to smoke from trash burning in the theater were first expressed in the wake of the 1990–1991 Gulf War and stimulated a series of studies that indicated that exposures to smoke from oil-well fires and from other combustion sources, including waste burning, were stressors for troops. In January 2013, Congress directed the Department of Veterans Affairs (VA) to establish and maintain a registry for service members who may have been exposed to toxic airborne chemicals and fumes generated by open burn pits.

Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry analyzes the initial months of data collected by the registry and offers recommendations on ways to improve the instrument and best use the information it collects. This report assesses the effectiveness of the VA’s information gathering efforts and provides recommendations for addressing the future medical needs of the affected groups, and provides recommendations on collecting, maintaining, and monitoring information collected by the VA’s Airborne Hazards and Open Burn Pit Registry.

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