According to a recent report by a private, non-profit institute, a Department of Veterans Affairs registry used to track hearth disease and help obtain treatment for sick veterans uses questionnaires that are too difficult to answer and that render it useless for research on toxic exposure.
“The health issues faced by the many veterans deployed to South West Asia deserve sustained and rigorous attention and must be addressed, but the [VA’s] Airborne hazards and the open burn registry are not the right mechanism to meet all needs,” said David Savitz, professor of epidemiology at Brown University School of Public Health and chair of the committee that wrote the report.
The report from the National Academies of Sciences, Engineering and Medicine – dubbed “Reassessment of the Veterans Affairs Department’s Airborne Hazards and Open Pit Registry” – found that the registry in its current version could not fulfill its purpose of supporting the search for the cause. or the origin of a veteran’s illness or condition. He also said the registry could not monitor the population exposed to airborne hazards.
Throughout the 1990s and post-9/11 wars, the military used open pits to burn garbage, jet fuel, paint, medical waste, plastics, and other materials. Veterans diagnosed with cancer, respiratory problems and lung disease at a young age have blamed exposure to toxic fumes.
In January 2013, then-President Barack Obama signed into law the Enhanced Dignified Burials and Veterans Benefits Act of 2012. The law included the requirement for the VA to establish a registry to help service members and veterans report exposures to airborne hazards such as hot spots, oil well fires, and other forms of pollution and to document their health problems.
The VA’s Airborne Hazard and Open Pit Registry was launched in June 2014. It was designed to help the agency monitor veterans’ health, investigate the cause or origin of illness or of a veteran’s condition, improve care, support agency processes such as benefits claims and programs, and provide outreach services to veterans, health care providers, and others stakeholders.
The law also required an independent scientific organization to provide reports on the VA Registry to determine and monitor the health effects of veterans’ and service members’ exposure to toxins and its public information campaign on the Registry. The AV selected and sponsored the National Academies of Science, Engineering, and Medicine to assess the registry and write the reports.
The first report was published in 2017 and was the registry’s first assessment. The report addressed VA registry issues and data use and reviewed the self-assessment questionnaire.
The second report, released on Friday, focuses on the reassessment of the registry. It assessed how the VA and the Department of Defense collect and maintain registry data regarding a veteran’s health effects from toxic exposure and whether the registry has fulfilled or can fulfill the purpose.
More than 3.7 million veterans and military personnel can enroll in the registry. As of July 1, more than 317,000 veterans have signed up for the registry and completed the questionnaire, which includes 140 questions. Fifty percent of the 317,000 requested an optional health assessment from the registry, but only 30,000 participants received the health assessment. Additionally, more than 130,000 veterans have started their registration but have not yet completed it.
Kristen Olson, director of the Office of Sociological Research at the University of Nebraska-Lincoln and a member of the reassessment committee, said Friday during a virtual public briefing on the report that the registry process was cumbersome and the veterans had to go through various stages to become a participant in the registry. Once in the questionnaire, the questions, which are quite long, are not easy to complete or answer.
“The more deployments you have had, the longer it will take you to complete the questionnaire,” she said. “Many veterans do not know the information requested in the questionnaire and … do not know or refuse to answer the question.”
As for monitoring veterans’ health, Olson said, the registry collects participant data only once. Veterans also cannot update their health information in the registry, which she says makes it impossible to track the same person’s emerging health conditions over time.
“While health assessment may improve a veteran’s knowledge of their health status, it does not improve their access to health care or its continuity,” the report states.
The report also revealed that the VA does not use the register for its internal policy decisions. Additionally, the Veterans Benefits Administration says the review process is separate from the veterans registry. Although a veteran may use their questionnaire responses and health care assessment results to support a disability claim, the registry assessment does not replace a disability claim review.
As for using the registry for research, Olson said it has major design and data quality issues that cannot be resolved.
“Even making substantial changes to the registry questionnaire would not be enough to make the registry suitable for etiologic research of airborne hazards, exposures and health outcomes,” she said.
This is not the first report to criticize the register’s questionnaire. In July, the VA Inspector General’s Office released a report saying the questionnaire was unclear. The report also found that more than 106,000 veterans interested in a Fireplace Registry Health Assessment had not scheduled or completed the exams and were unaware that they were responsible for scheduling their own exams. .
Terrence Hayes, VA press secretary, said now is the time to rethink the registry for the better. He also said the National Academies of Sciences, Engineering and Medicine’s report, in addition to that of the VA Inspector General, provides the agency with guidance and advice on improving the registry to better serve veterans at respiratory risk.
“VA will explore all options when building the next registry to ensure it meets the needs of veterans who served in Southwest Asia,” Hayes said. “VA’s goal for the registry is to provide information to improve access and quality of health care for veterans exposed to airways. The registry can also serve as a communication channel for veterans and their healthcare providers to address concerns about respiratory risks.”