The U.S. Military and the Exposome

  • Christopher BradburneEmail author
  • John A. Lewis


The US military has great potential to study and utilize the exposome, as well as great need. By their very nature, military Service members serve in diverse environments, under a variety of stressors, with pressure to perform and execute tasks under any conditions. The US military is unique in the range of environments they deploy to, as well as the kinds of industrial chemicals and materials they are exposed to, making them one of the most dynamic occupational health populations in the world. Unique environmental exposures include documented incidents such as burn-pit exposure, sulfur fires at the Mishraq sulfur mine, and water quality at Camp Lejeune, versus subtle exposures such as lead from munitions training, diesel exhaust, or JP-8 jet fuel exposure. Balancing the environmental health concerns of individuals with the operational needs of a unit can be challenging and dynamic. This has led the military to prioritize efforts for exposure surveillance, mitigation strategies, and leading-edge research initiatives. In this chapter, we will discuss the unique operational environments and exposures warfighters encounter, as well as the biomonitoring, military records for exposures, and how this relates to individual exposomes. The military has unique assets for exposome monitoring, such as uniform electronic health records (EHR), individual longitudinal exposure records (ILER), serum collection pre- and post-deployment for biobanking and surveillance, and a more normalized population relative to nutrition and demographics. This makes the military exposome unique, and provides important avenues for study and application.


U.S. Military Warfighters Electronic health records Exposure Surveillance 


Conflict of Interest

The views, opinions, and/or findings contained in this report are those of the authors and should not be construed as official Department of the Army position, policy, or decision, unless so designated by other official documentation.


  1. Ankley GT, Bennett RS, Erickson RJ, Hoff DJ, Hornung MW, Johnson RD, Mount DR, Nichols JW, Russom CL, Schmieder PK, Serrrano JA, Tietge JE, Villeneuve DL (2010) Adverse outcome pathways: a conceptual framework to support ecotoxicology research and risk assessment. Environ Toxicol Chem 29:730–741. Scholar
  2. (2013) Nett Warrior gets new end-user device. [Online] [Cited: 5 6, 2016]
  3. Beasley RP, Lin CC, Hwang LY, Chien CS (1981) Hepatocellular carcinoma and hepatitis B virus: a prospective study of 22 707 men in Taiwan. Lancet 2(8256):1129–1133CrossRefGoogle Scholar
  4. Biggs ML, Kalman DA, Moore LE, Hopenhayn-Rich C, Smith MT, Smith AH (1997) Relationship of urinary arsenic to intake estimates and a biomarker of effect, bladder cell micronuclei. Mutat Res 386:185–195CrossRefGoogle Scholar
  5. Bradburne C, Hamosh A (2016) Integrating the microbiome into precision medicine. Expert Rev Precis Med Drug Dev 1:475–477CrossRefGoogle Scholar
  6. Bradburne C, Graham D, Kingston HM, Brenner R, Pamuku M, Carruth L (2015) Overview of omics technologies for military occupational health surveillance and medicine. Mil Med 180:34–48CrossRefGoogle Scholar
  7. De Castro M, Biesecker L, Turner C, Brenner R, Witkop C, Mehlman M, Bradburne C, Green R (2016) Genomic medicine in the military. NPJ Genom Med 1:15008CrossRefGoogle Scholar
  8. Foxnews (2016) Thousands-iraq-afghan-war-vets-sickened-after-working-at-burn-pits. News ReportGoogle Scholar
  9. FoxNews (2017) Bipartisan-bill-to-provide-assistance-to-burn-pit-vets-introduced-in-senate. News ReportGoogle Scholar
  10. Institute of Medicine (2011) Long-term health consequences of exposure to burn pits in Iraq and Afghanistan. National Academies Press, Washington, DCGoogle Scholar
  11. King MS, Eisenberg R, Newman JH et al (2011) Constrictive bronchiolitis in soldiers returning from Iraq and Afghanistan. N Engl J Med 365:222–230CrossRefGoogle Scholar
  12. Koutros S, Andreotti G, Berndt SI, Hughes Barry K, Lubin JH, Hoppin JA, Kamel F, Sandler DP, Burdette LA, Yuenger J, Yeager M, Alavanja MC, Freeman LE (2011) Xenobiotic metabolizing gene variants, pesticide use, and risk of prostate cancer. Pharmacogenet Genomics 10:615–623CrossRefGoogle Scholar
  13. Lindler LE (2015) Enhancing the department of defense’s capability to identify environmental exposures into the 21st century. Mil Med 180:5–9CrossRefGoogle Scholar
  14. MacKay C, Davies M, Summerfield V, Maxwell G (2013) From pathways to people: applying the adverse outcome pathway (AOP) for skin sensitization to risk assessment. ALTEX 30:473–486CrossRefGoogle Scholar
  15. Morris MJ, Dodson DW, Lucero PF, Haislip GD, Gallup RA, Nicholson KL, Zacher LL (2014) Study of active duty military for pulomary disease related to environmental deployment resources. Am J Respir Crit Care Med 190:77–84. Scholar
  16. National Academies of Sciences, Engineering, and Medicine (2016a) Assessing health outcomes among veterans of project SHAD. National Academy of Sciences, Washington, DCGoogle Scholar
  17. National Academies of Sciences, Engineering, and Medicine (2016b) Veterans and agent orange: update 2014. National Academy of Science, Washington, DCGoogle Scholar
  18. National Academies of Sciences, Engineering, and Medicine (2016c) Gulf war and health: volume 10: update of health effects of serving in the gulf war. National Academy of Sceince, Washington, DCGoogle Scholar
  19. OECD (2012) Proposal for a template, and guidance on developing and assessing the completeness of adverse outcome pathways, pp 1–17Google Scholar
  20. Perdue CL, Eick-Cost AA, Rubertone MV (2015) A brief description of the operation of the DoD serum repository. Mil Med 180:10–12CrossRefGoogle Scholar
  21. Porter KL, Green FH, Harley RA, Vallyathan V, Castranova V, Waldron NR, Leonard SS, Nelson DE, Lewis JA, Jackson DA (2015) Evaluation of the pulmonary toxicity of ambient particulate matter from camp victory, Iraq. J Toxicol Environ Health 78:1385–1408. Scholar
  22. Rappaport SM (2016) Genetic factors are not the major causes of chronic diseases. PLoS One 11:e0154387CrossRefGoogle Scholar
  23. Rose C, Abraham J, Harkins D, Miller R, Morris M, Zacher L, Meehan R, Szema A, Tolle J, King M, Jackson D, Lewis J, Stahl A, Lyles MB, Hodgson M, Teichman R, Salihi W, Matwiyoff G, Meeker G, Mormon S, Bird K, Baird C (2012) Overview and recommendations for medical screening and diagnostic evaluation for postdeployment lung disease in returning US warfighters. J Occup Environ Med 54:746–751. Scholar
  24. Smith B, Wong CA, Smith TC, Boyko EJ, Gackstetter GD (2009) Newly reported respiratory symptoms and conditions among military personnel deployed to Iraq and Afghanistan: a prospective population-based study. Am J Epidemiol 170:1433–1442CrossRefGoogle Scholar
  25. Sweeney LM (2015) Evaluation of pharmacokinetic models for the disposition of lead (Pb) in humans, in support of application to occupational exposure limit derivation. Naval Medical Research Unit Dayton, US Navy, NAMRU-D-16-11Google Scholar
  26. Szema AM, Peters MC, Weissinger KM, Gagliano CA, Chen JJ (2010) New-onset asthma among soldiers serving in Iraq and Afghanistan. Allergy Asthma Proc 31:67–71CrossRefGoogle Scholar
  27. US Army Public Health Command (2014) Provisional blood lead guidelines for occupational monitoring of lead exposure in the DoD. US Army, Aberdeen Proving Ground, MDGoogle Scholar
  28. Vinken M (2013) The adverse outcome pathway: a pragmatic tool in toxicology. Toxicology 312:158–165CrossRefGoogle Scholar
  29. Wild CP (2012) The exposome: from concept to utility. Int J Epidemiol 41:24–32CrossRefGoogle Scholar
  30. World Health Organization (1949) The preamble of the constitution of the World Health Organization. Bull World Health Organ 80(12):982Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Applied Physics LaboratoryJohns Hopkins UniversityLaurelUSA
  2. 2.McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins UniversityBaltimoreUSA
  3. 3.US Army Center for Environmental Health ResearchFt DetrickUSA

Personalised recommendations