Respiratory Health Associated With Systemic Metal Exposure in Post-9/11 Veterans in the Department of Veterans Affairs Toxic Embedded Fragment Registry

J Occup Environ Med. 2024 Sep 1;66(9):722-730. doi: 10.1097/JOM.0000000000003143. Epub 2024 Jun 10.

Abstract

Objective: Adverse respiratory outcomes in post-9/11 veterans with elevated urinary metal measures and enrolled in the VA's Toxic Embedded Fragment registry were compared to those without elevated urinary metals.

Methods: Veterans completed questionnaires, underwent pulmonary physiology tests (pulmonary function and oscillometry), and provided urine samples for analysis of 13 metals. Respiratory symptoms, diagnoses, and physiology measures were compared in veterans with ≥1 urine metal elevation to those without metal elevations, adjusted for covariates, including smoking.

Results: Among 402 study participants, 24% had elevated urine metals, often just exceeding upper limits of reference values. Compared to veterans without elevated metals, those with elevated metals had had higher FEV 1 values but similar frequencies of respiratory symptoms and diagnoses and abnormalities on pulmonary physiology tests.

Conclusions: Mild systemic metal elevations in post-9/11 veterans are not associated with adverse respiratory health outcomes.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Male
  • Metals / urine
  • Middle Aged
  • Occupational Exposure / adverse effects
  • Occupational Exposure / analysis
  • Registries*
  • Respiratory Function Tests
  • September 11 Terrorist Attacks*
  • Surveys and Questionnaires
  • United States
  • United States Department of Veterans Affairs
  • Veterans* / statistics & numerical data

Substances

  • Metals