Deployed Military Services Use Varying Approaches to Collect OEHS Data and Have Not Submitted All OEHS Reports for OIF

The deployed military services generally have collected and reported  OEHS data for OIF, as required by DOD policy. To increase data collection uniformity, the Joint  Environmental Surveillance Working Group has made some progress in  devising cross-service standards and practices for some OEHS activities. However, CHPPM officials said that  they could not measure the magnitude of noncompliance because they  have not received all of the required quarterly consolidated lists of OEHS  reports that have been completed. For example, although one water monitoring standard has  been adopted by all military services, the services have different standards  for both air and soil monitoring. Deployed Military Services Have Not Submitted All Required OEHS Reports for OIF, and the Magnitude of Noncompliance Is Unknown

The deployed military services have not submitted all the OEHS reports  that the preventive medicine units completed during OIF to CHPPM for  archiving, according to CHPPM officials. Progress Made in Using OEHS Reports to Address Immediate Health Risks, Though Limitations Remain for Addressing Both Immediate and Long- term Health Issues

DOD has made progress in using OEHS reports to address immediate  health risks during OIF, but limitations remain in employing these reports  to address both immediate and long-term health issues. During OIF, OEHS  reports have been used as part of operational risk management activities  intended to assess, mitigate, and communicate to servicemembers any  potential hazards at a location. In addition,  DOD’s centralized archive of OEHS reports for OIF is limited in its ability  to provide information on the potential long-term health effects related to  occupational and environmental exposures for several reasons, including  limited access to most OEHS reports because of their security  classification, incomplete data on servicemembers’ deployment locations,  and the lack of a comprehensive federal research plan incorporating the  use of archived OEHS reports. DOD Has Made Progress in Using Deployment OEHS Data and Reports in Risk Management but Does Not Monitor Implementation of These Efforts

To identify and reduce the risk of immediate health hazards in OIF, all of  the military services have used preventive medicine units’ OEHS data and  reports in an operational risk management process. Difficulties Exist in Linking Archived OEHS Reports to Individual Servicemembers, but Some Efforts Are Under Way to Include Information in Medical Records

Linking OEHS reports from the archive to individual servicemembers will  be difficult because DOD’s centralized tracking database for recording  servicemembers’ deployment locations currently does not contain  complete or comparable data. During OIF, some efforts have been made to include information about  specific incidents of potential and actual exposure to occupational or  environmental health hazards in the medical records of servicemembers  who may have been affected. In addition, the military services have taken some steps to include  summaries of potential exposures to occupational and environmental  health hazards in the medical records of servicemembers deployed to  specific locations. No Federal Research Plan Exists for Using OEHS Reports to Follow the Health of OIF Servicemembers over Time

According to DOD and VA officials, no federal research plan that includes  the use of archived OEHS reports has been developed to evaluate the long- term health of servicemembers deployed in support of OIF, including the  effects of potential exposure to occupational or environmental hazards. Consequently, we recommended that the Secretary  of Defense ensure that cross-service guidance is created to implement  DOD’s policy, once that policy has been revised, to improve the collection  and reporting of OEHS data during deployments and the linking of OEHS  reports to servicemembers. However, efforts by a  joint DOD and VA working group to develop a federal research plan for  OIF that would include examining the effects of potential exposure to  occupational and environmental health hazards have just begun, despite  similarities in deployment location to the 1991 Persian Gulf War. DOD  partially concurred with our recommendation, and VA concurred.
Why GAO Did This Study

Following the 1991 Persian Gulf War, research and investigations into the causes of servicemembers' unexplained illnesses were hampered by a lack of servicemember health and deployment data, including inadequate occupational and environmental exposure data. In 1997, the Department of Defense (DOD) developed a militarywide health surveillance framework that includes occupational and environmental health surveillance (OEHS)--the regular collection and reporting of occupational and environmental health hazard data by the military services. This testimony is based on GAO's report, entitled Defense Health Care: Improvements Needed in Occupational and Environmental Health Surveillance during Deployment to Address Immediate and Long-term Heath Issues (GAO-05-632). The testimony presents findings about how the deployed military services have implemented DOD's policies for collecting and reporting OEHS data for Operation Iraqi Freedom (OIF) and the efforts under way to use OEHS reports to address both immediate and long-term health issues of servicemembers deployed in support of OIF.

What GAO Found

Although OEHS data generally have been collected and reported for OIF, as required by DOD policy, the deployed military services have used different data collection methods and have not submitted all of the OEHS reports that have been completed. Data collection methods for air and soil surveillance have varied across the services, for example, although they have been using the same monitoring standard for water surveillance. For some OEHS activities, a cross-service working group has been developing standards and practices to increase uniformity of data collection among the services. In addition, while the deployed military services have been conducting OEHS activities, they have not submitted all of the OEHS reports that have been completed during OIF. Moreover, DOD officials could not identify the reports they had not received to determine the extent of noncompliance. DOD has made progress in using OEHS reports to address immediate health risks during OIF, but limitations remain in employing these reports to address both immediate and long-term health issues. OEHS reports have been used consistently during OIF as part of operational risk management activities intended to identify and address immediate health risks and to make servicemembers aware of the risks of potential exposures. While these efforts may help in reducing health risks, DOD has not systematically evaluated their implementation during OIF. DOD's centralized archive of OEHS reports for OIF has several limitations for addressing potential long-term health effects related to occupational and environmental exposures. First, access to the centralized archive has been limited due to the security classification of most OEHS reports. Second, it will be difficult to link most OEHS reports to individual servicemembers' records because not all data on servicemembers' deployment locations have been submitted to DOD's centralized tracking database. To address problems with linking OEHS reports to individual servicemembers, the deployed military services have tried to include OEHS monitoring summaries in the medical records of some servicemembers for either specific incidents of potential exposure or for specific locations within OIF. Additionally, according to DOD and Veterans Affairs (VA) officials, no federal research plan has been developed to evaluate the long-term health of servicemembers deployed in support of OIF, including the effects of potential exposures to occupational or environmental hazards. GAO's report made several recommendations, including that the Secretary of Defense improve deployment OEHS data collection and reporting and evaluate OEHS risk management activities and that the Secretaries of Defense and Veterans Affairs jointly develop a federal research plan to address long-term health effects of OIF deployment. DOD plans to take steps to meet the intent of our first recommendation and partially concurred with the other recommendations. VA concurred with our recommendation for a joint federal research plan.