Federal OEHS Policy

As a result of numerous investigations that found inadequate data on  deployment occupational and environmental exposures to identify the  potential causes of unexplained illnesses among veterans who served in the  1991 Persian Gulf War, the federal government has increased efforts to  identify potential occupational and environmental hazards during  deployments. 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. In  addition, the deployed military services have not submitted all of the OEHS  reports they have completed for OIF to CHPPM’s centralized archive, as  required by DOD policy. 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. To improve OEHS reporting compliance, DOD officials  said they were revising an existing policy to add additional and more  specific OEHS requirements. 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. Each military service’s OEHS practices for implementing data collection  standards also have differed, due to the varying levels of training and  expertise among the service’s preventive medicine units. 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 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 security classification, incomplete data on  servicemembers’ deployment locations, and the lack of a comprehensive  federal research plan incorporating the use of archived OEHS reports. 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. 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. Scope and Methodology

To describe how the military services have implemented the Department of  Defense’s (DOD) policies for collecting and reporting occupational and  environmental health surveillance (OEHS) data for Operation Iraqi  Freedom (OIF), we reviewed pertinent DOD policies and military services’  guidance that delineated the requirements for OEHS data collection and  reporting. To identify the efforts to use OEHS reports to address the more immediate  health issues of servicemembers deployed in support of OIF, we reviewed  DOD policies and documents describing the operational risk management  process.
Why GAO Did This Study

Following the 1991 Persian Gulf War, research and investigations into the causes of servicemembers' unexplained illnesses were hampered by 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. GAO is reporting on (1) how the deployed military services have implemented DOD's policies for collecting and reporting OEHS data for Operation Iraqi Freedom (OIF) and (2) 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. Variations in data collection have been compounded by different levels of training and expertise among service personnel responsible for OEHS. 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, which DOD officials attribute to various obstacles, such as limited access to communication equipment to transmit reports for archiving. Moreover, DOD officials did not have the required consolidated lists of all OEHS reports completed during each quarter in OIF and therefore could not identify the reports they had not received to determine the extent of noncompliance. To improve OEHS reporting compliance, DOD officials said they were revising an existing policy to add additional and more specific OEHS requirements. 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. OIF was the first major deployment in which OEHS reports have been used consistently as part of operational risk management activities intended to identify and address immediate health risks and to make servicemembers aware of the health risks of potential exposures. While these efforts may help reduce health risks, DOD has no systematic efforts to evaluate their implementation in OIF. In addition, 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. For example, none of the military services submitted location data for the first several months of OIF. To address problems with linking OEHS reports to individual servicemembers, the deployed military services have made efforts 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. Third, according to DOD and VA officials, no federal research plan has been developed to evaluate the longterm health of servicemembers deployed in support of OIF, including the effects of potential exposures to occupational or environmental hazards.