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DRRD Toolkit for Veterans
Welcome!
We know that starting the process of seeking care can feel overwhelming, but you’ve already made an important choice. Let us help you take the next step. This toolkit was created in partnership with Veterans, just like you. It is intended to provide valuable information for fellow Veterans who are concerned about potential military exposures to airborne hazards and deployment-related respiratory disease. The purpose of this toolkit is to assist you, as needed, to obtain better health through the VA.
Do you have any specific concerns? We want you to know that you are not alone. Click each section title below for information and resources.
We know that starting the process of seeking care can feel overwhelming, but you’ve already made an important choice. Let us help you take the next step. This toolkit was created in partnership with Veterans, just like you. It is intended to provide valuable information for fellow Veterans who are concerned about potential military exposures to airborne hazards and deployment-related respiratory disease. The purpose of this toolkit is to assist you, as needed, to obtain better health through the VA.
Do you have any specific concerns? We want you to know that you are not alone. Click each section title below for information and resources.
Learn about airborne hazards +
What are airborne hazards? "Airborne hazard" refers to any sort of contaminant or potentially toxic substance that you are exposed to through the air you breathe. During your military service, you may have been exposed to a variety of airborne hazards including:
- Smoke and fumes from open burn pits
- Chemicals, herbicides, and chemical warfare agents
- Sand, dust, and particulate matter
- General air pollution common in certain countries
- Fuel, aircraft exhaust, and other mechanical fumes
- Smoke from oil well fires, burning debris, explosions, etc.
Identify respiratory symptoms +
***Important: if you are experiencing a serious medical problem, such as chest pain or difficulty breathing, call 911!***
"Are my symptoms related to my military service? I don't have any symptoms now, but what should I watch for?" These are valid questions, and you are right to ask. Keep reading to learn the answers to some of your other questions related to respiratory symptoms and diagnoses.
"Are my symptoms related to my military service? I don't have any symptoms now, but what should I watch for?" These are valid questions, and you are right to ask. Keep reading to learn the answers to some of your other questions related to respiratory symptoms and diagnoses.
+ Was I exposed?
It is difficult to say with certainty whether an individual was exposed to a toxin, or the amount they were exposed to. Because of that, the VA presumes that if you were deployed to certain locations (including but not limited to the Persian Gulf) on or after August 2, 1990, then you may have been exposed to airborne hazards. Veterans may have been exposed to airborne hazards during other time periods and locations as well.
- Here is a deployment-related respiratory symptom questionnaireYou can use this to help guide a conversation with your healthcare provider.
+ If I was exposed, will I develop symptoms?
Exposure to airborne hazards is a risk factor that may increase the likelihood of your developing a deployment-related respiratory disease. But exposure does not mean you will develop a disease. Most Veterans who were exposed to airborne hazards do not develop a respiratory condition. VA encourages all Veterans who are concerned about exposure to burn pits or other airborne hazards to talk to their health care provider, apply for VA health care, and file a claim for compensation and benefits.
+ What symptoms should I watch for?
You should talk with your health care team about any changes to your health, no matter the severity or how ordinary they seem. This includes how you feel physically, emotionally, or mentally. A few common symptoms following airborne hazard exposure include: coughing, burning throat, or itchy skin. But experiences can vary - you may never experience any symptoms, or you might experience one symptom, or your symptoms may arise long (even years) after your exposure.
- Use this respiratory questionnaire to list your own symptoms to review with your healthcare provider.
+ What is deployment-related respiratory disease?
The term deployment-related respiratory disease refers to any long-term respiratory conditions related to exposure to airborne hazards during military service. Respiratory symptoms, such as coughing, phlegm, or shortness of breath, could be signs of a deployment-related respiratory disease. The most common deployment-related respiratory diseases are asthma, sinusitis, and rhinitis. Many other conditions, including both upper and lower respiratory conditions, can also cause respiratory symptoms.
Veteran TIP: If you were treated for a condition while on active duty, it is still important to talk with your provider about your symptoms, including describing when they first started and any symptoms that are not going away with treatment.
Know what to expect from VA medical appointments for deployment-related respiratory disease +
- What can I expect from my medical appointment? Your provider will ask questions about your symptoms to determine whether you have a diagnosis of deployment-related respiratory disease (for example, asthma, sinusitis, or rhinitis). There is no specific test for deployment-related respiratory diseases. Instead, your provider will conduct an assessment: work with you to decide what conditions to evaluate for based on your symptoms, exposure history, medical history including other health conditions, family history, and other risk factors. VA providers have training and a toolkit (Available HERE) to guide diagnosis and treatment. You can expect to partner with your health care team by contributing your expertise about your own body and life situation - including your symptoms - to the clinical conversation. Here is information and a worksheet to write down your questions and share them with your provider.
- Here is what you can expect from your provider:
+ Your provider will ask you questions about your history and your health.You can expect to answer questions about your military service, whether you were exposed to any airborne hazards, and current respiratory symptoms (such as coughing, phlegm, shortness of breath etc).+ Your provider will evaluate for deployment-related respiratory diseases and treat your symptoms.The most common deployment-related respiratory diseases related to airborne hazards exposure are asthma, sinusitis, and rhinitis. To evaluate these, your provider may complete tests. Initial testing may include pulmonary function testing, chest CT imaging, or an evaluation of your sinuses.
Your provider may also recommend that you meet with a doctor who specializes in respiratory conditions, such as a pulmonologist (lung doctor) or otolaryngologist (ears, nose, and throat doctor). More information on treatment for deployment-related respiratory disease can be found in the section below: Understand deployment-related respiratory disease treatment.+ If your symptoms do not improve, your provider may do more specialized tests.These tests may look for other conditions that can cause symptoms, including obstructive sleep apnea (OSA), Gastroesophageal Reflux Disease (GERD), cardiac factors, laryngeal disorders, and anemia. Your provider will consider your specific symptoms and medical history when making decisions about what specialized tests are needed.+ Most Veterans can expect that symptoms will improve. However, if symptoms and/or other conditions do not improve with treatment, your provider may:- Refer you to a specialist for more advanced assessments, including paired inspiratory-expiratory high resolution CT scan, cardiopulmonary exercise test (CPET), and methacholine challenge test.
- Discuss the pros and cons of a lung biopsy. A lung biopsy is needed in rare cases to diagnosis certain conditions, such as constrictive bronchiolitis. However, lung biopsies are invasive. Because of this, your provider may recommend treating your symptoms without confirming a diagnosis through a lung biopsy.
Understand deployment-related respiratory disease treatment +
The questions and answers below can help you better understand how deployment-related respiratory disease is treated.
+ What is the treatment for my deployment-related respiratory disease?
Based on the results of testing, your care team will work with you to develop a treatment plan that meets your needs/goals to improve your quality of life. Your provider will discuss all available evidence-based treatment options to support your treatment goals. VA and DoD have clinical practice guidelines for some of the more commonly reported deployment-related respiratory diseases. You can find the VA/DoD clinical practice guidelines here.
+ What can I do?
Exposure to airborne hazards that may have happened in the past cannot be changed, but additional exposures can be limited. Watch for airborne hazards in your current environment: wear work-related safety equipment such as masks and respirators, limit inhalation of dust and wood smoke, and - if you smoke - consider taking advantage of resources to quit or reduce smoking.
+ Am I eligible for benefits?
VA encourages all Veterans to file a claim for compensation and benefits if they have a health condition or symptoms potentially related to their service.
Many illnesses have been identified as presumptive conditions - meaning that VA automatically assumes (or “presumes”) that your service is related to your condition. If you have a presumptive condition, you don't need to prove that your service caused the condition to be eligible for benefits. You only need to meet the service requirements for the presumption. This current list of presumptive conditions is not limited to respiratory diagnoses associated with airborne hazards. Regardless of the cause of your symptoms or conditions, your VA health care team is here to care for you.
Many illnesses have been identified as presumptive conditions - meaning that VA automatically assumes (or “presumes”) that your service is related to your condition. If you have a presumptive condition, you don't need to prove that your service caused the condition to be eligible for benefits. You only need to meet the service requirements for the presumption. This current list of presumptive conditions is not limited to respiratory diagnoses associated with airborne hazards. Regardless of the cause of your symptoms or conditions, your VA health care team is here to care for you.
Follow the latest research +
There is on-going research to better understand links between airborne hazards, symptoms, and diagnoses. Here are some resources to help you stay informed about the latest developments.
- Read about airborne hazards and burn pit exposures research and VA's Airborne Hazards & Burn Pit Center of Excellence (AHBPCE) here.
- Current Research on Airborne Hazards and Burn Pits:
here - Department of Defense, Congressionally Directed Medical Research Programs, Toxic Exposures Research Program (TERP)
- VA Office of Research and Development, Military Exposures Research Program (MERP)
More resources +
There are many tools and resources available to ensure you get the VA care you need. Here is a list to help you get started.
- I want to enroll in VA.
- I want to file a disability claim.
- I want help from a Veterans Service Officer to file a claim.
- I want to talk with a patient advocate.
- I want to know about the PACT act.
- I want to know about the Airborne Hazards & Open Burn Pit Registry.
- I want to talk with the Environmental Health Coordinator about local services and resources available to address my military exposure concerns.
- I want to learn more about VA's Whole Health resources to support my overall health.
- I want to know more about lung health and related topics, including the NIH Breathe Better program.
VETERAN TIP: State Veteran Service Officers can also help with identifying and applying for state benefits.
Checklists and worksheets +
