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War Related Illness and Injury Study Center

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Complex Exposure Threats Center (CETC)


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CETC research uses a translational approach to integrate with the Clinical Services. The three research cores are designed to develop new understanding of how complex exposures and poorly understood hazards impact Veteran health.

Computational Modeling and Data Integration Core

This research core will use computational tools to support the integration and translation of available knowledge connected to the exposures of interest. Application of advanced text-mining as well as quantitative and semi-qualitative models are used to capture and represent information by drawing on scientific literature, clinical insight and other relevant data sources. This core also offers a consistent framework for communicating exposure profiles through data integration aimed at characterizing exposure metrics from siloed disparate data sources to help develop clinically meaningful insights. Specifically, this core will focus on:

  • Health records review, exposure databases and health outcome anomaly detection

  • Model-based predictions of anticipated vulnerable populations and health effects of emerging threats

  • Simulation-based designs of precision-medicine interventions and protective training protocols

  • Creation of a scalable knowledge base that is applicable to a range of exposure profiles and health outcomes

  • Identification of knowledge gaps and development of focused study design and mechanistic hypotheses aimed at reducing uncertainty

Exposure Assessment Science Core

This research core will have close partnership with DoD to characterize novel exposure environments using subjective, acute monitoring, toxicological and epidemiological methods.Exposure metrics, assessment and monitoring are crucial in allowing us to better understand the extent and type of environmental hazards that may drive the emergence of adverse health outcomes. Direct VA involvement in this work on exposure data acquisition ensures that orientation is sustained towards the clinical relevance, particularly as they related to objective military exposure technology. This core will focus on:

  • Novel biomonitoring and environmental sensor technology

  • Medical record extraction using natural language processing techniques for characterizing symptoms and features of novel exposures.

  • Wearable technologies designed to continuously monitor physiological responses

  • Detailed modeling and prediction of exposure levels and dispersion patterns

  • Determination of common high-risk conditions and core exposure elements

  • Development of subjective occupational and environmental tools to assess exposure domains (Veterans Military and Occupational Exposure Assessment Tool (VMOAT))

  • Specialized Registry Development to track and surveil exposures

Clinical Research Core

This research core will focus on key standing protocols to establish common data elements of complex exposure sequalae across different exposure cohorts. These protocols offer deep phenotyping as well as measures of subclinical drivers of functional loss. This core will focus on:

  • Biomarker expression most directly related to health outcomes and how these may be tied to environmental hazards

  • Application of allostatic load evaluations to disrupt homeostasis during exercise challenge to evaluate symptom severity

  • Deep phenotyping descriptions of clinical symptoms