War Related Illness and Injury Study Center

Background: Military occupational and environmental exposures are common with 43% of surveyed Veterans reporting exposure concerns to their Veterans Affairs (VA) providers. The collective experience of military exposures may increase Veterans’ vulnerability to developing undesirable health outcomes. To address these concerns, the VA War Related Illness and Injury Study Center (WRIISC) in Washington, DC began development of the Veteran Military Occupational and Environmental Exposure Assessment Tool (VMOAT) in 2020. In support of the Honoring our PACT Act of 2022, the WRIISC continues to refine the VMOAT for both clinical and research use.

Overview: The VMOAT is a self-report questionnaire that evaluates multiple exposure domains in a comprehensive manner. The VMOAT is organized into environmental exposure categories and is designed to capture pre-military, military, and post-military exposures across a Veteran’s lifespan.

Development: Experienced occupational and environmental medicine clinicians as well as clinical researchers at the Complex Exposure Threats Center of WRIISC are developing the VMOAT over four phases:

• Phase I: Gap analysis and review of other occupational exposure assessment instruments (complete)
• Phase II: Development and initial testing (complete)
• Phase III: Improvement and updating VMOAT to offer 1) a research exposure composite score and 2) a clinical exposure summary (Summer 2024)
• Phase IV: Expanded use of VMOAT and programmed VMOAT implementation in general Veteran and military populations (planned for 2025)

Impact:  Establishing a comprehensive, standardized and structured narrative of exposure history represents a significant advancement in a topic of critical concern for Veterans

Citation for Collaborators*:

War Related Illness and Injury Study Center, Washington DC. (2024). Veteran Military Occupational and Environmental Exposure Assessment Tool (VMOAT): Comprehensive, Structured Self-Report Military Exposure Questionnaire. 

*The VMOAT is currently only available to collaborators working directly with investigators at the WRIISC/CETC.

Phase I and Phase II Reports, Abstracts and Conference Proceedings

Samuel, I.B.H., Pollin, K., Tschida, S., Lu, C., Prisco, M., Forsten, R., Ortiz, J., Barrett, J., Reinhard, M. & Costanzo, M.E. (2024) Linked Exposures Across Databases (LEAD): An exposure data aggregation framework to facilitate clinical exposure review [Manuscript submitted for publication].

Barrett, J., Samuel, I.B.H., Breneman, C., Lu, C., Ortiz, J., Pollin, K., Prisco, M., Costanzo, M.E., Brewster, R., Krahl, P.L., Forsten, R., Chun, T., & Reinhard, M. (in press). Development and Validation of the Veteran Military Occupational and Environmental Exposure Assessment Tool (VMOAT). Military Medicine.

Barrett, J., Samuel, I.B.H., Breneman, C., Lu, C., Pollin, K., Prisco, M., Costanzo, M.E., Brewster, R., Krahl, P.L., Ortiz, J., Forsten, R., Chun, T., & Reinhard, M (2023, August 14-17). Development and Validation of the Veteran Military Occupational and Environmental Exposure Assessment Tool (VMOAT) [Poster Presentation]. Military Health System Research Symposium 2023, Kissimmee, FL, United States.

Lu, C., Samuel, I.B.H., Breneman, C., Pollin, K., Chun, T., Prisco, M., Forsten, R., Krahl, P., Ortiz, J., Brewster, R., Costanzo, M., Reinhard, M., & Barrett, J. (2023, August 14-17). Comparison of the Veteran Military Occupational and Environmental Exposure Assessment Tool (VMOAT) with Other Measures of Exposure [Poster Presentation]. Military Health Systems Research Symposium 2023, Kissimmee, FL, United States.

Pollin, K., Samuel, I.B.H., Lu, C., Breneman, C., Chun, T., Prisco, M., Forsten, R., Krahl, P., Ortiz, J., Brewster, R., Costanzo, M., Reinhard, M., & Barrett, J. (2023, August 14-17) Using the Veteran Military Occupational and Environmental Exposure Assessment Tool (VMOAT) 1.0 to Characterize Complex Military Exposure Histories: Exposure Profiles of Explosive Ordnance Disposal (EOD) Veterans compared to Non-EOD Veterans [Poster Presentation]. Military Health Science Research Symposium Convention 2023. Kissimmee, FL, United States.

Barrett, J., Samuel, I.B.H., Breneman, C., Lu, C., Pollin, K., Prisco, M., Costanzo, M.E., Brewster, R., Valmas, M., Krahl, P.L., Ortiz, J., Chun, T., & Reinhard, M  (2022, September 12-15). Assessing Explosive Ordnance Disposal Specialists Exposures: Demonstrating the Veteran-Military Occupational and Environmental Exposure Assessment Tool (V-MOAT) with Other Assessment Methods [Poster Presentation]. Military Health System Research Symposium 2022, Kissimmee, FL, United States.

Samuel, I., Pollin, K. U., Breneman, C. B., Chun, T., Valmas, M.M., Brewster, R., Prisco, M., Barrett, J., Reinhard, M., & Costanzo, M.E. (2022). Effects of Military Occupational Exposures on Home-Based Assessment of Veterans’ Self-reported Health, Sleep and Cognitive Performance Measures. 24th HCI International Conference 2022, Journal of Augmented Cognition: 16th International Conference Proceedings, 13310, 91-102. https://doi.org/10.1007/978-3-031-05457-0_8