For clinical providers caring for Veteran patients
Ask the Veteran about exposure concerns
- What were you exposed to? Chemical (pollution, solvents, etc.), biological (infectious disease), or physical (radiation, heat, vibration, etc.)
- What precautions were taken? Avoidance, PPE, treatment, etc.
- How were you exposed? Inhaled, on skin, swallowed, etc.
- How concerned are you about the exposure?
- Where were you when you were exposed?
- When were you exposed?
- Who else may have been affected?
Create a care plan
- Perform a broad health screen. Exposures may affect any system of the body, but the most common sites are the skin and the nervous, respiratory, and cardiovascular systems.
- Do not rule out current or latent effects based on routine labs. In some cases, routine labs can indicate moderate or severe effects of an exposure. Depending on the type of hazard and the dose, however, signs and symptoms may be subtle or may not occur until years later and can be nonspecific.
- Follow up with your patient. Have the patient return periodically for check-ups to monitor their health. The response or lack of response to standard treatments can be an important factor to consider in Veteran patients with possible environmental exposures.
- Encourage healthy living. Advise your patient to incorporate healthier habits into their everyday lives. While the long-term effects of exposures may not be established, eliminating risk factors like smoking and obesity can help prevent the occurrence of significant health issues for many Veterans.
Discuss VA services with the Veteran
VA offers specialized programs to address health issues related to deployment. Providers should encourage their patients to enroll in VA health care in order to take advantage of these services as part of their overall health care plan.
- VA Environmental Health Clinics
Environmental Health Clinicians provide specialized knowledge about potential environmental exposures and conduct exams for registry programs: Ionizing Radiation, Agent Orange, Gulf War (includes Operations Iraqi Freedom and New Dawn), and Depleted Uranium. Find local VA Environmental Health Coordinator.
- War Related Illness and Injury Study Center (WRIISC)
Three locations nationwide provide telephone or inter-facility consultations: Washington, DC; East Orange, NJ; and Palo Alto, CA. WRIISC provides medical evaluations and treatment plans for chronic, difficult-to-diagnose conditions related to deployment.