Defense Health Care: Improvements Needed in Occupational and Environmental Health Surveillance During Deployments to Address Immediate and Long-Term Health Issues

GAO-05-632 Published: Jul 14, 2005. Publicly Released: Jul 19, 2005.
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Highlights

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.

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Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Defense To improve the collection and reporting of OEHS data during deployments and the linking of OEHS reports to servicemembers, the Secretary of Defense should ensure that cross-service guidance is created to implement DOD's policy, once that policy has been revised, which addresses improvements to conducting OEHS activities and to reporting the locations of servicemembers during deployment.
Closed – Implemented
DOD completed the revision of DoDI 6490.3 (to be re-titled, "Deployment Health Surveillance and Readiness") and it was issued on August 11, 2006. Jointly-developed, cross-Service implementation guidance for this instruction was completed on November 2, 2007. Both documents address improvements to conducting OEHS activities and to reporting the locations of servicemembers during deployment. However, in its comments to our 2005 report, DOD stated that it had already begun the process of revising this guidance and that this action was not taken in response to our work.
Department of Defense To improve the use of OEHS reports to address the immediate health risks of servicemembers during deployments, the Secretary of Defense should ensure that the military services jointly establish and implement procedures to evaluate the effectiveness of risk management efforts.
Closed – Not Implemented
No action has been taken by DOD in response to this recommendation. DOD stated that it already has procedures in place to evaluate risk management decisions through a jointly established and implemented lessons learned process, including lessons pertaining to OEHS risk management. However, there is no evidence of the implementation of the lessons learned process pertaining to OEHS risk management.
Department of Defense To better anticipate and understand the potential long-term health effects of deployment in support of OIF, the Secretary of Defense and the Secretary of Veterans Affairs should work together to develop a federal research plan to follow the health of these servicemembers that would include the use of archived OEHS reports.
Closed – Not Implemented
No action has been taken related to this recommendation. According to DOD, progress on standardizing occupational and environmental health surveillance (OEHS) data for DOD is reflected in the Defense Occupational and Environmental Health Readiness System (DOEHRS). DOEHRS is a web-based computerized system that collects and archives industrial hygiene data on servicemembers. A modular has been added for the collection and archiving of deployed OEHS data. U.S. Central Command began using this new system in July 2006. Upgrades are being developed so the system can used by all Services in 2008. However, upgrades to the system have not been completed, and the system has not been used to develop a federal research plan.
Department of Veterans Affairs To better anticipate and understand the potential long-term health effects of deployment in support of OIF, the Secretary of Defense and the Secretary of Veterans Affairs should work together to develop a federal research plan to follow the health of these servicemembers that would include the use of archived OEHS reports.
Closed – Not Implemented
The Department of Veterans Affairs has not taken steps to implement this recommendation. Currently, research to understand health effects of deployment in support of OIF is underway. VA did not provide a related update about this issue in 2008. Additionally, there was no evidence that VA has worked with DOD to develop a federal research plan.

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