NCT06305091

Brief Summary

Background: The VA and DoD estimate that 3.5 million Veterans and Service Members were exposed to open burn pits used for waste disposal during military deployments to countries such as Kuwait, Afghanistan, and Iraq since 1990. Since the lasting adverse effects of this exposure on health are unknown, the VA Airborne Hazards and Open Burn Pit Registry (AHOBPR) was created. More than 209,000 participants to date have answered the registry questionnaire about the extent of exposure to burn pits and other airborne hazards. The questions attempted to quantify the duration of exposure, the severity of acute health effects, and the relative timing of onset or worsening of chronic respiratory, cardiovascular, neurological, and other illnesses. However, the AHOBPR interview lacks specific inquiry about mental health and biomarkers. The proposed study will recruit AHOBPR participants and non-participant for a follow-up enhanced evaluation of their health in a translational research study to better characterize their psychological, physical health profile, and potentially harmful epigenetic and biochemical exposure-related alterations. Hypothesis: The investigators hypothesize that 1) the severity of individual exposure to burn pits will be positively correlated with levels of persistent organic pollutants in blood and metals in urine and specific epigenetic alterations in DNA methylation; and 2) levels of toxic chemicals and alterations in the methylation of specific genes will be positively correlated with chronic problems involving the cardiovascular, respiratory, neuropsychiatric and other systems. Specific Aims: (1) Describe and quantify relationships of the intensity and duration of exposure with persistent organic chemicals/metals in the registry participants and ascertain their relationships with health outcomes linked to burn pit exposure. (2) Discover and validate DNA methylation marks that best distinguish between individuals exposed to burn pits and those not; then describe and quantify the relationships between DNA methylation, intensity and duration of exposure, and health outcomes. Completion of these aims will allow quantitation of the relationships between toxic chemicals, DNA methylation, and individual health problems. Study Design: A clinical study will be conducted at the Central Arkansas Veterans Healthcare System and the University of Arkansas for Medical Sciences. The AHOBPR registry and non-specific recruitment will be used to enroll OBP exposed (N=220) and age and gender-matched unexposed (N=110) veterans. The unexposed veterans will be given the same questions as in the AHOBPR to determine their open burn pit exposure status with a confirmation of no exposure. A single study visit per participant will strengthen the registry by validating its contents using the electronic patient record and adding new study data on physical and mental function, including effects of epigenetic and toxicant measures obtained from blood and urine samples. Linear and logistic regression modeling will be used to determine the relationships described by the study aims while controlling for confounding variables and false discovery rates. Long-term and Short-term Impact on Patient Populations: The immediate goal of the study is to measure exposure-related differences in levels of potentially toxic chemicals present in blood and urine and differences in DNA methylation. The study will then determine the relationships between exposure, the biochemical and molecular measures, and the presence of health problems. The value of this information is high since the effects of burn pit exposure are largely unknown but potentially serious. The longer-term goal for this line of investigation is to enable personalized and tailored health management for exposed individuals. The investigators believe that the biochemical and molecular measures may become novel biomarkers that enable the prediction of risk for disease and adverse disease outcomes such that preventative measures can be employed. Furthermore, the results will be highly relevant to other occupations in which exposure to airborne pollutants is high.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
330

participants targeted

Target at P75+ for all trials

Timeline
11mo left

Started Mar 2023

Longer than P75 for all trials

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress78%
Mar 2023Mar 2027

Study Start

First participant enrolled

March 13, 2023

Completed
12 months until next milestone

First Submitted

Initial submission to the registry

March 4, 2024

Completed
8 days until next milestone

First Posted

Study publicly available on registry

March 12, 2024

Completed
3.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 31, 2027

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 31, 2027

Last Updated

March 12, 2024

Status Verified

March 1, 2024

Enrollment Period

4.1 years

First QC Date

March 4, 2024

Last Update Submit

March 7, 2024

Conditions

Keywords

Open Burn Pitstoxic exposureveterans

Outcome Measures

Primary Outcomes (1)

  • DNA methylation markers and heavy metals

    Day 1

Secondary Outcomes (1)

  • Physical and mental health comorbidities

    Day 1

Study Arms (2)

OBP exposed

Veterans exposed to Open Burn Pits (N=220)

Diagnostic Test: Health survey for physical and mental health comorbidities, epigenetic marker and heavy metals in blood and urine samples

OBP not exposed

Veterans not exposed to Open Burn Pits (N=110)

Diagnostic Test: Health survey for physical and mental health comorbidities, epigenetic marker and heavy metals in blood and urine samples

Interventions

Health survey for physical and mental health comorbidities, epigenetic marker and heavy metals in blood and urine samples

OBP exposedOBP not exposed

Eligibility Criteria

Age25 Years - 70 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodProbability Sample
Study Population

Veterans aged 25- 70 years

You may qualify if:

  • Age 25-70 years
  • Participants that reside in Arkansas
  • All Veterans that are deployed
  • Participants registered in the AHOBPR burn pit registry mainly for exposed Veterans. However, unexposed participants from the registry could also be included.
  • Participants not listed in the AHOBPR burn pit registry mainly for unexposed Veterans. However, exposed participants not from the registry could also be included.
  • Non-smokers: defined as smoke less than 10 cigarettes during lifetime.
  • Fluent in English

You may not qualify if:

  • Any occupation and/or hobbies involves diesel exhaust, welding, paint, or other chemical fumes or organic dust
  • Any use of tobacco or nicotine products within the past year, such as smoking (cigarettes, pipes, cigars, e-cigarettes, vaping devices)
  • Self-report and/or chart review that patient is pregnant
  • Self-report and/or chart review that patient weight is less than 110 lbs
  • Participants whom the PI deems to be otherwise ineligible

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Central Arkansas Veterans Healthcare System (3J/NLR)

North Little Rock, Arkansas, 72114, United States

RECRUITING

Biospecimen

Retention: SAMPLES WITH DNA

epigenetic and toxicant measures obtained from blood and urine samples

MeSH Terms

Interventions

Physical ExaminationBlood Specimen Collection

Intervention Hierarchy (Ancestors)

Diagnostic Techniques and ProceduresDiagnosisSpecimen HandlingClinical Laboratory TechniquesPuncturesSurgical Procedures, OperativeInvestigative Techniques

Study Officials

  • Kalpana Padala, MD, MS

    Central Arkansas Veterans Healthcare System, Little Rock, AR

    PRINCIPAL INVESTIGATOR
  • Shuk-Mei Ho, PhD

    University of Arkansas for Medical Sciences, Little Rock, AR

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Kalpana Padala, MD, MS

CONTACT

Trent Trice, BS

CONTACT

Study Design

Study Type
observational
Observational Model
CASE CONTROL
Time Perspective
CROSS SECTIONAL
Sponsor Type
FED
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Director Research, GRECC

Study Record Dates

First Submitted

March 4, 2024

First Posted

March 12, 2024

Study Start

March 13, 2023

Primary Completion (Estimated)

March 31, 2027

Study Completion (Estimated)

March 31, 2027

Last Updated

March 12, 2024

Record last verified: 2024-03

Data Sharing

IPD Sharing
Will not share

Locations