Name
#183 The Complex Exposure Threats Center of Excellence (CETCE): Leading the VA’s Efforts to Address the Complex Needs of Targeted Veteran Exposure Cohorts and to Anticipate Emerging Military Exposure Health Threats
Speakers
Content Presented on Behalf of
VHA/VA
Services/Agencies represented
Uniformed Services University (USU), Veterans Health Administration/Veterans Affairs (VHA/VA)
Session Type
Posters
Room#/Location
Prince Georges Exhibit Hall A/B
Focus Areas/Topics
Policy/Management/Administrative
Learning Outcomes
At the end of this presentation, attendees will be able to:
1. Discuss how the Complex Exposure Threats Center of Excellence (CETCE) bolsters the Veterans Affairs’(VA’s) ability to address Veterans' novel and complex exposure needs by focusing on targeted cohorts to stem new Veteran health discoveries. Specifically, how in-depth assessments of a subset of individuals will expand VA’s clinical knowledge and ability to respond to complex and emerging threats.
2. Identify the four current targeted military exposure cohorts of interest for the CETCE.
3. Describe how the CETCE has successfully built upon existing WRIISC expertise to offer specialized tertiary clinical evaluations and treatment recommendations to Veterans from targeted military exposure cohorts using its comprehensive, standardized clinical process.
4. Summarize how the CETCE meets VA research needs by focusing on complex exposure cohorts of interest and how it seeks to aid all Veterans by establishing foundational scientific relationships between military environmental exposures and physiologic responses.
5. Understand how CETCE’s education mission supports VA evidence-based communications through the dissemination of detailed clinical plans, exposure cohort updates, and evolving information about symptoms and healing for targeted hazardous exposures of Veterans.
1. Discuss how the Complex Exposure Threats Center of Excellence (CETCE) bolsters the Veterans Affairs’(VA’s) ability to address Veterans' novel and complex exposure needs by focusing on targeted cohorts to stem new Veteran health discoveries. Specifically, how in-depth assessments of a subset of individuals will expand VA’s clinical knowledge and ability to respond to complex and emerging threats.
2. Identify the four current targeted military exposure cohorts of interest for the CETCE.
3. Describe how the CETCE has successfully built upon existing WRIISC expertise to offer specialized tertiary clinical evaluations and treatment recommendations to Veterans from targeted military exposure cohorts using its comprehensive, standardized clinical process.
4. Summarize how the CETCE meets VA research needs by focusing on complex exposure cohorts of interest and how it seeks to aid all Veterans by establishing foundational scientific relationships between military environmental exposures and physiologic responses.
5. Understand how CETCE’s education mission supports VA evidence-based communications through the dissemination of detailed clinical plans, exposure cohort updates, and evolving information about symptoms and healing for targeted hazardous exposures of Veterans.
Session Currently Live
Description
Introduction: Military occupational exposures are common, with 44% of Veterans reporting exposure concerns to their Veterans Affairs (VA) providers. In support of the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 or PACT Act, the Complex Exposure Threats Center of Excellence (CETCE) has been established as part of the Washington, D.C. War Related Illness and Injury Study Center (DCWRIISC). Methods: This poster documents the process of establishing CETCE as a VA Center of Excellence (CoE), key services provided by the CETCE, and early data from patient encounters and findings from its research pilot projects. Results: The CETCE received its VA CoE designation on September 3, 2024, and will operate through 5 lines of effort:(1) health threat detection; (2) exposure cohort management; (3) specialized clinical evaluations; (4) innovative research; (5) and education services. The CETCE is focused on emerging and complex military exposure health concerns of its current four distinct Veteran exposure cohorts: Explosive Ordnance Disposal (EOD), Anomalous Health Incident (AHI)/Havana Syndrome, Chemical Warfare Agents (CWA), and from Qarmat Ali (sodium dichromate dust exposure). The CETCE is uniquely positioned with strong federal (e.g., DoD and National Institutes of Health) and academic (e.g., the University of Maryland and the University of Pennsylvania) partnerships and relationships with military health and research leadership. Over the past year, CETCE staff have presented at least 12 educational talks or posters in Regional or National settings and published 4 scientific papers. The CETCE leverages the established and standardized clinical process of the VA WRIISC, resulting in at least 108 exposure cohort Veterans (mainly EOD Veterans) receiving clinical evaluations from 2021 to August 2024. Patient satisfaction for the three National WRIISC centers’ comprehensive evaluations for FY 24 was 9.63/10, with 100% of these Veterans willing to refer other Veterans for these services; CETCE patient satisfaction likely mirrors these results. Discussion: Since planning started in 2022, efforts have been focused on fostering collaborations within and outside of the VA and recruiting and hiring highly qualified staff. As a newly designated CoE and nationally recognized program, the CETCE will leverage its clinical, educational, and research expertise to keep VA vigilant of new and emerging military exposure health threats. The CETCE’s efforts will align with DoD exposure health efforts and the PACT ACT to proactively understand new military exposure health concerns centered around its current exposure cohorts. While recent CETCE efforts have mainly involved our largest exposure cohort of EOD Veterans, the CETCE has also initiated efforts to engage Veterans from its CWA and Qarmat Ali cohorts. To date, our program has evaluated only one suspected AHI patient. In summary, the CETCE effectively serves the VA and Veterans through its innovative and comprehensive approach to exposure-informed care, cutting-edge research protocols, and timely educational support, all evolving from our identified complex exposure cohorts and from work to proactively detect military exposure health threats.