Occupational
Depression and anxiety disorders among Veterans following occupational jet fuel exposure: Preliminary findings from the Long-term Impact of Fuel Exposure (LIFE) Study Elizabeth R. Heitz* Elizabeth Heitz Nicholas A. Tilton Justin G. Bergeron Jennifer A. Rusiecki Gregory Wolff Aaron I. Schneiderman Edward A. Sheriff W. Scott Monks Terra D. Vincent-Hall
Occupational jet fuel exposure is common in military service members. Current evidence suggests a possible relationship between exposure to jet fuel and adverse effects on neurological function, cognition, and behavior. To better understand these and other possible health outcomes in Veterans, the Department of Veterans Affairs (VA) is conducting the LIFE Study. This retrospective cohort study utilizes administrative datasets from the Department of Defense (DoD) and VA to assess health outcomes in 1.3 million Veterans who entered service on or after January 1, 1995. Preliminary analyses were limited to Veterans with at least one documented healthcare encounter following their separation from service to ensure that longitudinal data were available for all subjects. Jet fuel exposure was classified based on military occupation codes, with total time spent in fuel-exposed occupations categorized into quintiles. Incident cases of anxiety and depressive disorders were identified using ICD-9 and -10 codes from DoD and VA health records. Cox proportional hazards models with time-varying exposure were used to estimate risk of anxiety and depression related to quintile of exposure. More than half of Veterans with anxiety or depression were diagnosed after separating from service. Initial results from regression models showed Veterans with approximately 3 to 6 years of occupational jet fuel exposure had the highest risk of anxiety and depression, compared to those with no fuel exposure. Associations were modest, but statistically significant, and consistent with results from past studies in other populations. LIFE Study analyses are ongoing. Its findings may have implications for both Veterans’ healthcare and hazard control in the military.