Invisibles Battles: Military Toxic Exposures and Health Provider Roles

Photo courtesy of U.S. Dept. of Veterans Affairs

The intersection of military service and environmental exposures has become an increasingly critical area of concern. Environmental factors affect the health and well-being of military personnel in complex and multifaceted ways, and ill and injured military veterans may find their high aspirations undermined by mental and physical ailments that significantly affect their quality of life.

This is the case for several of my family and friends, including my uncle, a veteran from the era of Desert Shield/Desert Storm, who has suffered for years because of the effects of environmental and other exposures while in the military.

A direct strike against health and wellness.

Many veterans say that they had a picture-perfect bill of health before exposure to environmental hazards during military service. Here is a glance at some of the exposures that service members faced in recent decades while in a garrison or on deployments to conflict zones.

Exposures and health impacts on service members:

    • Chemical/biological exposures such as Agent Orange, depleted uranium, and other battlefield contaminants. These exposures have been linked to cancer, respiratory diseases, neurological disorders, or reproductive issues.
    • Radiation exposure such as ionizing radiation, especially for those involved in nuclear operations or exposed to radioactive materials. These exposures can cause long-term health issues, including cancer, that require careful monitoring for early detection.
    • Occupational hazards such as noise pollution, extreme temperatures, and ergonomic challenges contribute to chronic health conditions and point to a need for greater attention to preventive measures.
    • Psychosocial stressors such as deployment-related stress and post-traumatic stress disorder (PTSD) are common and reflect the complex interplay between mental health and physical well-being in each individual.

Members of the military community make incredible sacrifices on our behalf. My uncle, like many other veterans, has suffered from PTSD, infertility, and other long-term health problems since serving in the Persian Gulf War. Health care providers should go beyond merely treating illnesses to actively fostering holistic health and wellness among veterans. An approach integrating mental health services and stress management is crucial given the interconnected nature of environmental exposures and overall well-being.

Education about environmental exposures: a powerful weapon.

Education can empower health care providers to effectively manage military environmental exposures. Continuous training and education programs enable health care professionals to stay abreast of evolving data and emerging research in military environmental medicine. This knowledge can equip providers with the skills needed to recognize, evaluate, and treat health conditions resulting from environmental exposures. Furthermore, education emphasizes the importance of early intervention and personalized care for military personnel.

Key Takeaways:

  • Providers need specialized training in recognizing and addressing health concerns related to military environmental exposures.
  • Providers should explore existing educational programs and initiatives aimed at enhancing the knowledge and skills in this domain.
  • It is important to understand military culture and the subculture of each branch.

What nurses and other health providers can do.

  • Realize that the peace and security of our nation isn’t free—someone must sacrifice.
  • Providers should learn about military exposures and experiences. Ask your patients if they’ve served.
  • Providers should address the need for support services for veterans dealing with the consequences of military environmental exposures.
  • Advocate for the integration of mental health and wellness programs.
  • Treat others the way that you want to be treated. Taking the extra step can save a life!

Each soldier, marine, airman, or sailor has their own story, and many of their stories have elements in common. Military service involves a myriad of challenges; among the less visible but equally consequential issues faced by service members are toxic exposures.

“Military Environmental Exposures” in the November issue of AJN aims to shed light on the often-overlooked consequences of military toxic exposures, exploring their sources, health implications, and the need for comprehensive solutions.

By understanding the diverse environmental risks and actively participating in early detection and treatment strategies, health care professionals can contribute significantly to the overall well-being of our nation’s veterans.

Cashmere Miller is a lieutenant in the U.S. Public Health Service Commissioned Corps and an NP for environmental health at the U.S. Department of Veterans Affairs in Atlanta. Contact author:

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