The U.S. Military and the Exposome

The US military has great potential to study and utilize the exposome, as well as great need. By their very nature, military Service members serve in diverse environments, under a variety of stressors, with pressure to perform and execute tasks under any conditions. The US military is unique in the range of environments they deploy to, as well as the kinds of industrial chemicals and materials they are exposed to, making them one of the most dynamic occupational health populations in the world. Unique environmental exposures include documented incidents such as burn-pit exposure, sulfur fires at the Mishraq sulfur mine, and water quality at Camp Lejeune, versus subtle exposures such as lead from munitions training, diesel exhaust, or JP-8 jet fuel exposure. Balancing the environmental health concerns of individuals with the operational needs of a unit can be challenging and dynamic. This has led the military to prioritize efforts for exposure surveillance, mitigation strategies, and leading-edge research initiatives. In this chapter, we will discuss the unique operational environments and exposures warfighters encounter, as well as the biomonitoring, military records for exposures, and how this relates to individual exposomes. The military has unique assets for exposome monitoring, such as uniform electronic health records (EHR), individual longitudinal exposure records (ILER), serum collection pre- and post-deployment for biobanking and surveillance, and a more normalized population relative to nutrition and demographics. This makes the military exposome unique, and provides important avenues for study and application.