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Abstract Introduction Burn pits (BPs) have been widely utilized by the U.S. military for waste disposal. Due to toxic nature of the BP emissions, exposure may contribute to adverse health conditions, including nocturnal breathing problems. This study aimed to examine the association between self-estimated amount of BP emission exposure and oxygen (O2) levels during sleep. Methods Using polysomnography reports in the Veteran Affairs electronic medical records, oxygen saturation (SaO2) measures were extracted for 4940 Veterans and active-duty personnel (age 39.7±9.2 y, BMI 29.3±4.6 kg/m2, 16% female, 66% white) registered on the VA/DoD Airborne Hazards and Open Burn Pit Registry. Outcomes included nadir and mean SaO2. Cumulative BP exposure (BPe) variable was calculated by multiplying the response (in hours) to a question about burn pit exposure by number of deployment days, summing across deployments, and categorized into quartiles by ranking (Q1-Q3, with Q0 as reference). Inverse probability treatment weighing method was used to adjust the imbalances of covariates age, BMI, sex, race, ethnicity, military branch, and duty status between treatment groups. We performed separate weighted logistic regression models to determine the association between cumulative BPe days and SaO2 (≤90%). Additional analyses were performed on current smoking subgroup. Results We observed higher odds of nadir (OR:1.2, p=.045) and mean (OR:1.29, p.0001) SaO2 in prolonged BPe quartile (Q3). Subgroup analyses revealed similar findings as prolonged BPe quartile in current smokers predicted higher odds of nadir (OR:1.69, p=0.02) and mean SaO2 (OR:1.97, p=.0003) Conclusion Higher levels of BP emission exposure was associated with lower oxygen saturation during sleep. Compared to former and never smokers, veterans with current smoking status and higher BPe had significant lower SaO2. Hence, smoking may exert a synergistic effect with BPe on nocturnal SaO2. Support (if any) This work is supported by the Department of emi Affairs, Veterans Health Administration, Office of Research and Development, and the Center for Innovations in Quality, Effectiveness and Safety (CIN 13-413), Michael E DeBakey Veteran Affairs Medical Center Bridge Grant, and the VA Airborne Hazards and Burn Pit Center of Excellence Pilot Grant (PI:Nowakowski).
Kokonda et al. (Sat,) studied this question.