PDF(Pubmed)
Abstract：
Understanding the health outcomes of military exposures is of critical importance for Veterans, their health care team, and national leaders. Approximately 43% of Veterans report military exposure concerns to their VA providers. Understanding the causal influences of environmental exposures on health is a complex exposure science task and often requires interpreting multiple data sources; particularly when exposure pathways and multi-exposure interactions are ill-defined, as is the case for complex and emerging military service exposures. Thus, there is a need to standardize clinically meaningful exposure metrics from different data sources to guide clinicians and researchers with a consistent model for investigating and communicating exposure risk profiles. The Linked Exposures Across Databases (LEAD) framework provides a unifying model for characterizing exposures from different exposure databases with a focus on providing clinically relevant exposure metrics. Application of LEAD is demonstrated through comparison of different military exposure data sources: Veteran Military Occupational and Environmental Exposure Assessment Tool (VMOAT), Individual Longitudinal Exposure Record (ILER) database, and a military incident report database, the Explosive Ordnance Disposal Information Management System (EODIMS). This cohesive method for evaluating military exposures leverages established information with new sources of data and has the potential to influence how military exposure data is integrated into exposure health care and investigational models.
摘要：
了解军事暴露的健康结果对退伍军人至关重要，他们的医疗团队,和国家领导人。大约43％的退伍军人向其VA提供者报告了军事接触问题。了解环境暴露对健康的因果影响是一项复杂的暴露科学任务，通常需要解释多个数据源；特别是当暴露途径和多重暴露相互作用不明确时，复杂和新兴的军事服务风险也是如此。因此，有必要对来自不同数据源的临床上有意义的暴露指标进行标准化,以指导临床医生和研究人员使用一致的模型来调查和传达暴露风险概况.跨数据库关联暴露（LEAD）框架提供了一个统一模型，用于表征来自不同暴露数据库的暴露，重点是提供临床相关的暴露指标。通过比较不同的军事暴露数据源来证明LEAD的应用：退伍军人军事职业和环境暴露评估工具（VMOAT），个人纵向暴露记录（ILER）数据库，还有一个军事事件报告数据库,爆炸物处置信息管理系统(EODIMS)。这种评估军事暴露的内聚方法利用已建立的信息和新的数据来源，并有可能影响军事暴露数据如何整合到暴露卫生保健和调查模型中。
