■美国军方通常将露天烧伤坑用于废物处理,但尚未将其作为头痛疾病的独立危险因素进行系统研究。
■评估暴露于开放性烧伤坑与头痛和偏头痛发生率之间的关联。
■这项回顾性队列研究使用了退伍军人健康管理局头痛队列的数据以及美国国防部和空降危害和开放式烧伤坑(AH&OBP)注册中心的数据,以评估注册参与者从2014年4月1日至2022年10月31日在退伍军人健康管理局可能暴露于开放式烧伤坑。通过将AH&OBP注册中心的数据与美国国防部和退伍军人健康管理局的电子健康记录联系起来,纳入了参与者。从分析样本中去除先前存在头痛的那些。该分析是在2022年11月1日至2024年1月31日之间进行的。
■基于注册问卷的露天烧伤坑暴露复合变量进行了检查,特别是在露天烧伤坑附近,天附近的露天烧伤坑,有露天燃烧坑的职责。
■主要事件结局包括医学诊断的头痛和医学诊断的偏头痛。
■分析样本包括247583名退伍军人(平均[SD]年龄,27.9[7.7]岁;222498[89.9%]男性)。在基线控制协变量后,在开放烧伤坑附近有开放烧伤坑职责的参与者在医学诊断的头痛疾病中的调整几率最高(调整后的优势比[AOR],1.59;95%CI,1.46-1.74),偏头痛(AOR,1.60;95%CI,1.43-1.79),和自我报告致残性偏头痛(AOR,1.93;95%CI,1.69-2.20)与没有接触的人相比。累积烧伤坑暴露的2个最高四分位数(290-448天和>448天)具有明显较高的医学诊断头痛的校正几率(290-448天:AOR,1.20;95%CI,1.09-1.31;>448天:AOR,1.55;95%CI,1.41-1.70)和偏头痛(290-448天:AOR,1.19;95%CI,1.07-1.34;>448天:AOR,1.48;95%CI,1.32-1.65)。
■在这项队列研究中,开放性烧伤空洞暴露与医学诊断的头痛和偏头痛之间存在剂量依赖性关联.这些新数据确定了开放烧伤钻头暴露与服务人员新发头痛之间的潜在重要关联,以及退伍军人健康管理局设施在强制筛查军事暴露期间可能更频繁地遇到的可能的健康状况。
UNASSIGNED: Open burn pits have commonly been used for waste disposal by the US military but have not been systematically investigated as an independent risk factor for headache disorders.
UNASSIGNED: To evaluate the association between exposure to open burn pits and incidence of headache and migraine.
UNASSIGNED: This retrospective cohort study used data from the Veterans Health Administration Headache Cohort along with data from the US Department of Defense and the Airborne Hazards and Open Burn Pit (AH&OBP) Registry to assess registry participants with potential exposure to open burn pits in the Veterans Health Administration from April 1, 2014, through October 31, 2022. Participants were included by linking data from the AH&OBP Registry to their US Department of Defense and Veterans Health Administration electronic health records. Those with preexisting headache were removed from the analytic sample. The analysis was conducted between November 1, 2022, and January 31, 2024.
UNASSIGNED: Open burn pit exposure composite variables based on the registry questionnaire were examined, specifically being near open burn pits, days near open burn pits, and having open burn pit duties.
UNASSIGNED: Primary incident outcomes included medically diagnosed headache disorders and medically diagnosed migraine.
UNASSIGNED: The analytic sample included 247 583 veterans (mean [SD] age, 27.9 [7.7] years; 222 498 [89.9%] male). After covariates were controlled for at baseline, participants who were near an open burn pit with open burn pit duties had the highest adjusted odds of medically diagnosed headache disorders (adjusted odds ratio [AOR], 1.59; 95% CI, 1.46-1.74), migraine (AOR, 1.60; 95% CI, 1.43-1.79), and self-reported disabling migraine (AOR, 1.93; 95% CI, 1.69-2.20) compared with those without exposure. The 2 highest quartiles of cumulative burn pit exposure (290-448 days and >448 days) had significantly higher adjusted odds of medically diagnosed headache (290-448 days: AOR, 1.20; 95% CI, 1.09-1.31; >448 days: AOR, 1.55; 95% CI, 1.41-1.70) and migraine (290-448 days: AOR, 1.19; 95% CI, 1.07-1.34; >448 days: AOR, 1.48; 95% CI, 1.32-1.65).
UNASSIGNED: In this cohort study, a dose-dependent association existed between open burn pit exposure and medically diagnosed headache and migraine. These new data identify potentially important associations between open burn bit exposure and new-onset headache among service personnel as well as a possible health condition that may be encountered more frequently in Veterans Health Administration facilities during mandatory screening for military exposures.