LAUSR

Burn pits (BPs) have been widely used by the U.S. military for waste disposal. Due to the obviously toxic nature of the BP emissions, exposure may contribute to diverse adverse health conditions, including sleep apnea. To our knowledge, this is the first study to examine the association between self-estimated amount of BP emission exposure and self-reported sleep complaints. We used an online health questionnaire of the VA/DoD Airborne Hazards and Open Burn Pit Registry administered between April 2014 and August 2022 to 320,231 Veterans and active-duty personnel (age 40.1±9.2 years, BMI 28.8±4.5 kg/m2, 11% female, 75% white). Outcomes included insomnia, short sleep duration < 6hrs, sleep apnea events, and snoring. The exposure variable was cumulative BP exposure that was calculated by multiplying the response (in hours) to a question about burn pit exposure by number of deployment days, summing across deployments, and categorizing by quartile. We employed separate logistic regression models to determine the association between cumulative BP exposure days and sleep outcomes using no BP exposure as the reference. We adjusted the models by age, BMI, sex, race, ethnicity, military branch and duty status. We observed higher odds of insomnia as the duration of BP exposure increased in each quartile (Q1-Q4 ORs:1.8-3.4, p<.001). The same trend was observed for shorter sleep duration (Q1-Q4 ORs:1.6-2.4, p<.001), sleep apnea (Q1-Q4 ORs:1.4-2.4, p<.0001) and snoring (Q1-Q4 ORs:1.3-1.8, p<.0001). Higher levels of BP emission exposure was associated with a greater report of insomnia symptoms, shorter sleep duration, snoring and sleep apnea events. Future research will focus on examining the association of BP emission ­exposure and objective sleep data extracted from polysomnography reports in the Veteran Affairs electronic medical records. This work is supported by the Department of Veteran 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 (PI: Nowakowski), and the VA Airborne Hazards and Burn Pit Center of Excellence Pilot Grant (PI: Nowakowski).