title: Findings From the Department of Veterans Affairs Qarmat Ali Medical Surveillance Program.
abstract: OBJECTIVE
  To review the Veterans Affairs (VA) medical surveillance program for Veterans with potential hexavalent chromium (CrVI) exposure that occurred during 2003.
  
  
  METHODS
  Retrospective review of medical records of the 124 Veterans that participated in standardized, in-person clinical evaluations for possible CrVI exposure during the incident in question. The evaluations were reviewed to define population level effects. In addition, a mortality analysis was conducted for the 808 unique personal identifiers available to Veterans Health Administration.
  
  
  RESULTS
  Mean reported number of days exposed was 21 (median 10). A history of respiratory (n = 78) and skin (n = 38) symptoms were reported during the period of exposure. No abnormalities that were specific to chromium exposure (e.g., nasal septum perforation) were found. Eight deaths occurred between 2005 and 2012.
  
  
  CONCLUSIONS
  The lack of severe nasal abnormalities in the VA evaluations supports a time-limited peak exposure. However, the overall low participation rate (15%) severely compromises any ability to generalize to the entire potentially exposed population. Regardless, since the actual level of exposure to CrVI will never be known with certainty, the VA will continue to monitor these Veterans with periodic evaluations to identify and manage any pathologic findings that might be associated with past CrVI exposure.
authors.affiliation: Post Deployment Health, Office of Public Health, Veterans Health Administration, 810 Vermont Avenue NW, Washington, DC 20420.
authors.forename: Paul
authors.initials: P
authors.lastname: Ciminera
authors.affiliation: Department of Preventive Medicine, Reynolds Army Community Hospital, 4301 Wilson Street, Fort Sill, OK 73503.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Superior
authors.affiliation: Post Deployment Health, Office of Public Health, Veterans Health Administration, 810 Vermont Avenue NW, Washington, DC 20420.
authors.forename: Tim
authors.initials: T
authors.lastname: Bullman
mesh_terms: D002857:Chromium / Q000633:toxicity*; D006801:Humans; D007493:Iraq; D054542:Iraq War, 2003-2011; D008889:Military Personnel; D016273:Occupational Exposure / Q000009:adverse effects*; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans; D058014:Veterans Health
chemical_list: D002857:Chromium; C074702:chromium hexavalent ion