Findings From the Department of Veterans Affairs Qarmat Ali Medical Surveillance Program.

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.