Air Force Medical Service:  Missile Community Cancer Study

https://www.airforcemedicine.af.mil/Resources/Missile-Community-Cancer-Study/

Quoting all of the questions and answers:

• Q. HAS A STUDY BEEN DONE TO SEE IF THERE ARE INCREASED RATES OF NON-HODGKIN LYMPHOMA IN MISSILEERS?
• Q. WHAT IS THE AIR FORCE DOING TO LOOK INTO THIS RISK?
• Q. SHOULD I GO GET SCREENED?
• Q. HOW IS NHL DIAGNOSED?
• Q. WHAT MEDICAL SIGNS AND SYMPTOMS SHOULD I BE LOOKING FOR?
• Q. CAN I GO GET SCREENED AT ANY TIME?
• Q. WHAT DOES TREATMENT LOOK LIKE IF I BECOME SYMPTOMATIC?
• Q. IS IT SAFE TO GO ON ALERT?
• Q. HOW ARE THESE HAZARDS DOCUMENTED IN MY MEDICAL RECORDS?
• Q. WHAT ARE THE POSSIBLE CAUSES / CONTRIBUTION FACTORS OF NHL?
• Q. ARE THERE ANY REPORTS FROM ANY OTHER MISSILE WINGS (BESIDES MALMSTROM)?
• Q. IS THERE ANY ENGAGEMENT WITH OUTSIDE ORGANIZATIONS LIKE THE ASSOCIATION OF AF MISSILEERS?
• Q. WHEN WILL UPDATES BE PROVIDED?

• Q. HAS A STUDY BEEN DONE TO SEE IF THERE ARE INCREASED RATES OF NON-HODGKIN LYMPHOMA IN MISSILEERS? U.S. Air Force School of Aerospace Medicine (USAFAM) completed a review of Malmstrom cancer concerns in 2001 showing no increased rates of non-Hodgkin lymphoma among missileers. The evaluation included record reviews encompassing 1991-2000, and it included site sampling. However, we acknowledge time has passed and have the responsibility to investigate any potential service-related risks to Airmen, Guardians or their dependents’ health. We take this responsibility seriously.
  
  
• Q. WHAT IS THE AIR FORCE DOING TO LOOK INTO THIS RISK? The USAF continues to employ significant resources to ensure the safety of force and family.  For example, each installation maintains a bio-environmental engineering team that routinely samples air, water, and workplace safety as well as a public health safety team that remains committed to the safety of force and family.  The USAF is also committed to a worldclass work environment.  Consequently, when the chain of command hear of this matter, General Thomas A. Bussiere, Commander, Air Force Global Strike Command, approved a comprehensive study design by USAFSAM to conduct a formal assessment that addresses specific cancer concerns raised by missile community members across related career fields and also examines the possibility of clusters of non-Hodgkin's lymphoma (NHL) at intercontinental ballistic missile bases.
  
  
• Q. SHOULD I GO GET SCREENED? There is no screening test for NHL. Current and former Service members and their dependents that are concerned or have questions can always speak with their health care provider about personal risk factors and a health care plan.
  
  
• Q. HOW IS NHL DIAGNOSED? Bone marrow and lymph node biopsies, in concert with CT scans, are used to diagnose NHL when a person has symptom or signs of illness. These tests are not screening tests.
  
  
• Q. WHAT MEDICAL SIGNS AND SYMPTOMS SHOULD I BE LOOKING FOR? One of the most common symptoms is an enlarged lymph node, causing a lump or bump under the skin, which is usually not painful. This is most often on the side of the neck or in the armpit or groin.
   
  Other symptoms can include fever, chills, night sweats, weight loss, feeling tired, and swelling in the abdomen. If an individual believes they have symptoms of NHL they should consult their health care provider.
  
  
• Q. CAN I GO GET SCREENED AT ANY TIME? There is no screening test for NHL. Current and former Service members and their dependents that are concerned or have questions can always speak with their health care provider about personal risk factors and a health care plan. HIPAA requires physicians to protect patient’s health information by using safeguards to ensure confidentiality, integrity and security of the information. Additionally, military members' information is only provided to command on an as needed basis if mission readiness is affected and only in general.
  
  
• Q. WHAT DOES TREATMENT LOOK LIKE IF I BECOME SYMPTOMATIC? Treatment for any cancer is complex. Individuals diagnosed with NHL should work with their health care providers to identify the best treatment plan for their specific cancer. Medical treatment is based on an individuals medical history, risks and comorbidities, and is individualized by the health care team along with the patient. There are different types and subtypes of NHL, with different risk factors and treatments.
  
  
• Q. IS IT SAFE TO GO ON ALERT? Safety is a precondition for every operation we conduct on base and in the missile complex. The Air Force takes the welfare of its personnel seriously and USAFSAM is reviewing the concerns. Our Airmen are also empowered to make the safety decisions in the field and base support agencies are postured to support them to ensure a safe operating environment.
  
  Lastly, if a Service member does not feel well or is concerned, they should seek medical care. If a Service member is under treatment for a condition, their health care team can help determine duty status to ensure their safety, in accordance with the Personnel Reliability Assurance Program and other programs.
  
  
• Q. HOW ARE THESE HAZARDS DOCUMENTED IN MY MEDICAL RECORDS? If a Service member is concerned with a workplace exposure, they should inform their health care provider who will document the concern in the medical record additionally contact your bio-environmental engineer flight that maintains, by Service member, the workplace hazards you have been exposed to throughout your career.
  
  Workplace hazards are monitored in accordance with the Occupational Safety and Health Administration. Medical and civil engineering / facilities meet monthly during the Occupational and Environmental Health Working Group to discuss shops with potential exposure that require surveillance. Service members and supervisors are trained that if a Service member is injured on the job, they should fill out an AF Form 978, notify their supervisor, and seek medical attention, if warranted.
  
  
• Q. WHAT ARE THE POSSIBLE CAUSES / CONTRIBUTION FACTORS OF NHL? Different types of NHL have different risk factors, including genetic and autoimmune predisposition. Depending on the type risk factors include (not all-inclusive): Age; obesity (BMI>30); diets rich in saturated and monounsaturated fats; high intake of red meat / chicken / beef / pork / lamb; infection with: H. pylori, Hepatitis C, HIV (Human Immunodeficiency Virus), EBV (Epstein-Barr Virus).
  
  
• Q. ARE THERE ANY REPORTS FROM ANY OTHER MISSILE WINGS (BESIDES MALMSTROM)? Listings that may be circulating on social media are not all-inclusive and are not official. The study underway by USAFSAM will address specific cancer concerns raised by missile field members across related career fields and examine the possibility of clusters of NHL at intercontinental ballistic missile bases.
  
  
• Q. IS THERE ANY ENGAGEMENT WITH OUTSIDE ORGANIZATIONS LIKE THE ASSOCIATION OF AF MISSILEERS? Yes, we have engaged various organizations. It’s important we use the connecting organizations and agencies around us to share information across as many spaces as possible so Airmen, former Airmen, retirees, reservists, guardsmen and families are aware of updates. We will continue to engage and stay open to suggestions on how to reach other organizations, forums, groups or audiences.
  
  
• Q. WHEN WILL UPDATES BE PROVIDED? Updates will be provided in a transparent way when there is significant information to share. It’s not possible to project when, during the course of the study, USAFSAM will have updates to share.