Professor Coauthors Report on Mental Health Effects of Toxic Exposures Among Veterans.
U.S. Marines move through southern Iraq on March 26, 2003. PHOTO: JOE RAEDLE (GETTY IMAGES)
Professor Coauthors Report on Mental Health Effects of Toxic Exposures Among Veterans
On a Veterans Affairs-convened National Academies committee, Jaimie Gradus coauthored a report assessing possible links between exposures to hazards during military service and mental, behavioral, and neurologic health conditions among post-9/11 veterans.
Since 9/11, millions of U.S. service members have deployed to Afghanistan, Iraq, and surrounding areas, where they have often encountered intense combat environments rife with environmental hazards, such as dust and particulate matter, exhaust fumes, and burn pits. In the years to follow, many veterans have reported chronic health issues possibly related to these exposures.
In 2022, Congress directed the Department of Veterans Affairs (VA) to investigate these concerns under Section 507 of the Sergeant First Class Heath Robinson Honoring Our Promise to Address Comprehensive Toxics (PACT) Act and the VA commissioned the National Academies of Sciences, Engineering, and Medicine (NASEM) to conduct a formal assessment.
A new report, published by NASEM in August 2025, contains the results of the inquiry which examined the existing evidence for potential links between exposures during military service and mental, behavioral, and neurologic health outcomes among post-9/11 veterans.
Among the coauthors of the report is Jaimie Gradus, a professor in the Department of Epidemiology and the director of SPH’s Center for Trauma and Mental Health. Gradus served on the ad hoc committee of experts NASEM assembled to conduct the study over the course of the past year.
The study and resulting report of the same name, Exploring Military Exposures and Mental, Behavioral, and Neurologic Health Outcomes Among Post-9/11 Veterans, represent one of the first comprehensive efforts to link specific environmental exposures to these health outcomes in the veteran population.
The authors examine how common and pressing conditions such as post-traumatic stress disorder (PTSD), depression, and suicide risk may be shaped by variables other than traumatic events and how cancers and respiratory issues may not be the only conditions related to environmental exposures. Their investigation integrates a structured review of the literature with an analysis of a dataset of more than 1 million veterans who received a diagnosis between 2017 and 2023 from the Veterans Health Administration (VHA).
Altogether, the researchers examined nine categories of exposures and 14 health outcomes, and out of 135 pairs of exposures and outcomes, they found 24 possible risk-conferring relationships. However, the committee cautioned that evidence was largely inadequate or insufficient to draw any conclusions about the vast majority of relationships between exposures and outcomes.
Gradus says that the quality and availability of data presented a major challenge to drawing any actionable conclusions from the study. She explains that researchers had to pool health outcomes and other administrative data from the Veterans Health Administration with toxic exposures data from the Individual Longitudinal Exposure Record, a joint VA and Department of Defense resource, to create a dataset worthy of analysis.
“Unfortunately, we didn’t have the data we would need for a rigorous study of these associations yielding strong evidence,” reflects Gradus. “I think it’s an important call to action to collect more data on this topic. A prospective study that gathers all this information on the same people, and systematically follows them over time, would be a huge advancement.”
An accomplished psychiatric epidemiologist, Gradus has received multiple grants to conduct research on trauma and trauma-related disorders in both veterans and the general population. She has also previously served on a NASEM committee and contributed her PTSD expertise to the creation of a report for the Social Security Administration. She says that being involved in committees such as these has proven one of the highlights of her role as a researcher.
“We had such a great collegial experience working on this together,” she says. “We hope to encourage more research in this area. There needs to be more data collected before we can definitively say more about these associations.”
