Women Veterans And Toxic Exposures

Burn pits and jet fuel aren’t just headlines; they’re lived experiences that can follow veterans for years. We sit down with Dr. Maheen Adamson (Research Director) and Dr. Jennifer Jennings (Clinical Director), two VA physicians leading the Women’s Operational Military Exposure Network Center of Excellence, to explain what we’re learning about military environmental exposure and why women veterans have been missing from the data for far too long.

We walk through the center’s mission and the real-world hazards under study, including airborne toxins, chemical exposures, burn pits, and fuels like JP4 and JP8. Then we dig into the health outcomes they’re prioritizing: reproductive cancers, endometriosis, fertility and infertility, menstrual cycle changes, and menopause. We also talk about the longer arc of exposure-related illness and how it can connect to sleep problems, autoimmune issues, psychiatric symptoms, cognitive decline, dementia risk, and heart health. The big theme is translation: pairing detailed clinic stories and intake questionnaires with massive VA and DoD datasets to get answers that are both personal and statistically sound.

We also cover how women veterans across the country can get involved, whether through database-driven research that happens behind the scenes or through hands-on studies that may include MRI, bloodwork, saliva samples, and cognitive testing. Finally, we look at how AI could accelerate discovery while raising real concerns about bias, oversight, and the protection of veterans’ data. If you’re a veteran, a caregiver, or a clinician trying to understand toxic exposure and women veterans' health, this is a practical starting point.

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Transcript

Larry Zilliox 0:15

Good morning. I'm your host, Larry Zilliaks, Director of Culinary Services here at the Warrior Retreat at Bull Run. And this week I have two special guests, Dr. Maheen Adamson and Dr. Jennifer Jennings. They are both with the VA at the Women's Operational Military Exposure Network Center of Excellence. And so these are honest to God, real doctors. This is not like your medic that you call doc. They have an extensive doctor background. I'm not going to go through it. You can go to the web page, which will be listed in the um show notes and read all about it. But uh I asked them to join us to talk about the the center and the research that they're doing out there on um military exposure for our women veterans. So Dr. Adamson and uh Dr. Jennings, welcome to the show.

Dr. Jennings 1:18

Thank you. Thank you for having us on. So thank you very much. Thank you for having us on.

Larry Zilliox 1:23

Yes, so Dr. Adamson, you are the research director. And let's see, Dr. Jennings, you are the clinical director. Dr. Adamson, could you tell our listeners what the difference is?

Dr. Adamson 1:36

Absolutely. The number one difference is that I'm a PhD and she's an MD. And particularly, she isn't she is an uh a neurosurgeon, and she is the best way to describe it for this woman's operational military exposure network center of excellence is that we we are a team. So I do research based on what she tells me are the most salient problems and the most important problems that exist in our veterans. And so we constantly are aligned together so that my research feeds into her clinical work and her clinical works feeds into research. So she sees patients, women, veterans, and I do research on their problem. So that really is the main difference. And Jen, you want to add to that?

What The Center Studies

Dr. Jennings 2:25

Yeah, I think um you covered it quite well. Um I've been the clinical director of the California World-related Illness Nature Study Center. So I've been seeing men and women um for a number of years now uh with unexplained uh military exposure related illness. And um, when we got funding for some special centers, California was designated uh to work with women veterans in military environmental exposure. So we were fortunate enough to, you know, to be able to develop that center and bring um Dr. Adamson on as research director, as well as an amazing team of an epidemiologist, statistician, um, a number of PhDs. Um, and so we're able to address a lot of the issues we had been seeing in our clinical program. Uh, now being able to take that into some translational research, that's kind of how we came about.

Research Priorities And Health Outcomes

Larry Zilliox 3:21

So, listeners, the network or the the center of excellence, they they focus on the health of women veterans who uh exposed to military environmental hazards. So this is, you know, your burn pits, your uh JP4 fuels, the spills like Red Hill, uh, it could be any number of things, but it's what I like is that it's a center and it's research being done specifically to find out how these environmental hazards affect our women veterans differently than our men veterans, because as we all know, for so long women veterans have been underserved. I'm sure for years uh everybody just said, Oh, well, I'm sure it affects them the same way. Dr. Adamson, can you tell us a little bit about the research that you have going on now? Like the number one uh program that you're you're looking into?

Dr. Jennings 4:20

Sure. First of all, I wanted to uh thank you for your comments and bringing us on the show because it is beyond an underserved um population women overall, but women veterans are even more than that. And as you know, the representation of women in the military has increased um from uh quite quite a bit. I think it's gone up to almost 19 to 20 percent now. And women are in slightly different uh military occupation in the military uh than men, but they are on the front lines and they are exposed to a lot of um airborne hazards, chemical um environment uh toxins, as well as other things such as you know, physical injuries and all of this is um delayed and converts into can be related into sleep problems, autoimmune, um, could be related to you know things like psychiatric issues. So there's a lot of downstream things that are not directly connected, but may be connected. And it is um so our portfolio is quite large. Um current seas are focusing on um specific things such as uh cancers, so reproductive cancers, breast cancer, uterine, um, ovarian. We also focus on uh menopause and menstrual cycle uh and reproductive problems such as endometriosis and um, you know, fertility infertility. We have uh worked, we are working on several databases and connecting with a lot of different VA and DOD databases to enlarge our numbers so that we can do epidemiological studies and find out the incidence and prevalence of certain things. We are also interested in things such as heart problems and also specifically things such as dementia, cognitive decline, and psychiatric issues. Um, because as you know, women have more Alzheimer's disease is more prevalent in women, and so is depression. Depression is very high in women, anxiety is higher in women. So we want to look at things not just by the numbers perspective, but also by the perspective of what is happening behind it in the brain, what's happening behind it in the body, such as what the mechanisms are, how the body is changing, how to do follow-ups, and how to provide not just better options for them, but also better treatment. And so, yeah, so it's an all-round thing that we're trying to do within the vendor.

Larry Zilliox 6:48

Well, Dr. Jennings, how does this work from a clinical standpoint? Do you take data from other VA hospitals uh that are seeing uh women veterans, or is it just the ones that you work with out there, or how does the whole program work?

Dr. Jennings 7:07

That's a good question. And I I think so we have kind of more the the qualitative or more personal data that you know uh our my clinical team acquires um from actually having the privilege to be able to speak with these veterans and see them for multiple appointments, spend several hours with them um when they're seen here. So we have kind of a detailed uh perspective that way and and qualitative data uh from that source. We have an intake packet for our particular patients, uh, which uh includes lots of questions on different exposures. I mean, you brought up jet fuel, you know, we like to even get down to whether it's JP4, JP8, um, you know, whether they worked on the fuel line, that kind of thing. And then so we've had that intake packet for the war-related illness and injury study center uh almost since its inception. But then we we realized that there weren't that many questions dealing with reproductive cancers, you know, fertility, things that affect women. So we created an addendum um in the last couple of years to ask those questions in addition to our regular intake packet. So we we have that data, um, which is extremely valuable. It's very, you know, detailed and personalized, and we have information about their deployment, um, you know, which state are they were in, what their MLS lies. And then um, but you know, the the numbers there are far smaller um in a sense uh because it's it's so detailed. So Meteen's team actually, we have, you know, kind of an advantage of being located in in Silicon Valley. Uh, you know, we have a data architect, we have these, you know, people that are great at crunching numbers. So they've actually gained access to really large databases that have, you know, almost all veteran data. And we're working on that. Going back to Jetfield, we just had a paper come out in conjunction with our uh home office in DC about jet fields and reproductive cancers. So for those types of data sets, we're looking at um, you know, large quantities of data. Uh, that's owned with its own sounds because you know, we there's some medical data in one repository and then their deployment data in another. And so, you know, I'm COVID store because these really smart people that are able to, you know, marry those databases and get those big qualitative, uh, big quantitative numbers for us as well. So we kind of have it's it's kind of a multi-client approach, I guess, is a good question.

Larry Zilliox 9:52

Well, is there a way for a a woman veteran, say, in Louisiana, is there a way for her to be part of your study, or is this all happen behind the scenes?

Dr. Jennings 10:06

Uh yes, I think and this isn't so there are two types of studies that we really are. I can divide it into two. One is we look at databases and we look at numbers and we report things that exist, right? So we can do epidemiological studies and tell you what the incidence is of a certain type of disease and women veterans. For that, we don't need women to come in. We just need to uh access all these databases, and we have a lot of expertise in that and continue to grow that expertise. The other type of studies that I was talking about is we are really big into neural imaging. We image the brain, we collect blood, we collect saliva, we collect how you perform on cognitive tasks. Um, we are very big on collecting how these exposure measures measures, which is basically intake packet that we have, in which we uh Dr. Jennings' team clinically have created a woman's uh woman's questionnaire that specifically asks for how your health problems are based on the exposures that you've gone through. So, for that, we need our our women veterans to be extremely excited about this and to work with us and either work with us virtually or work and come in for research studies. We're constantly looking to expand our horizon, tell people about what we do so that the women are interested. And to be honest, most of the women patients Dr. Jennings have seen, they have all been really interested in this. So we work nationally, we're a national center. So if someone is interested in our study and they find out through a fly or through another VA or through our, they are welcome to come and be part of it. And we either work with them virtually or we try to bring them in, depending on what the study is. Some of our studies take days because we are working on collecting blood and collecting MRI, talking to you about your reproductive uh issues. And so there's a lot of like we might, you know, we there's a lot of studies that we even can bring you in and we can um uh you know put you up in a in a hotel and pay for your travel based on the study that we are conducting.

Larry Zilliox 12:10

Okay.

Dr. Jennings 12:10

So yes, there's a lot of out there. Yeah.

Larry Zilliox 12:13

Okay. And would they would the process involve like going through their VA primary care?

Dr. Jennings 12:20

Um um that's a clinical question. I would let Dr. Jennings, because there's two different things. If they want to see us clinically, that's Dr. Jennings, and it'll go through the provider. And if it's research, it'll go, they'll just come to us and we'll we'll work directly with them for research. Correct, Jen? Yes. So the clinical program um is part of the national risk program. So we are divided geographically. Um, we're out in California, we cover kind of the western US, and then BC and New Jersey cover the remainder of the United States. So men or women uh with these deployment-related concerns, um, they can ask their primary care provider to put in a consultation for the war-related illness and injury study center, and they're automatically sent to uh catchment area. So, you know, they may naturally go to DC, but um I'm in constant contact with the clinical directors of DC in New Jersey. Uh, so if there is a woman that has specific concerns, uh they'll reach out to me if they get that consult. Um, but as uh Dr. Adamson said, once we have these studies up and running, and we'll we'll include uh a link to our website. Uh, you know, we should have the the contact numbers for those specific studies um online that they can reach out to you directly.

Larry Zilliox 13:42

And is that the war related illness.va.gov webpage?

Dr. Jennings 13:48

Um yes, I believe I believe it's the war related illness and injury study center webpage, and then um you can navigate to the Wimpen Center through that. Um, or we can we can attach a direct search us in Google.

Dr. Adamson 14:02

You just put in woman COE. We come up as Women COE, but we're uh uh we're a tab in within the War Related Illness and Injury Study Center.

Why Women Veterans Should Use VA Care

Larry Zilliox 14:11

Well, uh listeners, I'll have a link to the web page in our show notes. So there'll be a shortcut there for you. Don't worry about that. Dr. Jennings, uh one of the biggest problems that women veterans have is that when they separate and complete their service, it's hard for them to, I think, want to be veterans in the sense that they they don't act the same way as as men do, and they're not wearing hats, they're not, you know, they're not joining um organizations like the VFW, the uh American Legion. You know, about 65% of women veterans don't seek help from the VA. What would you say to them as as a as a doctor for the VA and who sees women veterans all the time about why they should um come and get treatment from the VA or at a minimum get into the system?

Dr. Jennings 15:09

Right. That's uh that's a great uh point. And we we really welcome women veterans in. I have to say, when I was in medical school uh, you know, in the late 1900s, um, we we really didn't see that many women. And I I could see why it wouldn't be um wouldn't be their first uh place to go for health care if we didn't have as many services for women as we do now. I do think uh that we've come a long way um in really recognizing um issues uh particular to women, uh SFDA, you know, there's Helvic Floor therapy, there's a lot of research going on. Um a lot of our providers are actually uh women veterans. Uh I serve on the clinical practice guideline group for menopause recommendations, with, you know, we have some active duty service members, um, some veterans. And so uh those recommendations will be coming out later this year, but there really is uh more of a focus on women. And especially speaking of menopause, a lot of times that transition from active duty to being a veteran comes at the same time as uh, you know, uh menopause as well. And so um we really don't want to lose these women to follow-up, and we want to have them a good, we want them to have a good transition uh to care. And I think we neglected to mention that our both the risk and the women COE have three components, which is clinical research and education. And so we do have this large education component, reaching out to providers in the VA, really spreading the word about um issues specific uh to women veterans. And uh we've tried to tailor our research and clinical programs as well to the fact that a lot of these women are um I maybe part of the reason they don't engage in some of these groups is that they are, you know, primary caretakers when they come home. And so, you know, we we're working to be able to then for them to have labs being able to be drawn at their home or video visits, uh, you know, so they can they can work and be caretakers and get the the medical care uh that they should be getting.

Dr. Adamson 17:31

Wow.

Dr. Jennings 17:32

But they are entitled to benefits, especially with the TAC Act. I encourage, you know, veterans to at least even if they have private insurance on the outside, I really I think it's valuable to be engaged with the VA.

Larry Zilliox 17:44

Yeah, I think uh all veterans should register with the VA and uh make a claim. Women uh veterans are no different. Uh they suffer the same illnesses and injuries that male veterans do. It's the same thing for women veterans as it is for guys. I tell them, look, it may not hurt you now, but I guarantee you when you get to be my age, it will. And then you'll be you'll get you know a rating and and some compensation. So get in there, make the claim now, and get registered, be part of this research and this program because uh it's going to benefit your fellow service members and fellow veterans. Uh, the research that they do is it's amazing.

Dr. Jennings 18:31

I think I see a lot of we're seeing a lot of Gulf War era veterans now, and I think they by nature they tough it out for as long as they can. And then, you know, um, yeah, as they get older, they they do come in and and um and that's what's valuable about working with the veterans because they are always willing to contribute to research. And I've heard time and time again, I don't know if you can help me, but if what I can contribute can help somebody else, then it's worth it.

AI In Exposure Research And Clinics

Larry Zilliox 18:58

Yeah, for sure. Um so as we wrap up, I just want to ask you both uh the same question. Um, Dr. Adamson, when you think about the work that you're doing, how do you think AI will affect what you're doing?

Dr. Adamson 19:16

Oh my goodness. Yes, it affects it very, very big. I think I was talking to um uh somebody who is really focused on the predictability of human behavior. So and I'll just give you an example. This is from an NIA study, and they actually wanted to find out how people are performing and how it has to do with what's called adherence to medication. That is a huge problem. A lot of people don't adhere to medication, and so they wanted to build these models so that they could figure out is are there any indications in their social media behavior that can predict that they will uh actually not adhere to the medication, give up their medication. And they were able to get permission to look at uh data from social media data, like what are the fun things about themselves? And that actually predicted their behavior of letting go of their medication or something like that. So there's so there's a lot of data mining that AI can do that can really help us do an incredible amount of disease um identification, progression, as well as treatment. So that's huge. The local the of course using it for like you know, avatars and helping people with um coming into the clinic, making them do uh specific uh questionnaires, how and all of that, the AI bots and stuff, that's great. But there's a higher purpose for AI, which I just explained with the study. So I think uh there are there are things like that that I would really like to do, or like the way we map the mental cycle now with even an Apple Watch, it is so much more it gives you so much more data than ever than we have ever known about a woman's body. And a woman's body changes a lot, and it changes a lot, not just in the body, it changes it's not just in like organs that are reproductive, it changes everywhere, it changes the brain at a certain time of the of the mental cycle. So it's really important to use AI as as a tool, and and I think it's really important to embrace it in the hospital, in the home, but also it's a beast. So you have to control it. You have to be able to double check it and make sure that it is telling you the right information. And one of the ways to double check it is that what data is going in it. Because what you have to make sure that there's enough information about women, about women veterans, about exposures, about everything, so that it can calculate on the right amount of variables. If the variables don't exist, then that's not going to be able to give you the output.

Larry Zilliox 22:02

I will uh pose the same question to you, Dr. Jennings. Uh on the clinical side, do you see any impact from uh AI?

Dr. Jennings 22:11

Uh I think it seems to be an inevitable. In a way. So, you know, I really approach it as using it potentially as a tool. I mean, like Dr. Adamson said, we are able to process large amounts of data using it, but recognizing that it is a tool and that, you know, I still need to use my clinical judgment and want to review everything. I also uh am very protective of the women's data that we gather. Um, you know, I mean, there are all these protections in place, but you know, I I feel like, you know, I there's a certain amount of trust in us as as providers, and um and we want to respect that. So, you know, I I guess I approach it costlessly. You know, I think it is uh, you know, there's no other way to process sometimes these large amounts of data, but to be very um, you know, to have a lot of supervision.

Register With VA And Closing

Larry Zilliox 23:07

Right. Well, uh listeners, again, it's the war-related illness.va.gov webpage. And I'm gonna have a link to it uh in the show notes. I want everybody to go and check it out, see the resources, see the research that they're doing on all sorts of military exposure. And uh this is the VA at work. And again, I want to go back to not only women, but all veterans. You need to register with the VA and put in a claim. And okay, you don't you're not gonna get you get a zero rating or you'll get no compensation, but you're gonna get on the books. Another thing that that helps with is that the more veterans that are registered in the VA is servicing, the more money it's gonna require, and the more they're gonna get from Congress, which means the more money that these amazing doctors have here to do this kind of research that's gonna benefit all of our veterans. So please check out the webpage, make sure you put in a claim with the VA. Doc, listen, I I can't thank you enough for coming on, both of you, and telling us all about the center. Uh, the work that you you guys do is amazing. You know, as a veteran, we really thank you for everything that you do.

Dr. Jennings 24:30

Thank you for having us on, and thank you to all the veterans for their service as well.

Dr. Adamson 24:35

Thank you very much. And uh uh I'm very thank thankful to all the veterans. Thank you for having us on the show. And I do remember uh the Under Secretary of the VA saying that the enrollment of the VA has increased this year. So I hope that it keeps increasing.

Larry Zilliox 24:50

That's good. We need we need everybody to be registered. So listeners, we'll have another episode next Monday morning at 0500. If you have any questions or suggestions, you can reach us at podcast at willingwarriors.org. You can find us on all the major podcast platforms. We're on YouTube and Wreaths Across America Radio. So until then, thanks for listening.