With the recent recognition of Remembrance Day on November 11th, it is important to acknowledge some of the effects of war that may go unrecognized. There are many things that a military veteran may be made aware of prior to entering the battle field. The risk of physical and/or mental injury, stress, and more. Many however may not have been aware of the fact that military service can increase one’s risk for Parkinson’s disease (PD) and other neurological conditions (Mantri et al., 2019). Something that is especially interesting is that those who served may not experience PD symptoms and only get diagnosed years, or even, decades following service (Veterans and Parkinson’s Risk, n.d.). These initial signs may include changes in sleep or mood patterns, which are common in veteran populations and may go unnoticed as an early part of the disease (Veterans and Parkinson’s Risk, n.d.).
Military Risk Factors for PD:
1. Traumatic head/brain injury: Sudden impact to the head inducing moderate to severe traumatic brain injury (TBI) has been implicated as a risk factor for multiple neurodegenerative disorders, but the strongest evidence is linked to PD (Delic et al., 2020).
2. Agent Orange and other herbicides: Between 1962 to 1975, the U.S. military used a powerful herbicide known as Agent Orange as a tactic to defoliate trees in Vietnam (Agent Orange & Other Toxic Exposures, 2022). The primary chemical in the herbicide, Dioxin, is associated in short-term exposure with skin lesions and altered liver functions, where long-term exposure is associated with impairment of the immune system, nervous system, endocrine system, and reproductive system (World, 2016).
3. Trichloroethylene (TCE): TCE is a chemical compound used to degrease metal parts and pollute outdoor air, groundwater, and is very strongly linked to the development of PD (E. Ray Dorsey et al., 2023). TCE causes selective loss of dopamine-producing neurons, which is a hallmark of the disease (E. Ray Dorsey et al., 2023).
Identification of Risk Factors
Canadian Military personal who came in contact with any of the above risks factors as a result of service in battle may be entitled to specific disability benefits, which is a tax-free, financial payment to support one’s well-being (Veterans Affairs Canada, 2023). Many government bodies recognize Parkinson’s as a “presumptive” illness linked to Agent Orange, TCE, and moderates to severe TBI (Veterans Affairs Canada, 2023). The amount of money that one may receive depends on the degree to which their condition is related to their service (entitlement) and the severity of their condition, including its impact on one’s quality of life (Veterans Affairs Canada, 2023). All this being said, the majority of veterans will not develop PD, however, it is important that one’s understanding of these risk factors in order to best prioritize your health. Self-monitoring for symptoms such as slowness, stiffness, and/or tremor, and regular doctor visits can help those at increased risk stay on top of their health (Veterans Affairs Canada, 2023). Many individuals remark that understanding their personal risk factors allows them to take positive steps to self-care through healthy diet, regular exercise, and participating in PD research (Veterans and Parkinson’s Risk, n.d.).
Research contribution
Regardless of their current health status and location of military service, veterans have many valuable experiences to contribute to ongoing research (Veterans and Parkinson’s Risk, n.d.). Previous research specific to veterans living with PD has mainly focused on the role of TBI on the development/progression and PD and its symptoms, the associations between PD and mental health conditions (depression and anxiety), and the negative impacts of PD on quality of life (Feeney et al., 2022). Current research aims to identify where potential interventions could lead to improved health outcomes for veterans living with PD (Feeney et al., 2022).
References
Agent Orange & Other Toxic Exposures. (2022). Parkinson’s Foundation. https://www.parkinson.org/living-with-parkinsons/finding-care/veterans/agent-orange
Delic, V., Beck, K. D., Pang, K., & Citron, B. A. (2020). Biological links between traumatic brain injury and Parkinson’s disease. Acta Neuropathologica Communications, 8(1). https://doi.org/10.1186/s40478-020-00924-7
E. Ray Dorsey, Zafar, M., Lettenberger, S. E., Pawlik, M. E., Kinel, D., Myrthe Frissen, Schneider, R., Kieburtz, K., Tanner, C. M., De, B. R., Goldman, S., & Bloem, B. R. (2023). Trichloroethylene: An Invisible Cause of Parkinson’s Disease? Journal of Parkinson’s Disease, 13(2), 203–218. https://doi.org/10.3233/jpd-225047
Feeney, M., Duda, J. E., Hiller, A., Phillips, J., Evers, C., Yarab, N., Todaro, V., Rader, L., & Rosenfeld, S. (2022). Understanding health care needs among Veterans with Parkinson’s disease: A survey study. Frontiers in Neurology, 13. https://doi.org/10.3389/fneur.2022.924999
Mantri, S., Duda, J. E., & Morley, J. F. (2019). Early and Accurate Identification of Parkinson Disease Among US Veterans. Federal Practitioner : For the Health Care Professionals of the VA, DoD, and PHS, 36(Suppl 4), S18–S23. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6604980/
Veterans Affairs Canada. (2023). Disability benefits - Veterans Affairs Canada. Veterans.gc.ca. https://www.veterans.gc.ca/eng/financial-support/compensation-illness-injury/disability-benefits
Veterans and Parkinson’s Risk: Three Things to Know. (n.d.). https://www.michaeljfox.org/sites/default/files/media/document/At_Risk_One_Pagers_Veterans_06.29.22.pdf
World. (2016, October 4). Dioxins and their effects on human health. Who.int; World Health Organization: WHO. https://www.who.int/news-room/fact-sheets/detail/dioxins-and-their-effects-on-human health#:~:text=Short%2Dterm%20exposure%20of%20humans,endocrine%20system%20and%20reproductive%20functions.