Environmental Epidemiology in Military Populations: Summary and Conclusions of the First Military Environmental Epidemiology Symposium.

INTRODUCTION: On April 22, 2025, researchers from the Department of Defense (DoD) (currently referred to as Department of War [DoW]), Department of Veterans Affairs, National Institutes of Health, and other institutions convened for the inaugural Military Environmental Epidemiology Symposium (MEES) at the Uniformed Services University in Bethesda, Maryland. MATERIALS AND METHODS: Leading experts explored the state of research, including research resources and infrastructure, and identified critical challenges, future opportunities, and strategies for advancing the field. RESULTS: Presentations highlighted contributions from ongoing large-scale studies, that is, the Millennium Cohort Study and the Million Veterans Program, and case-control studies nested in the DoD Serum Repository (DoDSR) cohort to understanding long-term health impacts of military service and environmental exposures. Valuable sources of data and biospecimens, such as the Defense Medical Surveillance System, Military Health System Data Repository, DoDSR, and Boston Biorepository, Recruitment and Integrated Network for Gulf War Illness (BBRAIN) were described. Exposure assessment methods, ranging from measuring key toxins and multi-omics in DoDSR serum samples to utilizing of military occupational coding, were discussed. Key exposure research areas highlighted were burn pits, per- and polyfluoroalkyl substances, polycyclic aromatic hydrocarbons, jet fuels, Gulf War exposures, and occupational hazards. The MEES focused on identifying critical challenges in the field, such as exposure data limitations, biospecimen and data access/sharing difficulties, data quality concerns, and the complexity of military exposures. CONCLUSIONS: Recommendations for future research strategies emphasized leveraging existing data and biospecimen resources, capitalizing on multi-omics technologies, advancing military exposure assessment, fostering cross-institutional collaborations, and applying new analytical tools.