Wearable Acquisition of Objective Military Environmental Exposures: Clinical Considerations for Delivery of Veterans Affairs Exposure-Informed Care

Abstract Wearables that characterize personal exposures are likely to play a critical role in the assessment of environmental health effects on military personnel and Veterans. The military operational environment has complex and often transient exposures that are extremely challenging to capture accurately through self-report, underscoring the need to measure environmental exposures more objectively at the individual level. In conjunction with area environmental monitoring, collecting wearable data as well as conducting clinical symptom assessments at the time of exposure, offers additional tools to estimate individual military exposure levels linked to risks of disease or injury. Specifically, wearables offer the ability to detect and identify the concentration of an exposure that can then be utilized to determine an exposure dose estimate when combined with measures of exposure frequency and duration (e.g., identification of the length of time of the exposure), its effect on the body or intensity (e.g., biological response during and after the exposure), as well as moderating effects (e.g., use of personal protective equipment (PPE), distance/shielding measures). Analysis of objective exposure data could improve the accuracy of these exposure dose estimates and therefore, enhances exposure disease risk paradigms and toxicity classification. This commentary emphasizes the growing need to study objective exposure data collection using wearable devices and the potential application of the data to inform clinical care.