Notice2025-20448
Decision Following the Formal Evaluation on the Relationship Between Exposure to Fine Particulate Matter and Certain Blood Conditions
Primary source
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Published
November 20, 2025
Issuing agencies
Veterans Affairs Department
Abstract
The Department of Veterans Affairs (VA) is issuing notice of the Secretary's determination under title 38 United States Code (U.S.C.) 1174(a)(2) that a presumption of service connection is not warranted for polycythemia vera, essential thrombocythemia, histiocytosis, mastocytosis, and chronic myeloproliferative disease for veterans exposed to fine particulate matter (PM<INF>2.5</INF>) while serving in the Southwest Asia Theater of Operations or Somalia on or after August 2, 1990, or in Afghanistan, Egypt, Jordan, Lebanon, Syria, Yemen, Djibouti, or Uzbekistan on or after September 11, 2001.
Full Text
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<title>Federal Register, Volume 90 Issue 222 (Thursday, November 20, 2025)</title>
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[Federal Register Volume 90, Number 222 (Thursday, November 20, 2025)]
[Notices]
[Pages 52494-52495]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2025-20448]
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DEPARTMENT OF VETERANS AFFAIRS
[Docket No. VA-2025-VACO-0001]
Decision Following the Formal Evaluation on the Relationship
Between Exposure to Fine Particulate Matter and Certain Blood
Conditions
AGENCY: Department of Veterans Affairs.
ACTION: Notice.
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SUMMARY: The Department of Veterans Affairs (VA) is issuing notice of
the Secretary's determination under title 38 United States Code
(U.S.C.) 1174(a)(2) that a presumption of service connection is not
warranted for polycythemia vera, essential thrombocythemia,
histiocytosis, mastocytosis, and chronic myeloproliferative disease for
veterans exposed to fine particulate matter (PM<INF>2.5</INF>) while
serving in the Southwest Asia Theater of Operations or Somalia on or
after August 2, 1990, or in Afghanistan, Egypt, Jordan, Lebanon, Syria,
Yemen, Djibouti, or Uzbekistan on or after September 11, 2001.
FOR FURTHER INFORMATION CONTACT: Dr. Erin Dursa, Veterans Health
Administration, 202-461-7297.
SUPPLEMENTARY INFORMATION: 38 U.S.C. 1171-74 details the process for
determining presumptions of service connection based on toxic
exposures. On November 20, 2024, the Secretary of Veterans Affairs
directed a formal evaluation \1\ of five blood conditions, including
polycythemia vera, essential thrombocythemia, histiocytosis,
mastocytosis, and chronic myeloproliferative disease for veterans
exposed to PM<INF>2.5</INF> while serving in the Southwest Asia theater
of operations or Somalia on or after August 2, 1990, or in Afghanistan,
Egypt, Jordan, Lebanon, Syria, Yemen, Djibouti, or Uzbekistan on or
after September 11, 2001.
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\1\ Report to The Secretary of Veterans Affairs on the Formal
Evaluation on The Relationship Between Exposure to Fine Particulate
Matter (PM<INF>2.5</INF>) in the Southwest Theater of Operations or
Somalia on or after August 2, 1990, or in Afghanistan, Egypt,
Jordan, Lebanon, Syria, Yemen, Djibouti, or Uzbekistan on or after
September 11, 2001, and Polycythemia Vera, Essential
Thrombocythemia, Histiocytosis, Mastocytosis, and Chronic
Myeloproliferative Disease, May 2025 (hereafter ``Formal Evaluation
Report'') is available at <a href="http://www.regulations.gov">www.regulations.gov</a>.
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VA conducted a formal evaluation between November 2024 and March
2025 that considered available medical evidence, Veterans Health
Administration (VHA) health care data, Veterans Benefits Administration
(VBA) claims data, and other factors, as required by 38 U.S.C. 1173. A
structured literature search did not yield any papers that were
directly relevant to assessing the relationship between exposure to
PM<INF>2.5</INF> and polycythemia vera, essential thrombocythemia,
histiocytosis, mastocytosis, and chronic myeloproliferative disease.
Additionally, the formal evaluation analyzed VHA electronic medical
record data for the five conditions of interest between Calendar Year
(CY) 2016 and CY24. The results indicate that the nine-year prevalence
of these conditions among post-9/11 veterans who served in the
Southwest Asia theater of operations who use VHA health care was lower
than the prevalence in the general population. The nine-year prevalence
of these conditions among the 1990-1991 Gulf War Era veteran population
utilizing VHA health care was higher than the general population,
except for mastocytosis; this was observed in both veterans who
deployed to Southwest Asia and those who served during the time period
of the war but did not deploy. This is likely due to this veteran
population's older age distribution.
The formal evaluation also analyzed VBA claims data for
polycythemia vera, essential thrombocythemia, histiocytosis,
mastocytosis, and chronic myeloproliferative disease across four Gulf
War Era cohorts, encompassing a total of 11,022,410 veterans. Between
2005 and 2025, 3,507 of those veterans filed claims for these
conditions. The claim filing rate for these blood conditions varied
minimally across cohorts, ranging from 0.01% to 0.06%. Among the
claims, 1,777 veterans were granted service connection. The grant rate
across the four cohorts was 50.67%. The service connection prevalence
rate was low and consistent across cohorts.
The formal evaluation report was reviewed by hematologists/
oncologists at the National Oncology Program Office.
Based on the findings from the formal evaluation, including a
literature search and the analysis of VHA and VBA data, the Secretary
has determined that a presumption of service connection is not
warranted for polycythemia vera, essential thrombocythemia,
histiocytosis, mastocytosis, or chronic myeloproliferative disease for
veterans exposed to fine particulate matter (PM<INF>2.5</INF>) while
serving in the Southwest Asia Theater of Operations or Somalia on or
after August 2, 1990, or in Afghanistan, Egypt, Jordan, Lebanon, Syria,
Yemen, Djibouti, or Uzbekistan on or after September 11, 2001.
Currently available evidence is not sufficient to conclude, or is not
sufficient to make a scientifically informed judgment, that a positive
association as likely as not exists
[[Page 52495]]
between these blood conditions and exposure to PM<INF>2.5.</INF> This
determination that presumptions of service connection are not warranted
at this time does not in any way preclude VA from granting service
connection based on the evidence in a particular case for any disease,
including those specifically discussed in this notice, nor does it
change any existing rights or procedures.
Signing Authority
Douglas A. Collins, Secretary of Veterans Affairs, approved this
document on October 24, 2025, and authorized the undersigned to sign
and submit the document to the Office of the Federal Register for
publication electronically as an official document of the Department of
Veterans Affairs.
Joseph Montanye,
Alternate Federal Register Liaison Officer, Department of Veterans
Affairs.
[FR Doc. 2025-20448 Filed 11-19-25; 8:45 am]
BILLING CODE 8320-01-P
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