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[Federal Register Volume 89, Number 229 (Wednesday, November 27, 2024)]
[Notices]
[Pages 93908-93909]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-27833]

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DEPARTMENT OF VETERANS AFFAIRS

Notice of Plans for Department of Veterans Affairs to Assess 
Exposures and Conditions of Interest for Veterans Who Served At Karshi-
Khanabad Air Base and To Solicit Public Comment

AGENCY: Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: The Department of Veterans Affairs (VA) announces that it 
plans to conduct an assessment of scientific literature and historical 
claims data to determine whether there is an association between 
military environmental exposure to toxic substances related to military 
service at Camp Stronghold Freedom in Karshi-Khanabad (K2) in 
Uzbekistan from 2001 to 2005 and medical conditions. VA entered into an 
agreement with the Center for Disease Control and Prevention's Agency 
for Toxic Substances and Disease Registry and published a Report to 
Congress in 2022 that identified the known health consequences 
associated with the identified toxic substances, chemicals, and 
airborne hazards at K2. As part of a continuing effort to assess the 
health risks that may be associated with military service at K2, VA is 
soliciting public comment on environmental exposures at K2 and medical 
conditions developed by Veterans who served there. This notice provides 
an opportunity for Veterans, caregivers, survivors, and the public to 
share relevant information with VA to inform decisions regarding 
presumptive benefits that could impact the roughly 16,000 Veterans who 
served at K2.

DATES: Comments must be received on or before December 27, 2024.

ADDRESSES: Comments must be submitted through www.regulations.gov. 
Except as provided below, comments received before the close of the 
comment period will be available as soon as possible after they have 
been received at www.regulations.gov for public viewing, inspection, or 
copying, including any personally identifiable or confidential business 
information that is included in a comment. VA will not post public 
comments that make threats to individuals or institutions or suggest 
that the commenter will take actions to harm an individual. VA 
encourages individuals not to submit duplicative comments. We will post 
comments from multiple unique commenters even if the content is 
identical or nearly identical to other comments. Any public comment 
received after the comment period's closing date is considered late and 
will not be considered in any potential future rulemaking.

FOR FURTHER INFORMATION CONTACT: Peter D. Rumm, M.D., MPH, Director of 
Policy, Health Outcomes Military Exposures, Veterans Health 
Administration, Department of Veterans Affairs, 810 Vermont Avenue NW, 
Washington, DC 20420, at 202-461-7297. This is not a toll-free number.

SUPPLEMENTARY INFORMATION: Camp Stronghold Freedom was established at a 
former Soviet Air Base in K2 located in Southwest Uzbekistan in October 
2001 and occupied by U.S. forces through the middle of 2005. During 
this period, several environmental site surveys were conducted by the 
Department of Defense (DOD) to assess contaminants that could impact 
the operational readiness of U.S. military operations and the safety of 
U.S. forces that deployed to K2. These surveys identified several 
contaminants, such as dust and particulate matter, underground jet fuel 
plumes, surface dirt with traces of asbestos, depleted uranium, 
benzene, chromium, and others. The Public Health website of the Defense 
Health Agency of the DOD lists contaminants of concern it identified at 
K2 [1].
    Since 2021, VA has been assessing the potential health effects, 
including respiratory conditions and cancers, among K2 Veterans. 
Section 2010 of the Johnny Isakson and David P. Roe, M.D.

[[Page 93909]]

Veterans Health Care and Benefits Improvement Act of 2020, Public Law 
116-315 (the Isakson and Roe Act) [2], directed VA to engage the Center 
for Disease Control and Prevention's Agency for Toxic Substances and 
Disease Registry to describe the known health effects associated with 
the toxic substances, chemicals, airborne hazards, and other substances 
DOD identified at K2. This effort has been completed, and a report was 
submitted to Congress in January 2022, which documented the DOD 
identified contaminants of concern, medium of exposure, along with the 
potential cancer and noncancer health effects. The findings from this 
report can be found on VA's K2 website [3]. The Department of Defense 
has also studied the mortality among K2 Service members and found that 
a more in-depth study of health issues is necessary [4]. Section 2010 
of the Isakson and Roe Act also directed VA to assess the health 
effects associated with deployment to K2, with a final report due to 
Congress no later than 2030 [2]. VA created a public health 
surveillance program to address this requirement. Analyses are underway 
and data are updated annually on all K2 Veterans to allow VA to address 
new information on adverse health outcomes and health concerns of 
veterans as they become known.
    The purpose of this Notice is to provide the K2 community (K2 
Veterans, their caregivers, and their survivors) and the broader public 
the opportunity to share relevant information for VA to determine if VA 
should recognize the unique environmental exposures (individually and 
in combination) and medical conditions as presumptive based on a 
Veteran's service at K2. VA encourages the K2 community and broader 
public to submit thoughts, recommendations, and requests regarding the 
exposures and health conditions they feel are related to K2 service and 
warrant specific consideration by VA as a presumptive condition. VA 
also invites the public to submit information, evidence, and 
suggestions that may help VA assess potential exposures at K2 and 
health effects that may be associated with such exposures.
    In accordance with 38 U.S.C. 1172, as created by section 202 of the 
Sergeant First Class Heath Robinson Honoring our Promise to Address 
Comprehensive Toxics Act of 2022 (PACT Act), VA is publishing this 
notice about its planned scientific assessment of the possibility of a 
relationship between all medical conditions and military environmental 
exposures related to service at Camp Stronghold Freedom in K2 from 2001 
to 2005. Pursuant to section 202, the VA Secretary must determine 
whether to establish or remove presumptions for service connections 
based on military environmental exposure and the evaluation of adverse 
health outcomes. VA's procedure includes issuing a public notice 
regarding reviews, soliciting public comment, and recommendations for 
corrections to the Secretary from the working group subject matter 
experts to better reflect Veterans and dependents. Here, in recognition 
of the unique exposure environment at K2, Secretary McDonough directed 
a PACT Act presumptive process to formally solicit stakeholder input 
and demonstrate the rigor VA continues to apply to important questions 
concerning the contaminants present at K2 and the conditions that K2 
Veterans developed following service there.
    In accordance with 38 U.S.C. 1119 and 1120, as created by the PACT 
Act, Uzbekistan is included as an eligible country covered under the 
PACT Act for certain presumptions of exposure and service connection. 
Thus, K2 Veterans are eligible for hundreds of individual presumptive 
conditions encompassed by the 23 disease categories designated under 
this landmark legislation [5]. Additionally, K2 Veterans are eligible 
to receive health care from the Veterans Health Administration, 
regardless of whether they have filed a claim for disability [6]. VA 
encourages all K2 Veterans to register for health care and encourages 
all K2 Veterans and their survivors to submit a claim for any adverse 
health outcome, even if not covered under the PACT Act, that they feel 
is related to their military service at K2 or elsewhere.

Signing Authority

    Denis McDonough, Secretary of Veterans Affairs, signed and approved 
this document on November 15, 2024, 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.

Jeffrey M. Martin,
Assistant Director, Office of Regulation Policy & Management, Office of 
General Counsel, Department of Veterans Affairs.

References

1. Karshi-Khanabad Airbase Exposures, (2024). https://ph.health.mil/topics/envirohealth/hrasm/Pages/K2-Airbase-Exposures.aspx
2. Johnny Isakson and David P. Roe, M.D. Veterans Health Care and 
Benefits Improvement Act of 2020, Public Law 116-315, Sec.  2010. 
https://www.congress.gov/116/plaws/publ315/PLAW-116publ315.pdf
3. Karshi-Khanabad (K2) Air Base in Uzbekistan Potential Historical 
Contaminants of Concern (COCs) (2022). https://www.publichealth.va.gov/docs/exposures/K2_Contaminants.pdf#.
4. Environmental Hazards Study: Mortality Among U.S. Service Members 
Deployed to Karshi-Khanabad Air Base, Uzbekistan (2024). https://health.mil/Military-Health-Topics/Health-Readiness/Environmental-Exposures/Environmental-Hazards-Study-K2
5. Exposure to Burn Pits and Other Specific Environmental Hazards 
(2024). https://www.va.gov/disability/eligibility/hazardous-materials-exposure/specific-environmental-hazards/
6. Eligibility for VA Health Care (2024). Eligibility For VA Health 
Care  Veterans Affairs.

[FR Doc. 2024-27833 Filed 11-26-24; 8:45 am]
BILLING CODE 8320-01-P
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