Federal Register / Vol. 74, No. 62 / Thursday, April 2, 2009 / Notices 15063 

DEPARTMENT OF VETERANS 

AFFAIRS 

Determination of Presumption of 

Service Connection Concerning 

Illnesses Discussed in National 

Academy of Sciences Report on Gulf 

War and Health: Volume 5: Infectious 

Diseases 

AGENCY: Department of Veterans Affairs. 

ACTION: Notice. 

SUMMARY: As required by law, the 

Department of Veterans Affairs (VA) 

hereby gives notice that the Secretary of 

Veterans Affairs, under the authority 

granted by the Persian Gulf War 

Veterans Act of 1998, Public Law 105– 

277, title XVI, 112 Stat. 2681–742 

through 2681–749 (codified in part at 38 

U.S.C. 1118), has determined that there 

is no basis to establish a presumption of 

service connection for Al Eskan disease, 

idiopathic acute eosinophilic 

pneumonia, wound and nosocomial 

infection, mycoplasmas, as discussed in 

the October 2006 report of the National 

Academy of Sciences, titled ‘‘Gulf War 

and Health Volume 5: Infectious 

Diseases’’, or for any illness based on 

exposure to biologic-warfare agents 

during service in the Persian Gulf 

during the Persian Gulf War. 

FOR FURTHER INFORMATION CONTACT: 

Thomas Kniffen, Chief, Regulations 

Staff (211D), Compensation and Pension 

Service, Veterans Benefits 

Administration, Department of Veterans 

Affairs, 810 Vermont Avenue, NW., 

Washington, DC 20420, (202) 461–9725. 

SUPPLEMENTARY INFORMATION: 

I. Statutory Requirements 

The Persian Gulf War Veterans Act of 

1998, Public Law 105–277, title XVI, 

112 Stat. 2681–742 through 2681–749 

(codified at 38 U.S.C. 1118), and the 

Veterans Programs Enhancement Act of 

1998, Public Law 105–368, 112 Stat. 

3315, directed the Secretary to seek to 

enter into an agreement with the 

National Academy of Sciences (NAS) to 

review and evaluate the available 

scientific evidence regarding 

associations between illnesses and 

exposure to toxic agents, environmental 

or wartime hazards, or preventive 

medicines or vaccines to which service 

members may have been exposed during 

service in the Persian Gulf during the 

Persian Gulf War. Congress directed the 

NAS to identify agents, hazards, 

medicines, and vaccines to which 

service members may have been 

exposed during service in the Persian 

Gulf during the Persian Gulf War. 

Congress mandated that the NAS 

determine, to the extent possible: (1) 

Whether there is a statistical association 

between exposure to the agent, hazard, 

medicine, or vaccine and the illness, 

taking into account the strength of the 

scientific evidence and the 

appropriateness of the scientific 

methodology used to detect the 

association; (2) the increased risk of 

illness among individuals exposed to 

the agent, hazard, medicine, or vaccine; 

and (3) whether a plausible biological 

mechanism or other evidence of a causal 

relationship exists between exposure to 

the agent, hazard, medicine, or vaccine 

and the illness. 

Section 1118 of Title 38 of the United 

States Code provides that whenever the 

Secretary determines, based on sound 

medical and scientific evidence, that a 

positive association (i.e., the credible 

evidence for the association is equal to 

or outweighs the credible evidence 

against the association) exists between 

exposure of humans or animals to a 

biological, chemical, or other toxic 

agent, environmental or wartime hazard, 

or preventive medicine or vaccine 

known or presumed to be associated 

with service in the Southwest Asia 

theater of operations during the Persian 

Gulf War and the occurrence of a 

diagnosed or undiagnosed illness in 

humans or animals, the Secretary will 

publish regulations establishing 

presumptive service connection for that 

illness. If the Secretary determines that 

a presumption of service connection is 

not warranted, he is to publish a notice 

of that determination, including an 

explanation of the scientific basis for 

that determination. The Secretary’s 

determination must be based on 

consideration of the NAS reports and all 

other sound medical and scientific 

information and analysis available to 

the Secretary. 

Although section 1118 does not 

define ‘‘credible evidence,’’ it does 

instruct the Secretary to consider 

whether the results (of any report, 

information, or analysis) are statistically 

significant, are capable of replication, 

and withstand peer review. See 38 

U.S.C. 1118(b)(2)(B). Simply comparing 

the number of studies that report a 

significantly increased relative risk to 

the number of studies that report a 

relative risk that is not significantly 

increased is not a valid method for 

determining whether the weight of 

evidence overall supports a finding that 

there is or is not a positive association 

between exposure to an agent, hazard, 

medicine, or vaccine and the 

subsequent development of the 

particular illness. Because of differences 

in statistical significance, confidence 

levels, control for confounding factors, 

and other pertinent characteristics, 

some studies are clearly more credible 

than others, and the Secretary gives the 

more credible studies more weight in 

evaluating the overall weight of the 

evidence concerning specific illnesses. 

II. Prior National Academy of Sciences 

Reports 

The NAS issued its initial report 

titled, Gulf War and Health, Volume 1: 

‘‘Depleted Uranium, Sarin, 

Pyridostigmine Bromide, Vaccines,’’ on 

January 1, 2000. In that report, NAS 

limited its analysis to the health effects 

of depleted uranium, the chemical 

warfare agent, sarin, vaccinations 

against botulism toxin and anthrax, and 

pyridostigmine bromide, which was 

used in the Persian Gulf War as a 

pretreatment for possible exposure to 

nerve agents. On July 6, 2001, VA 

published a notice in the Federal 

Register announcing the Secretary’s 

determination that the available 

evidence did not warrant a presumption 

of service connection for any disease 

discussed in that report. See 66 FR 

35702 (2001). 

The NAS issued its second report 

titled, ‘‘Gulf War and Health, Volume 2: 

Insecticides and Solvents,’’ on February 

18, 2003. In that report, the NAS 

focused on the health effects of 

insecticides and solvents that were 

shipped to the Persian Gulf during the 

Persian Gulf War. The pesticides 

considered by the NAS were 

organophosphorous compounds 

(Malathion, diazinon, chlorpyrifos, 

dichlorvos, and azamethiphos), 

carbamates (carbaryl, propoxur, and 

methomyl), pyrethrins and pyrethyroids 

(permethrin and d-phenothrin), lindane, 

and N,N-diethyl-3-methylbenzamide 

(DEET). The NAS considered 53 

solvents in eight groups: aromatic 

hydrocarbons (including benzene), 

halogenated hydrocarbons (including 

tetrachloroethylene and dry-cleaning 

solvents), alcohols, glycols, glycol 

esters, esters, ketones, and petroleum 

distillates. On August 24, 2007, VA 

published a notice in the Federal 

Register announcing the Secretary’s 

determination that the available 

evidence did not warrant a presumption 

of service connection for any disease 

discussed in that report. 72 FR 48734 

(2007). 

The NAS issued an update on sarin in 

a report titled ‘‘Gulf War and Health: 

Updated Literature Review of Sarin,’’ on 

August 20, 2004. In that report, the NAS 

focused on the long-term health effects 

from exposure to the nerve agent, sarin. 

VA published a Federal Register Notice 

announcing the Secretary’s 

determination that it was not necessary 

to establish new presumptions of 

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15064 Federal Register / Vol. 74, No. 62 / Thursday, April 2, 2009 / Notices 

service connection for any diseases 

based on the updated findings on longterm health effects from sarin. 73 FR 

42411 (2008). 

The NAS issued its third report, titled 

‘‘Gulf War and Health, Volume 3: Fuels, 

Combustion Products, and Propellants,’’ 

on December 20, 2004. In that report, 

the NAS focused on the health effects of 

hydrazines, red fuming nitric acid, 

hydrogen sulfide, oil-fire byproducts, 

diesel-heater fumes, and fuels (for 

example, jet fuel and gasoline). VA 

published a Federal Register Notice 

announcing the Secretary’s 

determination that the available 

evidence did not warrant a presumption 

of service connection for any disease 

discussed in that report. 73 FR 50856 

(2008). 

The NAS issued its fourth report, 

titled ‘‘Gulf War and Health Volume 4. 

Health Effects of Serving in the Gulf 

War,’’ on September 12, 2006. In that 

report the NAS focused on the health 

status of veterans of the 1991 Gulf War. 

The report was intended to inform VA 

about illnesses and clinical issues 

including possible relevant treatments, 

which might have been overlooked 

among this population, regardless of the 

specific underlying cause. VA is 

drafting a Federal Register notice 

announcing the Secretary’s 

determination that the available 

evidence does not warrant a 

presumption of service connection for 

any disease discussed in that report. 

III. Gulf War and Health, Volume 5: 

Infectious Diseases 

The NAS committee issued its fifth 

report, titled ‘‘Gulf War and Health 

Volume 5: Infectious Diseases’’ on 

October 16, 2006. The committee 

reviewed published, peer-reviewed 

scientific and medical literature on 

long-term health effects from infectious 

diseases associated with Southwest 

Asia. Based on the NAS’s report, VA is 

currently drafting a proposed rule to 

establish presumptive service 

connection for nine infectious diseases 

discussed in the report and providing 

guidance regarding long-term health 

effects associated with these diseases. 

However, the NAS additionally 

discussed several infectious diseases 

and agents that had been identified as 

possible causes of illnesses in veterans 

with service in Southwest Asia or that 

otherwise presented issues of special 

interest to such veterans. This notice 

provides the Secretary’s determination 

that the scientific evidence in the report 

does not warrant a presumption of 

service connection for any illnesses 

caused by these diseases and agents. 

The diseases and agents are Al Eskan 

disease, idiopathic acute eosinophilic 

pneumonia, wound and nosocomial 

infection, mycoplasmas, and biologicwarfare agents. 

Al Eskan Disease 

Al Eskan disease is named after a 

village in Saudi Arabia where U.S. 

military personnel lived during the 1991 

Gulf War. These soldiers reported a 

vague systemic illness causing primarily 

respiratory symptoms that was termed 

Al Eskan disease or Desert Storm 

pneumonitis in three studies: KorenyiBoth et al. 1992; Korenyi-Both et al. 

1997; Korenyi-Both et al. 2000. During 

Operation Desert Shield (ODSh) and 

Operation Desert Storm (ODSt), 

approximately 697,000 troops were 

deployed. Although researchers are 

unable to determine the exact number of 

troops affected by Al Eskan disease, data 

on respiratory illnesses in troops reveal 

that respiratory symptoms in general 

were more common in those with a 

history of lung disease, smoking, and 

longer deployment; more common in 

those with less outdoor exposure; more 

common in those with less outdoor 

exposure; and were most prominent in 

personnel who slept in air-conditioned 

facilities. Al Eskan disease or a similar 

illness has not been reported in troops 

deployed to Operation Iraqi Freedom 

(OIF) or Operation Enduring Freedom 

(OEF). 

Al Eskan disease was first reported in 

1992, and was characterized by sudden 

or insidious onset of chills, fever, sore 

throat, hoarseness, nausea and vomiting, 

and generalized malaise followed by 

respiratory tract complaints which 

included increasingly severe dry cough 

or expectoration of tan sputum 

(Korenyi-Both et al. 1992). The disease 

appears to be self-limited, and physical 

findings are minimal. Systemic 

description and precise definition of Al 

Eskan disease are unavailable. 

Korenyi-Both and colleagues have 

ascribed Al Eskan disease to an immune 

response to sand-particle exposure, and 

argued that Al Eskan disease is most 

likely a form of acute silicosis 

aggravated by the pulmonary immune 

response and perhaps other genetic and 

environmental factors (Korenyi-Both et 

al. 1992; Korenyi-Both et al. 1997; 

Korenyi-Both et al. 2000). There are no 

clinical data to support this hypothesis 

and no reports of chronic lung disease 

consistent with silicosis in veterans. 

The hypotheses and conclusions of 

these researchers have not been 

uniformly accepted and have generated 

considerable debate (Clooman et al. 

2000; Kilpatrick 2000). 

The NAS found that no data link Al 

Eskan disease to any specific chronic 

illness. Further, there is no evidence 

that the syndrome or disease observed 

in troops in Al Eskan village was caused 

by a communicable microbial pathogen. 

Koryeni-Both et al. have argued that the 

disease is caused by exposure to the 

unique sand dust of the central and 

eastern Arabian Peninsula and in 

particular to the silica in the sand. 

However, more than 13 years have 

passed since the initial description of Al 

Eskan disease appeared in the literature, 

and researchers have been unable to 

link chronic respiratory diseases in 

military personnel to exposure to 

Persian Gulf sand. 

Based on the NAS report, the 

Secretary has determined that there is 

insufficient evidence to conclude that 

there is a positive association between 

the condition described as Al Eskan 

disease and exposure to an agent, 

hazard, preventive medicine or vaccine 

associated with Gulf War service. To the 

extent the described condition involves 

respiratory symptoms of unknown 

etiology, current VA regulations provide 

a presumption of service connection for 

chronic disability due to undiagnosed 

illness manifest by respiratory signs and 

symptoms. See 38 CFR 3.317. 

Idiopathic Acute Eosinophilic 

Pneumonia 

Idiopathic Acute Eosinophilic 

Pneumonia (IAEP) is a syndrome 

characterized by a febrile illness, diffuse 

pulmonary infiltrates, and pulmonary 

eosinophilia (Allen et al. 1989; Badesch 

et al. 1989; Philit et al. 2002). Patients 

with IAEP have no history of asthma, 

allergy, or chronic lung disease and no 

discernible infection. Patients with 

IAEP present with fever, diffuse 

pulmonary infiltrates, cough, shortness 

of breath, and, not infrequently, 

respiratory failure. Most IAEP patients 

who survive the acute illness make a 

complete recovery. Eighteen soldiers 

deployed to Southwest Asia in OIF 

developed IAEP. 

In many cases, IAEP has been 

associated with cigarette smoking and 

exposure to dust (Badesch et al. 1989; 

Pope-Harman et al. 1996; Rom et al. 

2002). No causative pathogens were 

detected or implied by the immune 

repose of soldiers with IAEP (Allen et 

al. 1989; Shorr et al. 2004). Survey 

results failed to identify a common 

source of environmental, drug, or toxin 

exposure (Shorr et al. 2004). IAEP 

would not be expected to have longterm adverse health outcomes. 

Based on the NAS report, the 

Secretary has determined that there is 

insufficient evidence to conclude that 

there is a positive association between 

IAEP and exposure to an agent, hazard, 

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Federal Register / Vol. 74, No. 62 / Thursday, April 2, 2009 / Notices 15065 

preventive medicine, or vaccine 

associated with Gulf War service. 

Wound and Nosocomial Infection 

Soldiers can experience a wide 

variety of exposures to pathogens from 

explosives or combat (wound infections) 

or in health-care settings (nosocomial 

infections). One condition that is more 

prevalent in troops in Southwest Asia 

than in civilian settings is infection with 

Acinetobacter calcoaceticus-baumannii 

complex, a well-recognized cause of 

wound infection in general and among 

military troops in particular (CDC 2004; 

Davis et al. 2005). The complex is also 

a cause of nosocomially-acquired 

infection when wounded, infected 

soldiers are intermingled with other 

patients in the intensive care unit, 

emergency room, or hospital ward. 

Research data has also revealed that 

A. baumannii bacteremia was common 

in OEF and OIF returnees who were 

hospitalized for injuries, although it was 

rare before the state of OEF and OIF 

(CDC 2004; Davis et al. 2005; Zapor and 

Moran 2005), and that nearly any wartheater injury, whether combat-derived 

or otherwise, may result in infection. 

The risk of infection is inherent in 

military service, training, readiness 

activities, transport, or combat (Zapor 

and Moran 2005). 

Both wound infections and 

nosocomial infections are hazards for 

U.S. personnel deployed to Southwest 

Asia. Given modern medical and 

surgical treatment and the ability to 

evacuate injured military personnel 

rapidly, most infections will be seen 

within days or weeks of wounds. 

The NAS found that both wound 

infections and nosocomial infections 

manifest within a short period after 

injury or exposure, such that making an 

epiodemiological link between a 

particular infection and the 

precipitating wound or exposure is 

rarely difficult. The NAS further noted 

that, in rare cases, infections associated 

with chronic osteomyelitis could go 

undetected and become manifest after 

service, although it noted a ‘‘near 

absence’’ of case reports documenting 

that occurrence. In view of the 

possibility of infections from other 

military and civilian sources outside of 

Gulf War service, the NAS stated that 

determining whether any infections 

manifest after service were associated 

with such service or with other causes 

would require case-by-case evaluations 

of the epidemiologic, clinical, and 

microbiological characteristics of the 

infection. 

Based on the NAS report, the 

Secretary has determined that there is 

insufficient evidence to conclude that 

there is a positive association between 

wound or nosocomial infections 

manifest after service and any exposure 

to an agent, hazard, preventive 

medicine, or vaccine associated with 

Gulf War service. Any such infections 

manifest within service or within a 

short period following an in-service 

wound or exposure would be subject to 

service connection on a direct basis 

under current law. 

Mycoplasmas 

Mycoplasmas are ubiquitous 

microorganisms found as commensal 

colonizers and as pathogens in plants, 

insects, and animals. They are 

pleomorphic and filamentous and have 

a deformable membrane, which allows 

them to pass through filters that retain 

bacteria. They are fastidious and 

difficult to culture on cell-free media; at 

the same time, because of their common 

presence as nonpathogenic colonizers, 

they are common contaminants of cell 

cultures. The propensity for 

contamination of cell cultures can lead 

to false conclusions about the 

association of mycoplasmas with a 

variety of clinical syndromes (Baum 

2005). 

Culture of Mycoplasma fermentans on 

cell-free media (which decrease the risk 

of contamination) has been extremely 

difficult, and this has led to controversy 

over whether the organisms are true 

pathogens or merely contaminants. 

The NAS noted that mycoplasmas are 

ubiquitous and did not suggest that they 

are more prevalent in the Gulf War 

theater than in other locations. 

However, it addressed mycoplasmas as 

a matter of special interest to Gulf War 

veterans because certain researchers 

have suggested that many of the 

symptoms of Gulf War illness could be 

explained by aggressive mycoplasma 

infections present as contaminants in 

vaccines administered to service 

members before deployment to the Gulf. 

Several studies by Nicolson and 

colleagues report a link between 

Mycoplasma fermentans and health 

problems in Gulf War veterans 

(Nicolson et al. 2002; Nicolson et al. 

2003; Nicolson and Rosenberg-Nicolson 

1995; Nicolson and Nicolson 1996). 

Nicolson and colleagues hypothesized 

that the source of such infections in 

Gulf War veterans may have been 

contamination of the multiple vaccines 

received by troops before and during 

deployment (Nicolson et al. 2003). It 

was suggested that many of the 

symptoms of Gulf War illness could be 

explained by ‘‘aggressive pathogenic 

mycoplasma infections, and they should 

be treatable with multiple courses of 

antibiotics, such as doxycycline or 

macrolides’’ (Nicolson and RosenbergNicolson 1995). However, independent 

attempts to confirm the results of 

studies conducted by Nicolson and his 

colleagues have been unsuccessful (Gray 

et al. 1999; Lo et al. 2000). One report 

noted that the methodology used by 

Nicolson and colleagues was ‘‘an 

inappropriate diagnostic method for 

detection of M. fermentans’’ and that 

neither the specificity nor the sensitivity 

of the test had been established (Dybvig 

1998). Because of the conflicting data 

related to M. fermentans infections and 

their possible association with Gulf War 

illnesses and the suggestion of possible 

benefits of treatment with doxycycline, 

VA conducted a randomized placebocontrolled trial to determine whether 

doxycycline could improve functional 

status of persons with Gulf War illness 

(Donta et al. 2004). Overall, the results 

of this study revealed no statistically 

significant difference between the 

doxycycline-treated and placebo groups. 

Although several studies by Nicolson 

and colleagues report a link between 

Mycoplasma fermentans and health 

problems in Gulf War veterans 

(Nicolson et al. 2002; Nicolson et al. 

2003; Nicolson and Rosenberg-Nicolson 

1995; Nicolson and Nicolson 1996), 

other investigators were not able to 

duplicate their work and there are 

concerns about the nuclear gene 

tracking technique used by Nicolson et 

al. (Dybvig 1998; Gray et al. 1999; Lo et 

al. 2000). After reviewing the evidence, 

mycoplasma infection is not believed to 

be related to the symptoms reported by 

Gulf War veterans. 

Based on the NAS report, the 

Secretary has determined that there is 

insufficient evidence to conclude that 

there is a positive association between 

mycoplasma infections and any 

exposure to an agent, hazard, preventive 

medicine, or vaccine associated with 

Gulf War service. The evidence does not 

show that mycoplasma infections are 

associated with Gulf War illness or any 

other chronic health outcome. 

Biologic-Warfare Agents 

Biologic warfare is defined as the use 

of microorganisms or toxic products 

derived from microorganisms to inflict 

mass casualties in military and civilian 

populations (Horn 2003). At the time of 

the 1991 Gulf War, Iraq had an active 

biologic warfare program. Iraq 

developed bombs, missile warheads, 

aerosol generators, and helicopter and 

jet spray systems for dispersal of 

biological warfare agents (Leitenberg 

2001). Iraqi sources reported that 

aflatoxin, botulinum toxin, and Bacillus 

anthracis were loaded in missiles and 

air-delivery bombs in preparation for 

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15066 Federal Register / Vol. 74, No. 62 / Thursday, April 2, 2009 / Notices 

the Gulf War (Roffey et al. 2002). Of the 

four biological warfare agents that Iraqi 

sources reported weaponized: aflatoxin, 

botulinum toxin, Bacillus anthracis, and 

ricin, only anthrax is a living 

microorganism and capable of 

multiplying in infected people. 

However, no evidence has been found 

that Iraq deployed any weapons 

containing biological warfare agents 

(Roffey et al. 2002; Zilinskas 1997). 

Based on the NAS report, the 

Secretary has concluded that a 

presumption is not warranted for any 

disease associated with exposure to 

biological warfare agents because such 

weapons were not shown to have been 

deployed in the Gulf War. 

IV. Conclusion 

After careful review of the findings of 

the 2006 NAS report, ‘‘Gulf War & 

Health Volume 5: Infectious Diseases,’’ 

the Secretary has determined that the 

scientific evidence presented in the 

report and other information available 

to the Secretary indicate that no new 

presumption of service connection is 

warranted for Al Eskan disease, 

idiopathic acute eosinophilic 

pneumonia, wound and nosocomial 

infection, mycoplasmas, or for any 

illness based on exposure to biologicwarfare agents. 

Approved: March 26, 2009. 

John R. Gingrich, 

Chief of Staff, Department of Veterans Affairs. 

[FR Doc. E9–7342 Filed 4–1–09; 8:45 am] 

BILLING CODE 

DEPARTMENT OF VETERANS 

AFFAIRS 

Advisory Committee on Cemeteries 

and Memorials; Notice of Meeting 

The Department of Veterans Affairs 

(VA) gives notice under Public Law 92– 

463 (Federal Advisory Committee Act) 

that a meeting of the Advisory 

Committee on Cemeteries and 

Memorials will be held on May 5–6, 

2009, at the El Paso Marriott, 1600 

Airway Boulevard, El Paso, Texas. On 

May 5, the meeting will begin at 8 a.m. 

and end at 3:45 p.m. and on May 6, the 

meeting will begin at 8:30 a.m. and end 

at 4 p.m. The meeting is open to the 

public. 

The purpose of the Committee is to 

advise the Secretary of Veterans Affairs 

on the administration of national 

cemeteries, soldiers’ lots and plots, the 

selection of new national cemetery sites, 

the erection of appropriate memorials, 

and the adequacy of Federal burial 

benefits. 

On May 5, the Committee will receive 

updates on National Cemetery 

Administration issues. On May 6, the 

Committee will tour Fort Bliss National 

Cemetery, located at 5200 Fred Wilson 

Boulevard, El Paso, Texas, and then 

reconvene at the hotel for a business 

session in the afternoon. The May 6 

session will include discussions of 

Committee recommendations, future 

meeting sites, and potential agenda 

topics at future meetings. 

Time will not be allocated for 

receiving oral presentations from the 

public. 

Any member of the public wishing to 

attend the meeting should contact Mr. 

Michael Nacincik, Designated Federal 

Officer, at (202) 461–6240. The 

Committee will accept written 

comments. Comments may be 

transmitted electronically to the 

Committee at Michael.n@va.gov, or 

mailed to the National Cemetery 

Administration (41C2), 810 Vermont 

Avenue, NW., Washington, DC 20420. 

In the public’s communications with the 

Committee, the writers must identify 

themselves and state the organizations, 

associations, or persons they represent. 

Dated: March 27, 2009. 

By Direction of the Secretary. 

E. Philip Riggin, 

Committee Management Officer. 

[FR Doc. E9–7455 Filed 4–1–09; 8:45 am] 

BILLING CODE 8320–01–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

Advisory Committee on OIF/OEF 

Veterans and Families; Notice of 

Meeting 

The Department of Veterans Affairs 

(VA) gives notice under Public Law 92– 

463 (Federal Advisory Committee Act) 

that the Advisory Committee on OIF/ 

OEF Veterans and Families will meet on 

April 15–16, 2009, at the St. Regis Hotel, 

923 16th Street, NW., Washington, DC, 

from 8:30 a.m. to 4:30 p.m. each day. 

The meeting is open to the public. 

The purpose of the Committee is to 

advise the Secretary of Veterans Affairs 

on the full spectrum of health care, 

benefits delivery and related family 

support issues that confront 

servicemembers during their transition 

from active duty to veteran status and 

during their post-service years. The 

Committee focuses on the concerns of 

all men and women with active military 

service in Operation Iraqi Freedom and/ 

or Operation Enduring Freedom, but 

pays particular attention to severely 

disabled veterans and their families. 

The agenda for April 15 and 16 will 

feature a review of information gathered 

by the Committee during the past two 

years. The Committee will also discuss 

the possibility of transferring records 

and sharing the results of its various 

fact-finding initiatives with other VA 

advisory committees which have 

complementary jurisdictions and 

similar areas of interest. 

The public may submit written 

statements for the Committee’s review 

to the Advisory Committee on OIF/OEF 

Veterans and Families (008), 

Department of Veterans Affairs, 810 

Vermont Avenue, NW., Washington, DC 

20420. Any member of the public 

seeking additional information should 

contact Laura O’Shea, Designated 

Federal Officer, at (202) 461–5765. 

Dated: March 31, 2009. 

By Direction of the Secretary. 

E. Philip Riggin, 

Committee Management Officer. 

[FR Doc. E9–7456 Filed 4–1–09; 8:45 am] 

BILLING CODE 8320–01–P 

DEPARTMENT OF VETERANS 

AFFAIRS 

Genomic Medicine Program Advisory 

Committee; Notice of Meeting 

The Department of Veterans Affairs 

(VA) gives notice under Public Law 92– 

463 (Federal Advisory Committee Act) 

that the Genomic Medicine Program 

Advisory Committee will meet on April 

27, 2009, at the Madison Hotel, 1177 

15th St NW., Washington, DC. The 

meeting will start at 8 a.m. and end at 

5 p.m. 

The purpose of the Committee is to 

provide advice and make 

recommendations to the Secretary of 

Veterans Affairs on using genetic 

information to optimize medical care of 

Veterans and to enhance development 

of tests and treatments for diseases 

particularly relevant to Veterans. 

The Committee will meet in an open 

session from 8 a.m. until 3:30 p.m. to 

receive updates from the VA program 

staff; discuss optimal ways for VA to 

incorporate genomic information into its 

health care program while applying 

appropriate ethical oversight and 

protecting the privacy of Veterans; and 

receive an overview of the recent 

Institute of Medicine report on privacy 

protections in health research and 

discussions of potential areas of 

research in diseases/conditions 

prevalent in Veterans such as diabetes, 

women’s health, specifically breast 

cancer, and the application of 

pharmacogenomics in clinical care. 

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