AFGSC leadership address questions from the field on missile base health concerns Published Feb. 8, 2023 Air Force Global Strike Public Affairs BARKSDALE AIR FORCE BASE, La. -- The Commander and Command Chief, Air Force Global Strike Command, held two virtual town halls on Jan. 30 with AFGSC leadership teams and Airmen from the nuclear enterprise to discuss concerns from Airmen about the “Malmstrom Initiative Slide Deck.” In that discussion a number of questions were put forth to Gen. Thomas A. Bussiere and Chief Master Sgt. Melvina A. Smith. They, along with the AFGSC Surgeon General, Col Lee D. Williames, answered questions until there were no more questions from the field. If any Airman - past or present, Guardian, family member has a question or concern, they are encouraged to speak to their medical provider or they can submit their question through the AFGSC Official Website at: https://www.afgsc.af.mil/Contact-Us/ or via the Office of the Air Force Surgeon General at: https://www.airforcemedicine.af.mil/Contact-Us/. This article will be updated as new questions are received and answered. Here are the questions and the answers from the two virtual town halls: Q: Is this (study) limited to only the 341 MW or are the 90 MW and 91 MW also going to be part of this? A: (Gen Bussiere) My opening posture is that this is not limited, not specific to one base, to one AFSC, I am not binding myself to that; this is all bases, all ranks, all AFSCs, the entire spectrum - to include the environments; I want to look cumulatively at this vs. discretely, this problem set is much bigger than one unit, one AFSC, one location or any one factor. For the analysis, I’ve directed it be bound logic, that is disciplined, methodical and informed by judgement; I’m asking for smart people to open the aperture and make informed assessments as to how we can best evaluate this, to scope it and scale it; we may need to go outside AF sources and personnel for analytics, to get the right expertise, manpower/manning and technical expertise. Beyond looking at potential risks, exposures, and programs and we also already looked at the 2001 and 2005 studies. Q: Will the study include current missileers? A: (Col Williames, AFGSC Surgeon General) Studies are either retrospective, current or prospective. If current members are involved or need to be available, we will work with members for availability. Past studies didn’t have access to members so there were challenges with data. There are study protocols in place to protect individuals and their health information. We will ensure we protect our Airmen if and when they may be involved in a study. Q: Are you going to look at those Airmen who were pregnant when on duty in the missile enterprise? A: (Col Williames, AFGSC Surgeon General) Great question, don’t know right now, we will see what is possible and we will get back to you with a better answer. Q: Are there any reports from any other missile wings (besides Malmstrom)? A: (Col Williames, AFGSC Surgeon General) There is information out there that are lists, but not official registries like the VA Cancer Registry, for example. We need to look more and broader and deeper, this is evolving. Listings that may be out there are not all-inclusive and are not official, but we will look for a study or studies that is or are more comprehensive and this will also be part of our analysis. Q: Are we engaging with outside organizations like the Association of AF Missileers, for example? A: (Gen Bussiere) I received good feedback this weekend from the AAFM based on my message that went out in the media, so I’m happy the message is getting out. We are trying to be open and transparent and keep up with the speed of information with facts as we know them. We want to engage as far and wide with as many people, Airmen, former Airmen and families in the loop with information. We will continue to work to get information out to as many Airmen and family members possible but also our retirees and veterans and family members who served with them. We will continue to engage and are open to suggestions on how to reach other organizations, forums, groups or audiences. Q: What sort of health care is available for an Airman who may be asymptotic? A: (Col Williames, AFGSC Surgeon General) Non-Hodgkin’s Lymphoma is several different types of cancers under one umbrella term, so there’s not one screening procedure or test that’s predictive. We encourage all Airmen or those with concerns to speak to their PCM. This is a one-on-one, case-by-case, individual situation vs. one blanket answer or approach. If you have symptoms like fever, fatigue, swollen lymph nodes you should see a provider. Our commander’s toolkit lists potential symptoms of concern. Q: Do you think this could be because of environmental impacts like PFOS, PFOA, or Air quality? A: (Gen Bussiere) We don’t want to assume or discard that it has something to do with anything in particular (water, soil, air, launch capsule, facilities, etc.), we want to look at this holistically. This includes looking at the installation, environment, changes to operations and facilities, we want to look cumulatively. Q: Can an Airman seek alternative healing methods? In other words, for Airmen or others who are diagnosed, are there going to be options for different healing modalities such as holistic, radiation, or other non-standard treatments? A: (Col Williames, AFGSC Surgeon General) The standard for care is based on the individual. However, we have adopted a lot of treatments in the past few years with regard to different types of treatments. Individuals should talk to their PCM. Q: Are there concerns about folks in the field now: A: (Gen Bussiere) While there are no indicators right now or data points to indicate an unsafe environment for our Airmen in the field, I take this concern very seriously. We are going to analyze the issue and will address any concerns, if there are issues, as we discover issues. We still have an obligation for our Nation’s Defense. Any study should include all bases and all applicable AFSCs and ranks, but the bounding problem might be a bit different at each base or location; this is not a discreet issue. Q: In encouraging Airmen to seek the advice and counsel of their care team, are you concerned about overwhelming our PCM teams and their ability to provide quality care to all Airmen and families in a timely manner? A: (Gen Bussiere and Col Williames, AFGSC Surgeon General) Service members and their dependents that are concerned or have questions can always speak with their healthcare provider on personal risk factors and a healthcare plan. However, there is no screening test for NHL. There are currently only tests to diagnose NHL. I would encourage Airmen to engage their chain of command first, the commander’s toolkit covers the basic areas of concerns and has answers to questions that should cover most of the areas of concern at a level of non-medical speak. If the toolkit can address questions, there is no need to rush to one’s care team. Also, Airmen and family members do also need to know there is not one magic test or screening tool. However, it’s important that patients are able to maintain trust with their care team. Q: Is there a test one person can take to get screened? A: (Col Williames, AFGSC Surgeon General) There's no screening test that is predictive for someone who is asymptomatic for Non-Hodgkin Lymphoma. We recommend any Airman, past or present, or family member with concerns have a one-on-one discussion with your provider or care team. Q: For those that could not attend today, what do you want to pass along? A: (Gen Bussiere) There is no indication you are operating in an unsafe work environment. While everything we do in the Department of Defense is inherently dangerous, we owe it to our Airmen and their families to know that we take things very seriously and will address any issues as they arise. We also still have an obligation to maintain the foundational defense of our Nation and our allies through nuclear strategic deterrence, but we are just as passionate about this as you are and we will share whatever we can.