Health

Report urges Defense to collect genome data on all troops

The Defense Department should collect human genome sequence data from military personnel to help determine their genetic traits, which could improve performance and cut medical costs, a Defense scientific advisory panel recommended in a report released in December 2010.

The report, posted Jan. 13 on the Federation of American Scientists' website by Steven Aftergood, director of the organization's Project on Government Secrecy, said collecting genome data might help uncover phenotypes that pertain to short- and long-term medical readiness, physical and mental performance, and response to drugs and vaccines.

Thomas Murray, president of The Hastings Center, a nonprofit bioethics research institute in Garrison, N.Y., said phenotypes are the physical manifestation of DNA code contained in cells, which determine characteristics such as hair color, height, strength and mental acuity. Phenotypes also reflect exposure to environmental conditions and toxins as well as stress during childhood.

The Defense human genome report, prepared by JASON, an independent scientific advisory group, said the ability to determine phenotypes could help predict the response of individual troops to battlefield stress, including post-traumatic stress disorder, as well as the ability to tolerate conditions such as sleep deprivation and dehydration.

It also could help determine the ability of troops to withstand prolonged exposure to a range of elements, such as heat, cold or high altitude, or their susceptibility to complications like traumatic bone fracture, prolonged bleeding, or slow wound healing, the report said.

The collection of human genome data also could help the Veterans Affairs Department treat soldiers after they leave active duty, the report said, and recommended genome data be incorporated into the Defense and VA electronic health record systems.

While the National Institutes of Health and the Energy Department spent $300 million to initially sequence the human genome a decade ago, the JASON report noted costs have dropped to $20,000 and predicted that soon-to-be-released DNA sequencing systems will drive costs of chemical reagents below $100 per genome sequence.

The lower cost will enable Defense to sequence the data for its active duty force of 1.4 million troops relatively cheaply, the report said. But even at $100 for the chemicals needed to do the sequencing, the bill amounts to $140 million, which does not include data storage or computing costs.

Nor does it cover the costs of genetic counseling, Murray said, referring to the face-to-face session in which every member of the military has their genome explained.

Murray said it could take years before genome studies could have any bearing on troop health and readiness. He also is concerned that Defense could use genomic information to pin the blame for some conditions -- such as combat stress -- on genetic code, rather than taking responsibility for situations that caused those conditions, such as multiple combat tours.

According to Blaine Bettinger, a Syracuse, N.Y.-based intellectual property lawyer who has a doctorate in biochemistry with a concentration in genetics and writes the Genetic Genealogist blog, a mass collection of genome data at Defense could eventually help improve the health of military members and their families. Collecting basic genomic information on such a large population could also "benefit all of humanity," Bettinger said.

But Bettinger warned that collection of such data also could be used against individuals if, for example, they had conditions the military could cite as a reason to limit their careers.

Dr. Robert Cook-Deegan, director of the Center for Genome Ethics, Law & Policy at Duke University's Institute for Genome Sciences & Policy, said the report did not make a deep or persuasive case on how genomic information could help Defense better manage conditions such as PTSD.

In an e-mail to NextGov, Cook-Deegan said, "No one knows how important genetic factors will prove to be, or how that story will play out. The technical capacity for DNA sequencing merely means that the genetic part of that complex story will probably move faster than it otherwise would, but the causal pathway is still pretty complex, and it's not at all clear to me what Defense would do if it could identify some folks more prone to exhibiting symptoms of PTSD than others, and the report does not delve into such issues."

If he had one recommendation for Defense, Cook-Deegan said, it would be to take the lead to help set standards for the data formats that will be needed to make the genomic information portable and interoperable.

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