Veterans Affairs physicians will begin screening all department patients for military-related toxic exposures starting in November, the latest step in efforts to understand the scope and severity of injuries caused by burn pit smoke and other battlefield toxins.

The new screening tool, mandated under legislation passed by Congress this summer, has been used at 15 VA medical center pilot locations over the past few weeks.

VA Under Secretary for Health Dr. Shereef Elnahal told reporters Wednesday that of the more than 13,000 veterans who have gone through the screening so far, about 37% said they have “concerns” about possible toxic exposure issues during their time in the ranks.

“That represents a substantial percentage of veterans in our care that may have been exposed to a toxin that we were not aware of,” Elnahal said. “That could mean more benefits or a higher medical priority categorization for them … This is clearly already bearing fruit.”

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The issue of military toxic exposure — particularly poisonous smoke from burn pits — has been a focus of national attention in recent months. In August, Congress finalized and President Joe Biden signed into law the Promise to Address Comprehensive Toxics, or PACT, Act, a sweeping measure to improve the research, care and benefits surrounding those injuries.

Past Department of Defense studies have estimated that nearly 3.5 million troops from the wars in Iraq and Afghanistan may have suffered enough exposure to burn pit smoke to cause health problems.

VA officials said by better screening all department patients, they’ll be able to provide more information to physicians about common injuries and a better picture to researchers about the impact on the veteran population.

The screening tool will be expanded to all VA medical sites and the 9-million-plus veterans enrolled in VA medical care just before Veterans Day. Patients will be required to go through the screening at least once every five years, looking for any signs of lingering respiratory problems or emerging health issues.

The toxic exposure screening will not initially be available to veterans outside the VA health care system, Elnahal said.

The move comes as VA officials are also urging all veterans to look into whether they are eligible for free health care coverage through the department under benefits expansion included in the PACT Act.

Starting on Saturday, tens of thousands of veterans from the Vietnam War, first Gulf War and Post-9/11 conflicts will be eligible for new health care coverage. Veterans will have one year to enroll and could be eligible for lifelong coverage if physicians find evidence of serious service-connected health problems.

More information on enrollment is available at the VA website.

VA officials said they are working to handle the additional workload if the bulk of those newly eligible individuals enroll.

“Our number one strategic challenge is hiring,” said VA Secretary Denis McDonough. “We have concrete efforts we are doing to meet very aggressive hiring goals in a tough labor market.”