Embedded Fragments Registry (EFR)

In 2009, the Department of Defense estimated that approximately 40,000 service members who served in OEF/OIF may have embedded fragment wounds as the result of small arms fire or a blast or explosion caused by an Improvised Explosive Device (IED), rocket propelled grenade (RPG), landmine, grenade, or enemy or friendly fire. Studies have shown that embedded fragments are not inert in the body, but may breakdown slowly over time and potentially affect an individual�s health. The recognition of potential short and long-term health effects of embedded fragments and the large number of soldiers with injuries resulting in embedded fragments led the Presidential Task Force on Returning Global War on Terror Heroes to recommend that the VHA establish a registry and medical surveillance program for Veterans with retained fragments. The Toxic Embedded Fragment Surveillance Center (TEFSC) has been established at the Baltimore VA Medical Center to coordinate this charge. A critical component of the TEFSC medical surveillance program is the development of an Embedded Fragment Registry. This registry provides a mechanism to identify Veterans with embedded fragments, manage clinical data related to embedded fragments, and develop medical and surgical guidelines that will enable the TEFSC staff and VA clinicians to deliver appropriate medical care to these Veterans.