ALS risk varies by military service branch, study shows
A major new study examining nearly 10 million veterans in the VA medical system has found that the risk of developing ALS varies significantly depending on which branch of the military a veteran served in. Researchers from Harvard T.H. Chan School of Public Health and the Department of Veterans Affairs analyzed records from 2000 to 2024 and identified 14,419 patients who had received an ALS diagnosis, revealing notable differences in diagnosis rates across service branches.
ALS, or amyotrophic lateral sclerosis, is a fatal progressive disease that attacks motor neurons, causing them to lose connectivity and die off. Most famously associated with baseball legend Lou Gehrig and physicist Stephen Hawking, ALS is diagnosed in roughly 5,000 Americans each year according to the Centers for Disease Control and Prevention. The disease comes in two forms: sporadic, occurring without a known cause, and familial, likely resulting from inherited genetic mutations. For veterans, the VA presumes ALS to be service-connected given that military personnel are diagnosed at nearly twice the rate of civilians, though the exact cause has not been scientifically proven.
The study found that Air Force veterans had a 29 percent higher rate of ALS compared to Army veterans, who served as the baseline for comparison. Coast Guard veterans showed a 26 percent higher rate, while Navy veterans had a 15 percent higher rate. Marines had the lowest rate among all branches, coming in at 22 percent below Army veterans after researchers adjusted for sex, race, and ethnicity.
Beyond branch differences, the study revealed significant variations by rank and demographics. Officers overall had a 64 percent higher rate of ALS than enlisted personnel, with women officers showing a 72 percent higher rate. The differences among branches were most apparent in men ages 61 and younger, while becoming less evident among men older than 75. Study author Marc Weisskopf noted that these findings suggest officers and those serving in the Air Force, Navy, or Coast Guard may have been exposed to military environments that increase ALS risk.
Researchers have theorized that exposure to hazardous environments and substances during military service may contribute to the elevated ALS rates among veterans. Potential culprits include burn pits, jet fuel, exhaust, heavy metals, dioxins, and other toxic materials, though no direct connection has been scientifically proven. In the civilian population, occupations such as airline pilots, truck drivers, metal workers, and those working with pesticides show increased ALS risk, according to a 2022 Columbia University study.
For disabled veterans, this research matters because ALS is automatically presumed service-connected by the VA, meaning veterans diagnosed with the disease qualify for VA disability compensation and health care without needing to prove the condition resulted from their military service. The study authors emphasized that while the differences between branches are statistically significant, ALS remains rare overall, with less than 0.2 percent of the 9.9 million veteran records reviewed showing an ALS diagnosis. Weisskopf stressed that even the increased rates represent only modest increases in actual risk among military personnel.
Veterans who develop symptoms associated with ALS, such as muscle weakness, difficulty speaking or swallowing, or progressive loss of motor function, should seek medical evaluation through the VA health care system as soon as possible. Given the automatic service connection for ALS, veterans diagnosed with the condition should work with a veterans service officer to ensure they receive all applicable benefits and compensation. Early diagnosis and connection to VA care can provide access to specialized treatment and support services critical for managing this progressive disease.