SILVER SPRING, Md.—Nestled inside a generic-looking office building here in suburban Maryland, down the hall from cable-provider Comcast, sits the largest blood serum repository in the world.
Seven freezers, each roughly the size of a high school basketball court, are stacked high with row upon row of small cardboard boxes containing tubes of yellow or pinkish blood serum, a liquid rich in antibodies and proteins, but devoid of cells. The freezers hover at –30 degrees Celsius—cold enough to make my pen dry up and to require that workers wear protective jumpsuits, hats, gloves and face masks. Four more empty freezers, which are now kept at room temperature, await future samples.
The bank of massive freezers—and its contents—is maintained by the Department of Defense (DoD). The cache of government-owned serum may provide unique insights into the workings of various maladies when linked with detailed information on service members’ demographics, deployment locations and health survey data. New research projects tapping the precious serum could lead to breakthroughs in some of the hottest topics in military research—including the hunt for biomarkers for post-traumatic stress disorder and suicide risk. But DoD’s policy of keeping its samples in perpetuity—even after troops leave the force—could raise a few eyebrows.
From humble beginnings
The military started collecting serum samples 28 years ago as a by-product of its HIV surveillance. Since then serum has been routinely collected from leftover blood from HIV tests or standard post-deployment health check-ups and then frozen for future reference. Now the Department of Defense Serum Repository (DoDSR) has swelled to include 55.5 million samples of serum from 10 million individuals—mostly service members, veterans or military applicants. The armed forces use DoDSR for general health surveillance to track infectious diseases and to shape health policies. But the repository is also ripe for targeted research programs.
Annually the facility may field as many as 100 requests to use some of the serum from that icy reserve. Sixty-two requests received the green light to sample from DoDSR last year, half of them for research and half for clinical testing of an individual patient’s samples. In the past five years DoDSR has filled 278 such requests. But not all DoDSR uses are medical: they have also played a role in criminal proceedings, serving as a reference point for female victims in two rape cases, says Mark Rubertone, who oversees the DoDSR. “The value of the specimens does not go away, even after [service members] leave the military,” he says.
Even with the promise of ongoing health surveillance and potential research that would benefit the force, not all contributors to the repository are enthusiastic about—or even necessarily aware of—their participation. DoDSR does not discard serum samples, even if individual service members or military applicants request that their samples be removed. Fewer than 10 individuals have asked for the removal of their samples, according to Rubertone. But the requests are likely rare because service members and their families are not actively aware of the serum, even though they may know that their blood—in one form or another—is on file, Rubertone acknowledges. Thus far, no one has successfully retrieved his or her biological materials from the facility.
A RAND Corp. report on the facility, published in 2010 (after an earlier draft was revealed via Wikileaks), pointed out that nearly 900,000 samples in the repository were not from active duty or reservist personnel—they were from so-called “dependent beneficiaries” in service members' families. Those numbers have since grown, to a “couple million” samples, according to the DoDSR count. The biological material from military family members often ends up in the repository after beneficiaries receive pregnancy care or visit a sexually transmitted infection clinic. The data accompanying those samples are more sparse and so the serum specimens are not as useful for studies, although they are still kept in the repository. Another 4 percent of the samples come from civilians who applied for military service but did not join.