May 2012 - United States military personnel and civilian contractors deployed to Iraq and Afghanistan may be at risk for respiratory symptoms and chronic lung disease, including asthma and constrictive bronchiolitis. Respiratory therapists can play an important role in ensuring that patients who have respiratory symptoms following deployment are provided with appropriate referral and high-quality lung function testing as part of their diagnostic evaluation.
Since 2001, approximately 2 million US military men and women have deployed to Iraq or Afghanistan in support of OIF (Operation Iraqi Freedom) or OEF (Operation Enduring Freedom), respectively. Over the past decade, evidence has emerged that military personnel and civilian workers sent to southwest Asia may be at risk for developing potentially disabling chronic lung diseases, including asthma and constrictive bronchiolitis (CB).1,2 Specific environmental inhalation exposures of concern include ambient desert dusts, emissions from burn pits where waste products are incinerated, industrial pollutants, secondhand smoke, and airborne contaminants associated with degraded soils.
Reports of increased acute respiratory illnesses in deployed troops began surfacing in 2004.3 Subsequent epidemiologic studies showed that deployers have higher rates of newly reported respiratory symptoms than nondeployers (14% versus 10%), although rates of physician-diagnosed asthma and chronic bronchitis were not increased.4 More recent studies suggest that obstructive airways diseases, including asthma and constrictive bronchiolitis, are occurring in excess in returning troops.1,5 The magnitude and spectrum of respiratory illnesses from deployment are difficult to judge. Lack of predeployment spirometry and challenges with diagnosis limit accurate estimates of disease incidence and prevalence.
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