Environmental Exposures and Asthma in Active Duty Service Members

Area of Science:

• Environmental Health
• Pulmonary Medicine
• Military Health

Background:

• Increased reports of respiratory symptoms, including asthma, among service members (SM) deployed to South West Asia (SWA).
• Numerous environmental exposures have been investigated as potential causes.
• Need for understanding complex factors influencing respiratory health in deployed populations.

Purpose of the Study:

• To review evidence on environmental exposures, confounding conditions, and screening mechanisms for SM respiratory disease.
• To assess the relationship between deployment exposures and respiratory conditions in military personnel.
• To evaluate current screening methods for pulmonary issues in deployed SM.

Main Methods:

• Review of available evidence on environmental exposures and confounding conditions.
• Analysis of findings from studies like the Study of Active Duty Military for Pulmonary Disease related to Environmental Deployment Exposure (STAMPEDE) and STAMPEDE II.
• Assessment of reports from the Armed Forces Health Surveillance Center and the Institute of Medicine.

Main Results:

• Despite attention to particulate matter and burn pits, studies have not established a direct link to SM respiratory disease.
• STAMPEDE and STAMPEDE II found no effective routine screening methods.
• Other factors such as high tobacco use, obesity, childhood asthma recurrence, and conditions like Paradoxical Vocal Fold Motion are significant contributors.

Conclusions:

• The development of asthma and similar respiratory conditions in SM is multifactorial, involving a complex interplay of clinical inputs and environmental exposures.
• Clear associations and definitive assessment pathways for SM respiratory disease remain elusive.
• Continued research is needed to refine understanding and develop effective screening and management strategies.