Deployment-Related Respiratory Disease: Where Are We?

Area of Science:

• Environmental and Occupational Medicine
• Pulmonology
• Military Health

Background:

• Military personnel and veterans deployed to Afghanistan, Iraq, and Southwest Asia (SWA) since 1990 face risks of respiratory symptoms and deployment-related respiratory diseases (DRRDs).
• Common DRRDs include asthma, chronic sinonasal disease, laryngeal disease/dysfunction, and distal lung disease.
• Understanding and managing these conditions is crucial for the health of deployed service members and veterans.

Approach:

• This review synthesizes current knowledge on DRRDs, focusing on screening, diagnosis, evaluation, and management strategies.
• It highlights the utility of standard diagnostic tools like pulmonary function testing and chest imaging.
• Emerging noninvasive techniques such as lung clearance index testing, forced oscillation testing, and quantitative CT assessment are discussed for enhanced lung disease detection.

Key Points:

• Effective management requires a thorough occupational and deployment exposure history.
• Recommendations for diagnostic testing are provided to aid clinicians.
• The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 (PACT Act) is discussed, including its provisions for presumptive service connection for toxic exposures.

Conclusions:

• Pulmonary practitioners need updated information on DRRDs to effectively screen, diagnose, and manage affected military personnel and veterans.
• The PACT Act offers a framework for recognizing and addressing health conditions linked to SWA deployment toxic exposures.
• Resources are provided for clinicians involved in the care of patients with DRRDs.