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Longitudinal changes in lung function following post-9/11 military deployment in symptomatic veterans
Lauren M Zell-Baran1, Silpa D Krefft2, Matthew Strand3
1National Jewish Health, Division of Environmental and Occupational Health Sciences, Denver, CO, USA; Department of Epidemiology, Colorado School of Public Health, Colorado, Aurora, USA.
Military veterans exposed to burn pits and dust may develop deployment-related respiratory diseases (DRRDs). Those with distal lung disease (DDLD) showed declining lung function over time, indicating long-term impacts of combat exposures.
Area of Science:
- Occupational Medicine
- Environmental Health
- Pulmonology
Background:
- Military deployment to Southwest Asia and Afghanistan (SWA) involves exposure to hazards like burn pit smoke, dust, and diesel exhaust.
- These exposures are linked to deployment-related respiratory diseases (DRRDs) and potential long-term lung function decline.
Purpose of the Study:
- To assess the impact of deployment exposures on lung function in SWA-deployed veterans.
- To identify differences in lung function based on specific DRRD diagnoses and exposure intensity.
Main Methods:
- Evaluated lung function in 219 SWA-deployed veterans undergoing occupational lung disease assessment.
- Utilized linear mixed models to analyze changes in lung function over time.
- Assessed lung function differences based on deployment exposures and DRRD diagnoses.
Main Results:
- Most symptomatic veterans had high exposure but normal initial spirometry.
- Common DRRDs included distal lung disease involving small airways (DDLD, 41%) and deployment-related asthma (DRA, 13%).
- Veterans with both DDLD and DRA showed the lowest spirometry, and those with DDLD alone experienced an annual FEV1/FVC decline of 0.2%.
Conclusions:
- Higher inhalational exposure intensity correlates with reduced post-deployment lung function.
- Distal lung disease (DDLD) was associated with a significant longitudinal decline in FEV1/FVC ratio.
- Other DRRD diagnoses did not show similar longitudinal lung function decline.
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