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Respiratory Health Associated With Systemic Metal Exposure in Post-9/11 Veterans in the Department of Veterans
Stella E Hines1, Joanna M Gaitens, Clayton H Brown
1From the Department of Veterans Affairs Medical Center, Baltimore, Maryland (S.E.H., J.M.G., C.H.B., D.R.G., M.A.M.D.); University of Maryland School of Medicine, Baltimore, Maryland (S.E.H., J.M.G., C.H.B., D.R.G., M.R., K.H.C., E.L., M.A.M.D.); Tennessee Valley Healthcare System Veterans Affairs Medical Center, Nashville, Tennessee (K.L.C., W.E.L.); Malcolm Randall Veterans Affairs Medical Center, Gainesville, Florida (P.S.); Oklahoma City Veterans Affairs Medical Center, Oklahoma City, Oklahoma (L.B.); Audie L. Murphy Veterans Affairs Hospital, San Antonio, Texas (J.D.); and Phoenix Veterans Affairs Healthcare System, Phoenix, Arizona (S.M.A., P.P.).
Objective:
Adverse respiratory outcomes in post-9/11 veterans with elevated urinary metal measures and enrolled in the VA's Toxic Embedded Fragment registry were compared to those without elevated urinary metals.
Methods:
Veterans completed questionnaires, underwent pulmonary physiology tests (pulmonary function and oscillometry), and provided urine samples for analysis of 13 metals. Respiratory symptoms, diagnoses, and physiology measures were compared in veterans with ≥1 urine metal elevation to those without metal elevations, adjusted for covariates, including smoking.
Results:
Among 402 study participants, 24% had elevated urine metals, often just exceeding upper limits of reference values. Compared to veterans without elevated metals, those with elevated metals had had higher FEV 1 values but similar frequencies of respiratory symptoms and diagnoses and abnormalities on pulmonary physiology tests.
Conclusions:
Mild systemic metal elevations in post-9/11 veterans are not associated with adverse respiratory health outcomes.
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