Deployment as a Risk Factor of Rhinologic Disease: Systematic Review and Meta-Analysis

Identify deployment, relocation to a military site abroad, as a risk factor for upper and lower airway disease and investigate exposures in the deployed population that may play a role in the pathology. Highlight the clinical importance of the limitations in the current literature.

CINAHL, Cochrane Library, PubMed, and Scopus.

Literature was searched from inception to July 2024 for articles reporting upper airway disease in active duty service members (ADSM). Specific diseases of interest were chronic rhinosinusitis (CRS), allergic rhinitis (AR), bronchitis, asthma, and olfactory dysfunction. Primary outcome measures included mean difference of proportion (Δ), proportions (%), and risk ratio (RR) with 95% confidence intervals (CI).

A total of 10 studies (N = 2,789,222) were included. The prevalence of CRS in deployed ADSM was significantly higher than in the cohort of military members not deployed (8.26% vs. 5.60% [95% CI, 2.59-2.74], P < .0001). The relative risk of developing CRS between ADSMs deployed and not deployed was 3.02 ([95% CI, 2.96-3.08], P < .00001). The prevalence of AR, bronchitis, and asthma was also significantly higher in deployed ADSM with RRs = 2.68, 4.55, and 2.5 ([95% CIs, 2.65-2.72, 4.34-4.76, and 2.46-2.54, respectively], all P < .00001).

Deployed ADSM have significantly higher rates of CRS and unspecified sinus disease, as well as higher rates of AR, bronchitis, and asthma compared to their counterparts not deployed.