Deployment-related respiratory symptoms in returning veterans

July 1, 2014

In a new study of the causes underlying respiratory symptoms in military personnel returning from duty in Iraq and Afghanistan, a large percentage of veterans had non-specific symptoms that did not lead to a specific clinical diagnosis. Most patients who did receive a diagnosis had evidence of asthma or nonspecific airway hyperreactivity, which may have been due in some cases to aggravation of pre-existing disease by deployment exposures.

"Earlier studies of deployed in Southwest Asia have shown increases in non-specific respiratory symptoms related to exposure to increased levels of ," said lead author Michael J. Morris, MD, of the San Antonio Military Medical Center in Texas. "Accordingly, we conducted a prospective study of 50 consecutive individuals returning from active duty in Iraq and/or Afghanistan with new onset pulmonary symptoms to assess possible causes."

The study was published in the July 1 issue of the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

All study subjects completed a questionnaire detailing deployment history, airborne exposures, smoking history, pulmonary symptoms and medical treatment and underwent baseline spirometry, high resolution chest tomography, methacholine challenge testing and fiberoptic bronchoscopy with bronchoalveolar lavage.

Testing did not result in a specific diagnosis in 42% of the patients, including 12% of the patients who had normal testing but an isolated increase in neutrophils or lymphocytes (white blood cells that are increased in asthma). Evidence of airway hyperreactivity was seen in 36% of the sample, including 16% who met criteria for asthma and 20% with nonspecific airway hyperreactivity. Two patients had findings suggestive of airway hyperreactivity secondary to gastroesophageal reflux.

None of the patients had imaging results indicating the need for lung biopsy. Underlying mental health and sleep disorders were present in 66% of the patients.

"Evaluation of military personnel returning from duty in Southwest Asia with new onset respiratory symptoms should focus on airway hyperreactivity, although identifying an underlying cause and establishing a diagnosis may be difficult, and additional testing and follow-up may be necessary," said Dr. Morris. "Pre-existing underlying disease may play a role in in some patients, and mental health and sleep disorders, which were common in our sample, may also play a role in the occurrence of these symptoms."

Explore further: Late pulmonary function abnormalities are common among Iraq/Afghanistan veterans

Related Stories

Late pulmonary function abnormalities are common among Iraq/Afghanistan veterans

May 21, 2014
Pulmonary function abnormalities may be a precursor to chronic respiratory disease in Iraq/Afghanistan and Gulf War veterans years after their deployment, according to a new study presented at the 2014 American Thoracic Society ...

Occupational lung diseases in Iraq and Afghanistan veterans

May 18, 2011
A Wednesday morning session will explore the inhalational exposures and respiratory outcomes of military deployment to Iraq and Afghanistan. Presenters will review current knowledge on complex inhalational exposures, epidemiologic ...

UK study finds doctors are missing chances to diagnose COPD earlier

February 12, 2014
A retrospective study of almost 39,000 patients shows that opportunities to diagnose chronic obstructive pulmonary disease (COPD) at an earlier stage are frequently being missed in both primary and secondary care in the UK. ...

Pre-existing insomnia linked to PTSD and other mental disorders after military deployment

June 28, 2013
A new study from the Perelman School of Medicine at the University of Pennsylvania and the Naval Health Research Center has shown military service members who have trouble sleeping prior to deployments may be at greater risk ...

No harm in yoga: But not much help for asthma sufferers

June 2, 2014
Yoga has long been promoted as a method for improving physical and mental well-being. And although yoga is often suggested to asthma sufferers to help alleviate symptoms, a new study found little evidence that yoga will improve ...

Allergic disease worsens respiratory symptoms and exacerbations in COPD

May 10, 2013
Patients with chronic obstructive pulmonary disease (COPD) who also have allergic disease have higher levels of respiratory symptoms and are at higher risk for COPD exacerbations, according to a new study from researchers ...

Recommended for you

Pneumonia vaccine under development provides 'most comprehensive coverage' to date, alleviates antimicrobial concerns

October 20, 2017
In 2004, pneumonia killed more than 2 million children worldwide, according to the World Health Organization. By 2015, the number was less than 1 million.

Newly discovered viral marker could help predict flu severity in infected patients

October 20, 2017
Flu viruses contain defective genetic material that may activate the immune system in infected patients, and new research published in PLOS Pathogens suggests that lower levels of these molecules could increase flu severity.

H7N9 influenza is both lethal and transmissible in animal model for flu

October 19, 2017
In 2013, an influenza virus that had never before been detected began circulating among poultry in China. It caused several waves of human infection and in late 2016, the number of people to become sick from the H7N9 virus ...

Flu simulations suggest pandemics more likely in spring, early summer

October 19, 2017
New statistical simulations suggest that Northern Hemisphere flu pandemics are most likely to emerge in late spring or early summer at the tail end of the normal flu season, according to a new study published in PLOS Computational ...

New insights into herpes virus could inform vaccine development

October 18, 2017
A team of scientists has discovered new insights into the mechanisms of Epstein-Barr virus (EBV) infection, as well as two antibodies that block the virus' entry into cells. The findings, published in Proceedings of the National ...

Pair of discoveries illuminate new paths to flu and anthrax treatments

October 17, 2017
Two recent studies led by biologists at the University of California San Diego have set the research groundwork for new avenues to treat influenza and anthrax poisoning.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.