To compare the prevalence, severity, and impact of respiratory symptoms in soldiers with and without asthma returning from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF).
We circulated a questionnaire to 1,250 consecutive active duty soldiers and Department of Defense contractors returning from OEF/OIF. The questionnaire included basic demographics, smoking habits, respiratory symptoms, and impact on job performance before and during deployment. Patients with a history of asthma were asked to specify method of diagnosis, current symptoms and asthma therapy. Data analysis was performed using Fisher’s exact test.
1193 subjects returned the completed questionnaire (95% response rate). Baseline prevalence of dyspnea was 2.3%, and 155 subjects (13.4%) reported more dyspnea during deployment. Respiratory symptoms affected field duties more often in 11% of respondents during deployment, and 13% sought medical attention for breathing problems. Eleven subjects (0.9%) were hospitalized and 13 (1.2%) required medical evacuation. Sixty-one subjects (5%) reported a previous diagnosis of asthma. A majority had mild intermittent asthma based on their medical regimen, and 16 (28%) reported symptoms suggestive of inadequate asthma control. Asthmatics reported more wheezing, sputum production, and chest pain/tightness during deployment (p < 0.0001, 0.04, 0.03), and more difficulty with military duties (p < 0.03). Asthmatics were more likely to seek medical attention and receive duty limitations(p < 0.0001). Three asthmatics (7%) were hospitalized and one (2%) required medical evacuation. All clinically significant differences observed could be attributed to the poorly controlled asthma cohort, including three of the four asthmatics requiring hospitalization and medical evacuation.
Subjects with well controlled, mild asthma did not experience more respiratory sequelae during deployment to OEF/OIF compared to non-asthmatics. Asthma hospitalizations and medical evacuation rates were seen primarily in patients with poor baseline control.
Targeted evaluation and treatment of poorly controlled asthmatics prior to deployment may reduce the impact of asthma on operational readiness.
A.S. Niven, None.