SESSION TYPE: Occupational/ Environmental Lung Disease
PRESENTED ON: Tuesday, October 23, 2012 at 04:30 PM - 05:45 PM
PURPOSE: Evaluation of the respiratory health of military personnel returning from deployment to Iraq and Afghanistan has gained increasing attention. Reported environmental exposure to sulfur fire, burn pits, dust storms, or vehicle exhaust has been related as potential etiologies of pulmonary disease. There has been no systematic investigation to date of military personnel with established chronic lung disease.
METHODS: A retrospective chart review was conducted for military personnel evaluated in Army pulmonary clinics from 2005-2010. A preliminary identification was made through the M2 database and verification of primary diagnosis made by the pulmonologist was made by individual record review. In specific cases where the etiology was uncertain, diagnostic workup was reviewed. Particular interest was paid to chronic lung disease rather than asthma or COPD.
RESULTS: Approximately 17,000 active duty patients were identified during the initial search. The most common reason for active duty personnel to be seen in pulmonary clinics were sleep-related disorders. Obstructive lung disease encompassed the next largest group and has been previously reported. Interstitial lung diseases found included approximately 300 cases of a variety of with sarcoidosis (n = 160), cancer/chemotherapy-related (n = 29), or connective tissue disease related (n = 12). The remainder of ILD cases identified was less than 10 individually. Abnormal imaging (n = 165) and unexplained dyspnea (n=130) were common causes for evaluations. Preliminary data does not indicate increased numbers of patients due to deployment.
CONCLUSIONS: Dyspnea and other respiratory symptoms are commonly evaluated in active duty military personnel, but our data does not suggest increased chronic lung disease post-deployment. Previous reports have established a diagnostic link for acute eosinophilic pneumonia but not other chronic lung diseases where the rates of asthma and COPD have not increased post-deployment. Many active duty patients continue to be evaluated for dyspnea without established diagnoses.
CLINICAL IMPLICATIONS: Military deployment may present with various environmental exposures. Thorough evaluations should be performed in symptomatic patients. There is minimal evidence of increasing chronic lung disease.
DISCLOSURE: Michael Morris: Consultant fee, speaker bureau, advisory committee, etc.: Pfizer and Behringer Ingelheim
The following authors have nothing to disclose: Frederic Rawlins
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