Lung function abnormalities among service members returning from Iraq or Afghanistan with respiratory complaints

Respir Med. 2016 Sep:118:84-87. doi: 10.1016/j.rmed.2016.07.014. Epub 2016 Jul 25.

Abstract

Background: Service members deploying to Afghanistan (OEF) and Iraq (OIF) often return with respiratory symptoms. We sought to determine prevalence of lung function abnormalities following OEF/OIF.

Methods: We identified OEF/OIF patients who had unexplained respiratory symptoms evaluated using lung function testing. Lung function data were summarized and analyzed for associations with demographic and deployment characteristics.

Results: We found 267 patients with unexplained cough or dyspnea, lung function testing and a history of OEF/OIF deployment. All patients had basic spirometry performed and 82 had diffusion capacity for carbon dioxide (DLCO) measured. The median (IQR) number of deployments and total days deployed were 1 (1-2) and 352.0 (209-583), respectively. There were 83 (36.6%) patients with abnormal spirometry, 53 (63.9%) of whom had an abnormal FEV1/FVC. Only one (1.2%) patient had an abnormal DLCO adjusted for alveolar volume. Of 104 patients who had post bronchodilator (BD) testing performed, six (5.8%) had a positive response by ATS criteria. We found no relationships between lung function and time in theater, deployment location, deployment frequency, or land based-deployment. Dyspnea and enlisted rank were associated with tobacco use and lower FEV1, and cough was associated with total number of deployments.

Conclusions: Service members with respiratory complaints following OEF/OIF have a high prevalence of abnormalities on spirometry. Tobacco use, enlisted rank and total number of deployments were associated with symptoms or spirometric abnormalities.

Keywords: Airway disease; Dyspnea; Lung function testing; Service members.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Afghanistan
  • Carbon Dioxide / metabolism
  • Cough / diagnosis*
  • Cough / etiology
  • Dyspnea / diagnosis*
  • Dyspnea / etiology
  • Female
  • Forced Expiratory Volume / physiology
  • Humans
  • Iraq
  • Male
  • Middle Aged
  • Prevalence
  • Pulmonary Diffusing Capacity / methods
  • Respiration Disorders / diagnosis*
  • Respiration Disorders / epidemiology*
  • Respiration Disorders / ethnology
  • Respiration Disorders / physiopathology
  • Respiratory Function Tests / methods*
  • Retrospective Studies
  • Spirometry / methods
  • Tobacco Use / adverse effects
  • Veterans
  • Vital Capacity / physiology

Substances

  • Carbon Dioxide