Sinusitis and rhinitis among US veterans deployed to Southwest Asia and Afghanistan after September 11, 2001

J Allergy Clin Immunol Glob. 2024 Oct 31;4(1):100367. doi: 10.1016/j.jacig.2024.100367. eCollection 2025 Feb.

Abstract

Background: Post-9/11 veterans were exposed to environmental and occupational pollutants during deployment.

Objective: Our aim was to determine associations between deployment-related exposures and sinusitis and rhinitis.

Methods: Between April 2018 and March 2020, veterans with land-based deployment after 9/11 who were living within 25 miles of 6 Department of Veteran Affairs medical centers were randomly chosen by using a Defense Manpower Data Center roster. Participants completed interviewer-administered questionnaires, which included a 32-item deployment exposure battery and self-report of rhinitis and health professional-diagnosed sinusitis. Exposure categories included burn pit smoke, combustion engine exhaust/ground dust, other open combustion sources, toxicants, and military job-related VGDF. Each item was scored on the basis of frequency and duration of exposure; ordinal scores were summed and scaled to 100 within each category. Odds ratios (ORs) were estimated using logistic regression for sinusitis and rhinitis separately. ORs were scaled per 20-point exposure score.

Results: Among the 1960 participants, the incidences of sinusitis and rhinitis with onset during deployment were 2.1% and 3.6%, respectively; the incidences of postdeployment onset were 5.1% and 5.6%, respectively. Toxicant exposure consisted mainly of "applying pesticide, insecticide, or repellent to your own skin or to your own clothing" and was associated with rhinitis with onset during deployment (OR = 1.50 [95% CI = 1.31-1.84]) and onset after deployment (OR = 1.21 [95% CI = 0.93-1.50]). There were no associations with burn pit smoke or other exposure categories.

Conclusion: Veterans with deployment exposures to toxicants were at increased risk of rhinitis, particularly during deployment. The clinical evaluation of postdeployment veterans should address rhinitis as a deployment-related condition.

Keywords: Sinusitis; chronic rhinosinusitis; environmental exposure; military; occupational exposure; rhinitis; veterans.