• Silpa D Krefft, Jenna Wolff, Lauren Zell-Baran, Matthew Strand, Eva Brigitte Gottschall, Richard Meehan, and Cecile Stephanie Rose.
• National Jewish Health, Denver (Dr Krefft, Ms Wolff, Ms Zell-Baran, Dr Strand, Dr Gottschall, Dr Meehan, Dr Rose); Veterans Administration Eastern Colorado Health Care System (Dr Krefft); University of Colorado Anschutz Medical Campus (Dr Krefft, Dr Rose); Colorado School of Public Health (Dr Krefft, Ms Zell-Baran, Dr Strand, Dr Rose); University of Colorado (Dr Gottschall, Dr Meehan), Aurora, Colorado.
• J. Occup. Environ. Med. 2020 May 1; 62 (5): 337-343.

ObjectivePersistent respiratory symptoms following post-9/11 military deployment to Iraq and Afghanistan are well-recognized, but the spectrum of respiratory diseases remains poorly characterized. This study describes deployment-related respiratory diseases and the diagnostic utility of resting and exercise pulmonary function testing.MethodsBetween 2009 and 2017, 127 consecutive military workers ("deployers") with new-onset respiratory symptoms underwent clinical evaluation. Deployment-related respiratory diseases were classified as proximal and/or distal. Using descriptive statistics and logistic regression, we analyzed lung function parameters associated with deployment-related distal lung disease (DDLD).ResultsCommon deployment-related respiratory diseases included asthma (31.5%), intermittent laryngeal obstruction (14.2%), rhinosinusitis (15%), and DDLD (68.5%). Decreased diffusion capacity (odds ratio [OR] = 4.6, 95% confidence interval [CI]: 1.4 to 15.1, P = 0.01) was significantly associated with DDLD.ConclusionsA comprehensive diagnostic approach may identify a spectrum of proximal and distal respiratory diseases that can occur in symptomatic post-9/11 deployers, requiring a personalized approach to care.

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