• Military medicine · Mar 2020

    Exercise-Induced Bronchoconstriction in Iraq and Afghanistan Veterans With Deployment-Related Exposures.

    • Jacquelyn C Klein-Adams, Anays M Sotolongo, Jorge M Serrador, Duncan S Ndirangu, and Michael J Falvo.
    • Airborne Hazards and Burn Pits Center of Excellence, War Related Illness and Injury Study Center, Department of Veterans Affairs New Jersey Health Care System, 385 Tremont Ave, East Orange, NJ 07018.
    • Mil Med. 2020 Mar 2; 185 (3-4): e389-e396.

    IntroductionAcute exposure to high-levels of ambient fine particulate matter while exercising results in airway narrowing, but the long-term effects of repeated exposure on exercise-induced bronchoconstriction (EIB) are not well known. The goal of this preliminary study is to determine the rate of EIB among a sample of non-treatment seeking veterans deployed to Iraq and Afghanistan.Materials And MethodsTwenty-four veterans (median [interquartile range]: 35.0 [27.3, 45] years) without history of asthma volunteered for this study. Spirometry was assessed before and after a standardized exercise challenge. A positive EIB response was defined as an exercise-induced fall in forced expiatory volume in 1 second ≥10%. Secondary criteria (peak flow ≥10% or mid-expiratory flow ≥15%) were also considered as an estimate of probable EIB.ResultsA positive EIB response was observed in 16.7% and probable EIB response was observed in 41.7% of our sample. Median deployment length to Iraq or Afghanistan was 13.0 [10.3, 17.5] months and the median time since deployment was 4.2 [2.7, 7.7] years. At the time of testing, veterans reported persistent cough (58.3%), wheeze (37.5%), and shortness of breath (37.5%). During deployment, veterans reported exposure to dust and sand (70.8%), smoke from burn pits (66.7%), vehicle exhaust (83.3%), and regional air pollution (26.0%) on most days or daily.ConclusionsApproximately 17% of our sample of non-treatment seeking deployed Iraq and Afghanistan veterans demonstrated EIB, similar to the general population prevalence. However, persistent respiratory symptoms and alternative indices of probable EIB supports continued monitoring of this population.Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2019. This work is written by (a) US Government employee(s) and is in the public domain in the US.

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