In the past few years, evidence has emerged that U.S. military personnel and Department of Defense (DoD) contractors who have deployed to Iraq, Afghanistan and other sites in Southwest Asia may be at increased risk for developing respiratory symptoms and, in some cases, disabling chronic respiratory diseases including asthma, rhinitis, sinusitis and constrictive bronchiolitis. The causes of these lung diseases remain unknown, but may be related to exposure to hazardous chemicals and inhalation of small particles in the Southwest Asia environment.
Exposure Concerns
Military personnel deployed in Southwest Asia often are exposed to:
Open-air burn pits – burning or smoldering chemicals, metals, plastics and human waste
Desert dust and sandstorms
Industrial fires and emissions
Vehicular diesel exhaust
Improvised explosive device (IED) blasts
Combat dust and debris
Temperature and humidity extremes in the desert climate
Workplace vapors, dusts, gases and fumes such as paints and solvents
Who is at Risk?
Current or former military personnel who deployed to Southwest Asia (e.g., Iraq, Kuwait), Afghanistan, or Djibouti since 2001
Government contractors who worked in these areas since 2001
Deployment-Related Respiratory Conditions
The full spectrum of deployment-related respiratory diseases is unknown. Lung conditions that have been linked to deployment include:
Bronchiolitis
Asthma
Eosinophilic syndromes
Upper airway disorders such as rhinitis, sinusitis, tracheobronchomalacia/expiratory central airway collapse
Unexplained shortness of breath
How are these conditions diagnosed?
Medical evaluation is individualized. Testing may include:
Detailed occupational and medical history
Comprehensive physical exam
Lung function testing
Methacholine challenge
Exercise testing
Laryngoscopy
Bronchoscopy
Chest computed tomography (CT) scan
Lung biopsy
Is there treatment?
Our team of medical providers and caregivers develop a personalized treatment approach for each patient seen in our Deployment-Related Lung Disease Center, based on their respiratory disease diagnosis and severity. We use the latest evidence-based information to establish a program of treatment and medical follow-up. For some lung conditions like bronchiolitis, there are few available treatments that have been shown to work. Treatment for deployment-related lung disease is a major focus of our research program.
John Sepulveda arrived in Afghanistan in 2011 in peak form and proud to serve in the Air Force. His role was crucial, and he didn’t want to let down his fellow airmen, or his country. So, when he got sick less than a month into his deployment, he decided to tough it out. “That was the worst thing I could have done,” said Sepulveda.