The impact of deployment on COPD in active duty military personnel.
OBJECTIVE
To identify trends in chronic obstructive pulmonary disease (COPD) diagnoses among active duty U.S. military personnel based on deployment history and whether International Classification of Disease, 9th edition (ICD-9) coding meet criteria for the diagnosis of COPD.


METHODS
A retrospective chart review using the electronic medical system was conducted for military personnel diagnosed with COPD based on ICD-9 codes for emphysema or chronic obstructive lung disease with at least three qualifying outpatient COPD-coded encounters. Clinical symptoms, smoking history, pulmonary function testing, and radiographs obtained during the diagnostic workup were reviewed. The established diagnosis of COPD was analyzed in relation to deployment.


RESULTS
A total of 371 patients were identified during the study period (2005-2009). Of these patients, 194 (52.3%) deployed, whereas 177 (47.7%) did not deploy to Southwest Asia since 2003. Thirty-four percent had no documented smoking history despite the diagnosis of COPD. Airway obstruction was identified by spirometry in only 67% of individuals diagnosed with COPD. No statistically significant differences in pulmonary function testing values were identified between those deployed and nondeployed individuals.


CONCLUSIONS
Despite evidence of increased respiratory symptoms in deployed military personnel, the impact of deployment on increased diagnosis of COPD or severity of disease appears minimal.
Pulmonary Disease Service, Joint Base Elmendorf Richardson Hospital, 5955 Zeamer Avenue, JBER, AK 99506.
Tokunbo
T
Matthews
United States Army Public Health Command, 5158 Blackhawk Road, Aberdeen Proving Grounds, MD 21010.
Joseph
J
Abraham
Department of Medicine, Orlando Veterans' Administration Hospital, 5201 Raymond Street, Orlando, FL 32803.
Lisa L
LL
Zacher
Pulmonary/Critical Care Service, Department of Medicine, San Antonio Military Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, TX 78234.
Michael J
MJ
Morris
D000328:Adult; D000402:Airway Obstruction / Q000175:diagnosis; D000553:Ambulatory Care; D002248:Carbon Monoxide / Q000378:metabolism; D057286:Electronic Health Records; D004781:Environmental Exposure; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data; D011653:Pulmonary Diffusing Capacity / Q000502:physiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011656:Pulmonary Emphysema / Q000175:diagnosis; D013902:Radiography, Thoracic / Q000379:methods; D012115:Residual Volume / Q000502:physiology; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012907:Smoking; D013147:Spirometry / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D014109:Total Lung Capacity / Q000502:physiology; D014481:United States; D014797:Vital Capacity / Q000502:physiology; D000515:alpha 1-Antitrypsin / Q000032:analysis
C043392:SERPINA1 protein, human; D000515:alpha 1-Antitrypsin; D002248:Carbon Monoxide