title: Postdeployment Respiratory Health Care Encounters Following Deployment to Kabul, Afghanistan: A Retrospective Cohort Study.
abstract: Inhalational hazards are numerous in operational environments. A retrospective cohort study was conducted to investigate associations between deployment to Kabul, Afghanistan and subsequent respiratory health among U.S. military personnel. The study population consisted of personnel who deployed to Kabul, select Operation Enduring Freedom locations, personnel stationed in the Republic of Korea, and U.S.-stationed personnel. Incidence rate ratios (IRRs) were estimated for respiratory symptoms, signs, and ill-defined conditions, asthma, and chronic obstructive pulmonary disease. A significantly elevated rate of symptoms, signs, and ill-defined conditions was observed among Kabul-deployed personnel compared to personnel deployed or stationed in Bagram (IRR 1.12; 95% confidence interval [CI], 1.05-1.19), Republic of Korea (IRR 1.20; 95% CI, 1.10-1.31), and the United States (IRR 1.52; 95% CI, 1.43-1.62). A statistically elevated rate of asthma was observed among personnel deployed to Kabul, relative to U.S.-stationed personnel (IRR 1.61; 95% CI, 1.22-2.12). Statistically significant rates were not observed for chronic obstructive pulmonary disease among Kabul-deployed personnel compared to other study groups. These findings suggest that deployment to Kabul is associated with an elevated risk of postdeployment respiratory symptoms and new-onset asthma.
authors.affiliation: U.S. Army Public Health Command, 5158 Blackhawk Road, Aberdeen Proving Ground, MD 21010.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Sharkey
authors.affiliation: U.S. Army Public Health Command, 5158 Blackhawk Road, Aberdeen Proving Ground, MD 21010.
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Abraham
authors.affiliation: Armed Forces Health Surveillance Center, 11800 Tech Road, Silver Spring, MD 20910.
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Clark
authors.affiliation: Armed Forces Health Surveillance Center, 11800 Tech Road, Silver Spring, MD 20910.
authors.forename: Patricia
authors.initials: P
authors.lastname: Rohrbeck
authors.affiliation: Armed Forces Health Surveillance Center, 11800 Tech Road, Silver Spring, MD 20910.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Ludwig
authors.affiliation: Armed Forces Health Surveillance Center, 11800 Tech Road, Silver Spring, MD 20910.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Hu
authors.affiliation: U.S. Army Public Health Command, 5158 Blackhawk Road, Aberdeen Proving Ground, MD 21010.
authors.forename: Coleen P
authors.initials: CP
authors.lastname: Baird
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000397:Air Pollution / Q000009:adverse effects*; D001249:Asthma / Q000453:epidemiology*; D005260:Female; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects*; D007707:Kyrgyzstan; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D056910:Republic of Korea; D012140:Respiratory Tract Diseases / Q000453:epidemiology; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D055815:Young Adult