title: Increasing Prevalence of Chronic Lung Disease in Veterans of the Wars in Iraq and Afghanistan.
abstract: Research from the wars in Afghanistan and Iraq have focused on traumatic brain injury (TBI) and mental health conditions; however, it is becoming clear that other health concerns, such as respiratory illnesses, warrant further scientific inquiry. Early reports from theater and postdeployment health assessments suggested an association with deployment-related exposures (e.g., sand, burn pits, chemical, etc.) and new-onset respiratory symptoms. We used data from Veterans Affairs medical encounters between fiscal years 2003 and 2011 to identify trends in chronic obstructive pulmonary disease, asthma, and interstitial lung disease in veterans. We used data from Veterans Affairs and Department of Defense sources to identify sociodemographic (age, sex, race), military (e.g., service branch, multiple deployments) and clinical characteristics (TBI, smoking) of individuals with and without chronic lung diseases. Generalized estimating equations found significant increases over time for chronic obstructive pulmonary disease and asthma in both unadjusted and adjusted analyses. Trends for interstitial lung disease were significant only in adjusted analyses. Age, smoking, and TBI were also significantly associated with chronic lung diseases; however, multiple deployments were not associated. Research is needed to identify which characteristics of deployment-related exposures are linked with chronic lung disease.
authors.affiliation: South Texas Veterans Health Care System, 7400 Merton Minter Boulevard, San Antonio, TX 78229.
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Pugh
authors.affiliation: South Texas Veterans Health Care System, 7400 Merton Minter Boulevard, San Antonio, TX 78229.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Jaramillo
authors.affiliation: University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229.
authors.forename: Kar-Wei
authors.initials: KW
authors.lastname: Leung
authors.affiliation: Department of Health Science, Clinica Pneumologica, AO San Gerardo, University of Milan Bicocca, Via Pergolesi 22, Monza, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Faverio
authors.affiliation: University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Fleming
authors.affiliation: North Texas Veterans Health Care System, 4500 South Lancaster Road, Dallas, TX 75216.
authors.forename: Eric
authors.initials: E
authors.lastname: Mortensen
authors.affiliation: Edith Nourse Rogers VA Medical Center, 200 Springs Road, Bedford, MA 01730.
authors.forename: Megan E
authors.initials: ME
authors.lastname: Amuan
authors.affiliation: University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229.
authors.forename: Chen-Pin
authors.initials: CP
authors.lastname: Wang
authors.affiliation: South Texas Veterans Health Care System, 7400 Merton Minter Boulevard, San Antonio, TX 78229.
authors.forename: Blessen
authors.initials: B
authors.lastname: Eapen
authors.affiliation: South Texas Veterans Health Care System, 7400 Merton Minter Boulevard, San Antonio, TX 78229.
authors.forename: Marcos
authors.initials: M
authors.lastname: Restrepo
authors.affiliation: Uniformed Services University, Brooke Army Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, TX 78234.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Morris
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D002908:Chronic Disease / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008171:Lung Diseases / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data; D014728:Veterans / Q000706:statistics & numerical data*