title: Lung function abnormalities among service members returning from Iraq or Afghanistan with respiratory complaints.
abstract: Service members deploying to Afghanistan (OEF) and Iraq (OIF) often return with respiratory symptoms. We sought to determine prevalence of lung function abnormalities following OEF/OIF.
  
  
  
  We identified OEF/OIF patients who had unexplained respiratory symptoms evaluated using lung function testing. Lung function data were summarized and analyzed for associations with demographic and deployment characteristics.
  
  
  
  We found 267 patients with unexplained cough or dyspnea, lung function testing and a history of OEF/OIF deployment. All patients had basic spirometry performed and 82 had diffusion capacity for carbon dioxide (DLCO) measured. The median (IQR) number of deployments and total days deployed were 1 (1-2) and 352.0 (209-583), respectively. There were 83 (36.6%) patients with abnormal spirometry, 53 (63.9%) of whom had an abnormal FEV1/FVC. Only one (1.2%) patient had an abnormal DLCO adjusted for alveolar volume. Of 104 patients who had post bronchodilator (BD) testing performed, six (5.8%) had a positive response by ATS criteria. We found no relationships between lung function and time in theater, deployment location, deployment frequency, or land based-deployment. Dyspnea and enlisted rank were associated with tobacco use and lower FEV1, and cough was associated with total number of deployments.
  
  
  
  Service members with respiratory complaints following OEF/OIF have a high prevalence of abnormalities on spirometry. Tobacco use, enlisted rank and total number of deployments were associated with symptoms or spirometric abnormalities.
authors: Department of Pulmonary, Critical Care, and Sleep Medicine, WRNMMC, 8901 Rockville Pike, Bethesda, MD 20889, United States. Electronic address: aholley9@gmail.com.
authors: Aaron B
authors: AB
authors: Holley
authors: Department of Pulmonary, Critical Care, and Sleep Medicine, WRNMMC, 8901 Rockville Pike, Bethesda, MD 20889, United States. Electronic address: sobiemj@gmail.com.
authors: Michal
authors: M
authors: Sobieszczyk
authors: Department of Pulmonary, Critical Care, and Sleep Medicine, WRNMMC, 8901 Rockville Pike, Bethesda, MD 20889, United States. Electronic address: Michael.perkins321@gmail.com.
authors: Michael
authors: M
authors: Perkins
authors: Department of Pulmonary, Critical Care, and Sleep Medicine, WRNMMC, 8901 Rockville Pike, Bethesda, MD 20889, United States. Electronic address: Brian.m.cohee.mil@mail.mil.
authors: Brian M
authors: BM
authors: Cohee
authors: Department of Internal Medicine, WRNMMC, 8901 Rockville Pike, Bethesda, MD 20889, United States. Electronic address: Camille.b.costantoth.mil@mail.mil.
authors: Camille B
authors: CB
authors: Costantoth
authors: Department of Pulmonary, Critical Care, and Sleep Medicine, WRNMMC, 8901 Rockville Pike, Bethesda, MD 20889, United States. Electronic address: Donovan.l.mabe.mil@mail.mil.
authors: Donovan L
authors: DL
authors: Mabe
authors: Department of Radiology, WRNMMC, United States. Electronic address: Robert.A.Liotta.mil@mail.mil.
authors: Robert
authors: R
authors: Liotta
authors: Occupational and Environmental Medicine, USAPHC, United States. Electronic address: joseph.h.abraham.civ@mail.mil.
authors: Joseph H
authors: JH
authors: Abraham
authors: Department of Informatics, US Army Medical Research Institute of Infectious Diseases, United States. Electronic address: HolleyPR@msn.com.
authors: Paul R
authors: PR
authors: Holley
authors: Department of Pulmonary, Critical Care, and Sleep Medicine, WRNMMC, 8901 Rockville Pike, Bethesda, MD 20889, United States. Electronic address: John.H.Sherner.mil@health.mil.
authors: John
authors: J
authors: Sherner
mesh_terms: D000328:Adult; D000346:Afghanistan; D002245:Carbon Dioxide / Q000378:metabolism; D003371:Cough / Q000175:diagnosis* / Q000209:etiology; D004417:Dyspnea / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D007493:Iraq; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011653:Pulmonary Diffusing Capacity / Q000379:methods; D012120:Respiration Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology; D012129:Respiratory Function Tests / Q000379:methods*; D012189:Retrospective Studies; D013147:Spirometry / Q000379:methods; D064424:Tobacco Use / Q000009:adverse effects; D014728:Veterans; D014797:Vital Capacity / Q000502:physiology
chemical_list: D002245:Carbon Dioxide
keywords: Airway disease; Dyspnea; Lung function testing; Service members