Evaluation of pulmonary symptoms following military deployment

Abstract

Evaluating and defining the presence of pulmonary disease in relationship to military deployment to Southwest Asia can be challenging. There are defined environmental exposures such as geologic dusts, burn pit smoke, and urban pollution for which establishing symptom causality may be difficult. With lack of information on the indigenous population in this region, it is yet undetermined whether repeated deployments could potentially be a contributing factor. While there is a generalized increase in reported respiratory symptoms, most symptoms tend to resolve post-deployment. Published studies have established diagnoses such as asthma, inducible laryngeal obstruction, and acute eosinophilic pneumonia in this population. Some controversial studies suggest an increase in parenchymal lung diseases such as constrictive bronchiolitis. In any given individual with persistent respiratory symptoms, what should be the approach taken for further evaluation? Symptoms are typically only related to exercise, while baseline spirometry and chest imaging are frequently normal. As the primary center in the Department of Defense for evaluation of post-deployment respiratory symptoms, we have adopted a comprehensive approach to these patients referred for evaluation.