Increased Prevalence of Upper and Lower Respiratory Disease in Operation Enduring Freedom and Operation Iraqi Freedom US Veterans.

Abstract

Veterans of Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) were exposed to high levels of pollutants resulting in increased upper and lower respiratory symptoms and morbidity. The purpose of this study is to determine the physician diagnosed prevalence of upper and lower respiratory disease in OEF/OIF veterans. We queried the Veterans Health Administration Support Service Center database to identify veterans in the Desert Pacific Healthcare Network with International Classification of Diseases 10th Revision diagnoses related to upper respiratory and lower respiratory tract (URT and LRT) diseases and symptoms. Over 100,000 unique veterans were identified. OEF/OIF veterans had increased prevalence of both sinonasal disease and LRT pathology compared with non-OEF/OIF veterans. In 2016, 8.79% of OEF/OIF veterans demonstrated lower respiratory disease, which was 3.4 times greater than non-OEF/OIF veterans (P < 0.0001). Similarly, upper respiratory disease was 4.8 times more prevalent in OEF/OIF veterans, with 19.28% diagnosed compared with 3.95% of non-OEF/OIF veterans (P < 0.0001). This is the first database study that investigates the prevalence of upper airway disease in OEF/OIF veterans. Veterans serving in the post-9/11 era in Afghanistan and Iraq have a significantly increased prevalence of both lower and upper respiratory disease.