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Clinical evaluation of deployed military personnel with chronic respiratory symptoms: STAMPEDE (Study of Active Duty Military for Pulmonary Disease Related to Environmental Deployment Exposures) III

Chest Feb 07, 2020

Morris MJ, Walter RJ, McCann ET, et al. - Given that chronic respiratory symptoms are often documented following southwest Asia deployment in support of combat operations, and there is a lack of good characterization of the complete spectrum of clinical lung diseases associated with these deployments, so, researchers analyzed military personnel having chronic symptoms, mainly exertional dyspnea, who had a standardized cardiopulmonary assessment at two tertiary medical centers. Spirometry, lung volumes, diffusing capacity, impulse oscillometry, and bronchodilator testing were performed on these individuals. Testing was completed by 380 participants with a mean age of 38.5 ± 8.4 years. On the basis of obstructive spirometry/IOS and proof of airway hyperreactivity, the most common diagnosis was asthma, which was detected in 87 (22.9%). Reactivity with normal spirometry was seen in another 57 (15.0%) patients. High body mass index > 30 kg/m2 (34.2%), smoking (36.4%), positive allergy testing (43.7%), sleep apnea (38.5%), and esophageal reflux (13.6%) constituted significant co-morbidities reported. For post-deployment pulmonary assessment, two recommendations based on these observations are as follows: 1) to focus on common diseases such as asthma and airway hyperreactivity, and 2) to incorporate testing for upper airway disorders. Rare diagnoses of diffuse lung diseases were made while many co-morbidities were common.
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