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American Journal of Epidemiology Advance Access originally published online on October 22, 2009
American Journal of Epidemiology 2009 170(11):1433-1442; doi:10.1093/aje/kwp287
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American Journal of Epidemiology Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2009.

ORIGINAL CONTRIBUTIONS

Newly Reported Respiratory Symptoms and Conditions Among Military Personnel Deployed to Iraq and Afghanistan: A Prospective Population-based Study

Besa Smith*, Charlene A. Wong, Tyler C. Smith, Edward J. Boyko, Gary D. Gackstetter and Margaret A. K. Ryan for the Millennium Cohort Study Team

* Correspondence to Dr. Besa Smith, Department of Defense Center for Deployment Health Research, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106-3521 (e-mail: besa.smith{at}med.navy.mil).

Received for publication November 26, 2008. Accepted for publication August 12, 2009.

Concerns about respiratory conditions have surfaced among persons deployed to Iraq and Afghanistan. Data on 46,077 Millennium Cohort Study participants who completed baseline (July 2001–June 2003) and follow-up (June 2004–February 2006) questionnaires were used to investigate 1) respiratory symptoms (persistent or recurring cough or shortness of breath), 2) chronic bronchitis or emphysema, and 3) asthma. Deployers had a higher rate of newly reported respiratory symptoms than nondeployers (14% vs. 10%), while similar rates of chronic bronchitis or emphysema (1% vs. 1%) and asthma (1% vs. 1%) were observed. Deployment was associated with respiratory symptoms in both Army (adjusted odds ratio = 1.73, 95% confidence interval: 1.57, 1.91) and Marine Corps (adjusted odds ratio = 1.49, 95% confidence interval: 1.06, 2.08) personnel, independently of smoking status. Deployment length was linearly associated with increased symptom reporting in Army personnel (P < 0.0001). Among deployers, elevated odds of symptoms were associated with land-based deployment as compared with sea-based deployment. Although respiratory symptoms were associated with deployment, inconsistency in risk with cumulative exposure time suggests that specific exposures rather than deployment in general are determinants of postdeployment respiratory illness. Significant associations seen with land-based deployment also imply that exposures related to ground combat may be important.

longitudinal studies; lung diseases; military personnel; signs and symptoms, respiratory

Abbreviations: AOR, adjusted odds ratio; CI, confidence interval


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