FORT BRAGG, NC—Based on research investigating the potential link between deployment to Operation Iraqi Freedom and Operation Enduring Freedom and increases in pulmonary disease, data on conditions such as asthma and airway hyperreactivity are well established, but less is known about sarcoidosis, according to a new report.
That’s according to an article in Military Medicine, which reported the results of a retrospective chart review of all active duty military personnel diagnosed with sarcoidosis from 2005 to 2010.1
Womack Army Medical Center-led researchers obtained deployment dates and locations through the Armed Forces Health Surveillance Branch. Researchers reviewed electronic medical records to determine the following parameters:
- dates of diagnosis,
- temporal relationship of diagnosis and deployment,
- symptoms (pre- and/or post-deployment),
- spirometry,
- diffusing capacity,
- radiographic staging, and
- treatment course.
The study estimated pulmonary sarcoidosis incidence rates using International Classification of Diseases (ICD-9) coded medical encounter data from the Defense Medical Surveillance System and compared between Army and non-Army personnel, as well as between ever-deployed and never-deployed personnel.
Overall, a cohort of 478 soldiers was identified with sarcoidosis based on ICD-9 codes and individual review of the medical records. Among the cohort, which was 80% male,38.7% of soldiers with sarcoidosis never deployed. 11.7% were diagnosed prior to deployment, and 50.2% were diagnosed post-deployment.
The diagnosis of sarcoidosis was established with a tissue diagnosis in 68% of the deployed cohort, but overall differences in spirometry were not identified.
Results indicated that obstructed spirometry was similar in all deployment groups (never, pre, and post) at 9.2%, 15.8% and 8.7%, respectively. In addition, restrictive patterns based on total lung capacity—defined as less than 70%—were similar at 9.2%, 12.5% and 11.0%, respectively.
The authors reported that radiographic staging demonstrated a similar distribution in the populations with the never/pre- vs. post-deployment groups having Stage 0 = 2.3 vs. 3.5%, Stage I = 43.8 vs. 41.6%, Stage II = 33.1 vs. 41.0%, Stage III = 15.1 vs. 12.1% and Stage IV = 2.2 vs. 1.7%, respectively.
Researchers advised that, during 2005-2010, the estimated incidence rate of pulmonary sarcoidosis was low among active duty Army personnel (16.5 cases/100,000 person-years), and no trend in annual rates was observed, p = 0.89. Based on overall DoD medical data, they determined that estimated pulmonary sarcoidosis rates were lower among ever-deployed personnel, relative to nondeployed personnel.
“Based on this analysis of Army sarcoidosis patients, there was no difference in the rates of sarcoidosis diagnosis in deployed and non-deployed soldiers,” the authors concluded. “Spirometry values, total lung capacity, and radiographic staging did not show significant differences between deployment groups.”
- Forbes DA, Anderson JT, Hamilton JA, et al. Relationship to Deployment on Sarcoidosis Staging and Severity in Military Personnel. Mil Med. 2020;185(5-6):e804-e810. doi:10.1093/milmed/usz407