Clinical Topics

Tests Show No Lung Changes for Recent Veterans

by U.S. Medicine

August 12, 2019

SAN ANTONIO—Significant airborne hazards were reported during military conflicts in southwest Asia, including geologic dusts, burn pit emissions, chemical exposures, and increased rates of smoking.

Yet, despite significant concerns about the respiratory health of deployed military personnel serving there, no previous comparison of pre- and post-deployment lung function using tools such as spirometry, had been performed according to a report in the journal Respiratory Care.1

Brooke Army Medical Center-led researchers recruited servicemembers who deployed to southwest Asia from the Soldier Readiness Processing Center at Fort Hood, TX, from 2011 to 2014. Participants were asked to complete a brief survey on their respiratory health and received both spirometry and impulse oscillometry studies at baseline with repeated survey and testing after deployment.

Of the 1,693 deployed personnel who completed baseline examinations, 843 (50%) completed post-deployment testing.

The researchers determined that post-deployment values demonstrated no statistical or clinical change in spirometry, with an increase in mean ± SD FEV1 (% predicted) from 95.2 ± 12.6 to 96.1 ± 12.4 (P = .14), increase in mean ± SD FVC (% predicted) from 95.9 ± 11.8 to 96.4 ± 11.9 (P = 0.32), and increase in mean ± SD FEV1/FVC from 81.5 ± 5.9 to 81.8 ± 6.1 (P = 0.29).

At the same time, impulse oscillometry values showed statistical improvement with reduction in resistance (at 5 Hz and 20 Hz) and reactance (at 5 Hz), according to the results, which also indicated that the presence of predeployment obstruction, self-reported asthma, smoking history or increased body mass index also did not change spirometry values after deployment.

“To our knowledge, this was the first prospective evaluation of deploying military by using spirometry as an indicator for the possible development of pulmonary disease related to environmental exposures,” the study authors wrote. “Pre-deployment testing with spirometry and impulse oscillometry was unable to detect any significant change. In those with abnormal spirometry pre-deployment or asthma history, there was also not identifiable change that indicated worsening lung function.”

The study suggested that utilization of spirometry “for the deploying military population had little benefit and did not identify individuals with lung disease after deployment. Routine use was not warranted before or after deployment in the absence of pulmonary symptoms.”

1. Morris MJ, Skabelund AJ, Rawlins FA 3rd, Gallup RA, Aden JK, Holley AB. Study of Active Duty Military Personnel for Environmental Deployment Exposures: Pre- and Post-Deployment Spirometry (STAMPEDE II). Respir Care. 2019 May;64(5):536-544. doi: 10.4187/respcare.06396. Epub 2019 Jan 8. PubMed PMID: 30622173.



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