Semin Respir Crit Care Med 2023; 44(03): 370-377
DOI: 10.1055/s-0043-1764407
Review Article

Deployment-Related Respiratory Disease: Where Are We?

Silpa D. Krefft
1   Division of Environmental and Occupational Health Sciences, Department of Medicine, National Jewish Health, Denver, Colorado
2   Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
3   Department of Environmental and Occupational Health, Colorado School of Public Health, Aurora, Colorado
4   Division of Pulmonary and Critical Care Medicine, Department of Medicine, Veterans Administration Eastern Colorado Health Care System, Aurora, Colorado
,
Lauren M. Zell-Baran
1   Division of Environmental and Occupational Health Sciences, Department of Medicine, National Jewish Health, Denver, Colorado
5   Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado
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Abstract

Military personnel and veterans who have deployed to Afghanistan, Iraq, and parts of Southwest Asia (SWA) since 1990 are at risk of developing a host of respiratory symptoms and deployment-related respiratory diseases (DRRDs). This review aims to summarize our current understanding of DRRD and inform pulmonary practitioners of recent updates to DRRD screening, diagnosis, evaluation, and management. The most common respiratory diseases in these patients include asthma, chronic sinonasal disease, laryngeal disease/dysfunction, and distal lung disease. Pulmonary function testing and chest imaging are the most commonly used diagnostic tools, but techniques such as lung clearance index testing via multiple breath washout, forced oscillation testing/impulse oscillometry, and quantitative chest computed tomography (CT) assessment appear promising as noninvasive modalities to aid in lung disease detection in this population. We also summarize guidance on conducting an occupational and deployment exposure history as well as recommendations for testing. Finally, we discuss the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 (PACT Act) that includes a list of health conditions that are “presumptively” considered to be related to SWA military deployment toxic exposures, and provide resources for clinicians who evaluate and treat patients with DRRD.

Keywords

deployment-related respiratory disease - veterans - bronchiolitis - asthma - burn pits - PACT Act


Publication History

Article published online:
17 April 2023

© 2023. Thieme. All rights reserved.

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