A new study finds that soldiers returning from Iraq and Afghanistan have a high rate of breathing-related symptoms leading to lung function testing, prompting the authors of the study to propose the term “Iraq/Afghanistan War Lung Injury” (IAW-LI) to describe the newly recognized condition. The study appears in the Journal of Occupational and Environmental Medicine.
The researchers analyzed health data of more than 7,000 active-duty soldiers in the New York City/Long Island area, of which, approximately one-fourth had been deployed to Iraq or Afghanistan, while the rest served elsewhere. They looked at the percentage of soldiers who underwent a spirometry test to evaluate lung function. The respiratory symptoms leading to spirometry were analyzed, along with the test results.
Of soldiers returning from Iraq or Afghanistan, the researchers found that 14.5% had respiratory symptoms leading to spirometry, compared to 1.8% of those serving elsewhere. Although the rate of smoking was much higher among Iraq/Afghanistan veterans (about 35% versus 5%), this could not completely explain the difference in respiratory symptoms.
While previous studies have suggested that Iraq/Afghanistan War veterans have a higher rate of asthma than stateside-based troops, the spirometry results are more consistent with some type of lung injury causing irreversible declines in lung function rather than asthma causing reversible declines.
The researchers propose the term IAW-LI for this clinical syndrome of “fixed airway obstruction as a result of lung injury.”
The researchers suggest a number of possible explanations for lung injury in soldiers with IAW-LI, such as inhaling sharp and coarse dust grains, toxins, and allergens in the harsh, polluted combat environment. Lung damage caused by blast pressure or shock waves from improvised explosive devices is another possible cause. An additional potential contributor includes smoke from exposure to open burn pits in which trash is ignited with jet fuel and burned.
While further study is needed to clarify the incidence, causes, and appropriate treatment for IAW-LI, the researchers suggest that all soldiers returning from Iraq and Afghanistan undergo spirometry to screen for reduced lung function.
Source: Journal of Occupational and Environmental Medicine