Publication year
2014
Citation Title
Prevalence of respiratory diseases among Veterans of Operation Enduring Freedom and Operation Iraqi Freedom: Results from the National Health Study for a new generation of U.S. veterans.
Journal Name
Military Medicine
Journal Volume
179
Issue Number
3
Page Numbers
241-245
DOI
10.7205/milmed-d-13-00338
Summary
The population prevalence of asthma, bronchitis, and sinusitis were investigated among Veterans deployed to Afghanistan and Iraq compared to nondeployed Veterans (N = 20,563; 64% deployed, 36% nondeployed). Data for this study came from the National Health Survey for a New Generation of U.S. Veterans, a population-based longitudinal health survey. Deployed veterans exhibited an increased risk for sinusitis compared to nondeployed Veterans.
Key Findings
Among deployed Veterans diagnosed during or after 2001, the prevalence of asthma, bronchitis, and sinusitis was 3%, 6%, and 7%, respectively; among nondeployed Veterans diagnosed during or after 2001, the prevalence of asthma, bronchitis, and sinusitis was 3%, 5%, and 6%, respectively.
Among those diagnosed during or after 2001, deployed Veterans were 29% more likely to have been diagnosed with sinusitis compared to nondeployed Veterans.
There was no significant difference in asthma or bronchitis risk between deployed and nondeployed Veterans.
Implications for Program Leaders
Disseminate information on the importance of respiratory screenings as part of routine care to Service members and their families
Host support groups for Service members who have respiratory conditions to help them improve their coping and management of their conditions
Partner with community organizations to offer referrals and resources to Service members and their families who are retiring from military service
Implications for Policy Makers
Continue to support for ongoing, multi-layered, comprehensive support opportunities for Service members and families
Promote reintegration programs that include attention to assisting Service members’ families in adjusting to the Service member’s changes in functioning after deployment
Recommend education for service providers around the possible effects of deployment on Service members’ physical health
Methods
A 2009–2011 population-based health survey of 60,000 Veterans (34% response rate) asked about the history of doctor-diagnosed respiratory disease. The sample includes Veterans who use Veteran Affairs (VA) as well as other health care facilities.
Smoking status, a significant predictor of respiratory disease, was measured and controlled for in the statistical analyses.
The data were weighted to ensure that the findings reflect the prevalence and odds of respiratory disease in the population.
Participants
Participants included 20,563 Veterans (64% deployed, 36% nondeployed). Subsamples were similar except deployed Veterans were more likely to be male and to have served in the Army and National Guard than nondeployed Veterans.
Participants were mostly male (79%), 44 years or younger (57%), and White (70%).
Veterans represented the following branches: 54% Army, 21% Air Force, 15% Navy, and 10% Marine Corps. In addition, Veterans represented the following components: 38% Active Duty, 27% National Guard, and 35% Reserve.
Limitations
The study used self-report measures, which may introduce recall bias. Hence, over- or underreporting of disease may have affected the calculation of prevalence estimates.
Given the 34% response rate, selected participants may differ from non-participants in a way that was not measured, but affected the outcome variables (e.g., participants may be functioning better than non-participants).
Without longitudinal studies, causality cannot be established between deployment and respiratory disease.
Avenues for Future Research
Use longitudinal study designs to investigate the long-term respiratory effects of deployment (e.g., whether existing conditions improve or worsen over time)
Explore factors such as total number of deployments, time in service, respiratory exposures, and potential exposures during previous conflicts on the impact of respiratory conditions
Examine psychosocial risk factors (e.g., education level, socioeconomic status, etc.) that may impact the prevalence of respiratory conditions in Service members
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
This study investigated the population prevalence of asthma, bronchitis, and sinusitis among veterans deployed to Afghanistan and Iraq compared to nondeployed veterans. A 2009–2011 population-based health survey of 60,000 veterans (34% response rate) asked about the history of doctor-diagnosed respiratory disease. Analyses included smoking history, deployment status, and year of diagnosis. The prevalence of asthma, bronchitis, and sinusitis among those diagnosed during or after 2001 was 3.3%, 5.9%, and 6.9%, respectively, among the deployed veterans and 3.4%, 5.3%, and 5.6%, respectively, among the nondeployed veterans. Deployed veterans were 29% more likely to have been diagnosed with sinusitis during and after 2001 compared to nondeployed veterans (adjusted odds ratio = 1.30, 95% confidence interval = 1.13, 1.49). Deployed veterans are at increased risk for sinusitis compared to nondeployed. There was no significant difference in asthma or bronchitis risk between deployed and nondeployed veterans.
Attach