Cristian S Madar1, Michael R Lewin-Smith2, Teri J Franks3, Russell A Harley3, John S Klaric4, Michael J Morris5. 1. Pulmonary/Critical Care Service (MCHE-MDP), Department of Medicine, Womack Army Medical Center, 2817 Reilly Rd, Fort Bragg, NC, 28310, USA. cristian.s.madar.mil@mail.mil. 2. Environmental Pathology, The Joint Pathology Center, National Capitol Region Medical Directorate, Defense Health Agency, Silver Spring, MD, USA. 3. Pulmonary & Mediastinal Pathology, The Joint Pathology Center, National Capitol Region Medical Directorate, Defense Health Agency, Silver Spring, MD, USA. 4. Statistical Services, Department of Clinical Investigation, Womack Army Medical Center, Fort Bragg, NC, USA. 5. Pulmonary/Critical Care Service, Department of Medicine, San Antonio Military Medical Center, Fort Sam Houston, TX, USA.
Abstract
INTRODUCTION: The current understanding of associations between lung disease and military deployment to Southwest Asia, including Iraq and Afghanistan, is both controversial and limited. We sought to clarify the relation between military deployment and biopsy-proven lung disease. METHODS: Retrospective data were analyzed for military personnel with non-neoplastic lung biopsies evaluated at the Armed Forces Institute of Pathology or Joint Pathology Center (January 2005 to December 2012). RESULTS: Of 391 subjects, 137 (35.0%) had deployed to Southwest Asia prior to biopsy. Compared to non-deployed subjects, those deployed were younger (median age 37 vs. 51 years) with higher representation of African Americans (30.0 vs. 16.9%). Deployed patients were more likely diagnosed with non-necrotizing granulomas (OR 2.4). Non-deployed subjects had higher frequency of idiopathic interstitial pneumonias, particularly organizing pneumonia. Prevalence of small airways diseases including constrictive bronchiolitis was low. CONCLUSIONS: This study provides a broader understanding of diversity of biopsy-proven non-neoplastic lung disease as it relates to military deployment to Southwest Asia and importantly did not show an increased prevalence of small airway disease to include constrictive bronchiolitis.
INTRODUCTION: The current understanding of associations between lung disease and military deployment to Southwest Asia, including Iraq and Afghanistan, is both controversial and limited. We sought to clarify the relation between military deployment and biopsy-proven lung disease. METHODS: Retrospective data were analyzed for military personnel with non-neoplastic lung biopsies evaluated at the Armed Forces Institute of Pathology or Joint Pathology Center (January 2005 to December 2012). RESULTS: Of 391 subjects, 137 (35.0%) had deployed to Southwest Asia prior to biopsy. Compared to non-deployed subjects, those deployed were younger (median age 37 vs. 51 years) with higher representation of African Americans (30.0 vs. 16.9%). Deployed patients were more likely diagnosed with non-necrotizing granulomas (OR 2.4). Non-deployed subjects had higher frequency of idiopathic interstitial pneumonias, particularly organizing pneumonia. Prevalence of small airways diseases including constrictive bronchiolitis was low. CONCLUSIONS: This study provides a broader understanding of diversity of biopsy-proven non-neoplastic lung disease as it relates to military deployment to Southwest Asia and importantly did not show an increased prevalence of small airway disease to include constrictive bronchiolitis.
Entities:
Keywords:
Constrictive bronchiolitis; Military deployment; Pulmonary histology; Smoking
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