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A6082 - The Effect of Deployment on Pulmonary Function in Active Duty Military Members with Asthma
Author Block: J. Woods, B. Barber, M. J. Morris; Pulmonary and Critical Care Medicine, San Antonio Military Medical Center, San Antonio, TX, United States.
Introduction Respiratory symptoms are often reported by military members in the deployment and post-deployment periods. Environmental exposures to geologic dusts, burn pits, and other hazards in the deployed setting are well described. Military members with a prior diagnosis of asthma may be particularly sensitive to the effects of deployment. Prior studies have not evaluated the change in pulmonary function associated with deployment. Methods Retrospective chart review of military members with an established diagnosis of asthma by ICD-9 code and documented spirometry by CPT code was conducted, and individuals with a minimum of 3 encounters in Department of Defense Pulmonary Clinics were identified. Deployment dates and locations to Southwest Asia were verified by the Defense Manpower Data Center, and individuals with pre- and post-deployment spirometry were included. Paired two-sided T-tests were applied to compare pre- and post-deployment spirometry values. Results 642 active duty individuals with a diagnosis of asthma and documented spirometry with deployment to Southwest Asia between 2003 and 2015 were identified; of those, 71 individuals were identified with pre- and post-deployment spirometry. Mean age was 31.9 years and the cohort was 71.8% male. Mean pre- and post-deployment FEV1 (L) was 86% of predicted and 87% of predicted, respectively (p = 0.558) while FVC (L) was 94% of predicted and 95% of predicted, respectively (p = 0.459). In a subgroup of individuals with bronchodilator testing who had worse baseline control of asthma (FEV1 80% predicted versus FEV1 86% predicted in complete group) , pre- and post-deployment FEV1 was 80% and 84% of predicted (p = 0.16) and FVC was 92% and 97% of predicted (p = 0.04), respectively. No significant change in pre- and post-deployment ICS and LABA use was noted. Conclusions There was no significant difference in pre- and post-deployment FEV1 or FVC in the identified patient population. There was a signal to increased FEV1 and an increased FVC after deployment in the subgroup of patients with bronchodilator testing; this subgroup of patients had inferior asthma control prior to deployment. These findings suggest improved pulmonary function after deployment in asthmatics with inferior baseline control, which may be indicative of the effects of increased exercise habits in active duty individuals while deployed. These findings also suggest there is no significant decrement in pulmonary function related to potential airborne hazards in the Southwest Asia environment in the study population.