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A Comparison of the Prevalence and Impact of Respiratory Symptoms in Deployed Asthmatics and Non-Asthmatics

William Beaumont Army Medical Center, El Paso, TX

PURPOSE: To compare the prevalence, severity, and impact of respiratory symptoms in soldiers with and without asthma returning from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF).

METHODS: We circulated a questionnaire to 1,250 consecutive active duty soldiers and Department of Defense contractors returning from OEF/OIF. The questionnaire included basic demographics, smoking habits, respiratory symptoms, and impact on job performance before and during deployment. Patients with a history of asthma were asked to specify method of diagnosis, current symptoms and asthma therapy. Data analysis was performed using Fisher’s exact test.

RESULTS: 1193 subjects returned the completed questionnaire (95% response rate). Baseline prevalence of dyspnea was 2.3%, and 155 subjects (13.4%) reported more dyspnea during deployment. Respiratory symptoms affected field duties more often in 11% of respondents during deployment, and 13% sought medical attention for breathing problems. Eleven subjects (0.9%) were hospitalized and 13 (1.2%) required medical evacuation. Sixty-one subjects (5%) reported a previous diagnosis of asthma. A majority had mild intermittent asthma based on their medical regimen, and 16 (28%) reported symptoms suggestive of inadequate asthma control. Asthmatics reported more wheezing, sputum production, and chest pain/tightness during deployment (p < 0.0001, 0.04, 0.03), and more difficulty with military duties (p < 0.03). Asthmatics were more likely to seek medical attention and receive duty limitations(p < 0.0001). Three asthmatics (7%) were hospitalized and one (2%) required medical evacuation. All clinically significant differences observed could be attributed to the poorly controlled asthma cohort, including three of the four asthmatics requiring hospitalization and medical evacuation.

CONCLUSION: Subjects with well controlled, mild asthma did not experience more respiratory sequelae during deployment to OEF/OIF compared to non-asthmatics. Asthma hospitalizations and medical evacuation rates were seen primarily in patients with poor baseline control.

CLINICAL IMPLICATIONS: Targeted evaluation and treatment of poorly controlled asthmatics prior to deployment may reduce the impact of asthma on operational readiness.

DISCLOSURE: A.S. Niven, None.