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Erschienen in: Current Allergy and Asthma Reports 12/2022

12.11.2022 | Occupational Allergies (JA Poole, Section Editor)

A Clinician’s Guide to Occupational Exposures in the Military

verfasst von: Joel Van De Graaff, Jill A. Poole

Erschienen in: Current Allergy and Asthma Reports | Ausgabe 12/2022

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Abstract

Purpose of Review

Adverse occupational and environmental exposures are common causes of respiratory disease and health consequences requiring medical care. Understanding how these various exposures affect patients and how to elicit an adequate history is critical for any clinician. Military personnel are often overlooked when discussing groups at risk for environmental exposure-associated airway disease. There are close to 20 million active duty and veterans in the USA, and nearly all clinicians will at some point care for a patient that has served in the military.

Recent Findings

Exposures related to military work include burn pits, chemicals/toxins, sandstorms, and living conditions. Burn pits and military waste are increasingly recognized as potential hazards attributed to the ongoing conflicts in the Middle East. The link between these various military exposures and acute or chronic airway diseases remains difficult. Epidemiological studies are emerging to demonstrate correlations with chronic lung disease and prolonged burn pit exposure.

Summary

This review provides an overview of potential occupational and environmental exposures that may affect current and/or former military service men and women.
Literatur
2.
Zurück zum Zitat Falvo M.J. Is deployment an exposure in military personnel? J Occup Environ Med. 2014 Nov;56(11). Falvo M.J. Is deployment an exposure in military personnel? J Occup Environ Med. 2014 Nov;56(11).
3.
Zurück zum Zitat Dept of the Army Inspector General Special Interest Item Assessment of the Residential Communities Initiatives 2019 Mar. Dept of the Army Inspector General Special Interest Item Assessment of the Residential Communities Initiatives 2019 Mar.
4.
Zurück zum Zitat Rawlins FA et.al Management of asthma in the military. Fed Pract. 2015 Sep;32(10). Rawlins FA et.al Management of asthma in the military. Fed Pract. 2015 Sep;32(10).
5.
Zurück zum Zitat Nish WA, Schwietz LA. Underdiagnosis of asthma in young adults presenting for USAF basic training. Ann Allergy. 1992;69(3):239–42. Nish WA, Schwietz LA. Underdiagnosis of asthma in young adults presenting for USAF basic training. Ann Allergy. 1992;69(3):239–42.
6.
Zurück zum Zitat South T. Supreme Court rejects appeal from veterans in burn pit lawsuit against KBR, Halliburton. MilitaryTimes. 2019. Jan. South T. Supreme Court rejects appeal from veterans in burn pit lawsuit against KBR, Halliburton. MilitaryTimes. 2019. Jan.
7.
Zurück zum Zitat Sotolongo, A. et.al Military Burn Pits. Am J Respir Crit Care Med. 2020 Apr;201(7):13–14. Sotolongo, A. et.al Military Burn Pits. Am J Respir Crit Care Med. 2020 Apr;201(7):13–14.
8.
Zurück zum Zitat Long-term health consequences of exposure to burn pits in Iraq and Afghanistan. Institute of Medicine. Oct. 2011. Long-term health consequences of exposure to burn pits in Iraq and Afghanistan. Institute of Medicine. Oct. 2011.
9.
Zurück zum Zitat Banks DE, Bolduc CA, Ali S, Morris, MJ Constrictive bronchiolitis attibutable to inhalation of toxic agents: considerations for a case definition. J Occup Environ Med. 2018. Jan 60(1). Banks DE, Bolduc CA, Ali S, Morris, MJ Constrictive bronchiolitis attibutable to inhalation of toxic agents: considerations for a case definition. J Occup Environ Med. 2018. Jan 60(1).
10.
Zurück zum Zitat Abraham JH, DeBakey SF, Reid L, Zhou, J, Baird, CP. Does deployment to Iraq and Afghanistan affect respiratory health of US military personnel? J Occup Environ Med. 2012 June 54(6). Abraham JH, DeBakey SF, Reid L, Zhou, J, Baird, CP. Does deployment to Iraq and Afghanistan affect respiratory health of US military personnel? J Occup Environ Med. 2012 June 54(6).
12.
Zurück zum Zitat Szema A, Mirsaidi N, Patel B. Proposed Iraq/Afghanistan War-Lung Injury (IAW-LI) clinical practice recommendations: National Academy of Sciences’ Institute of Medicine Burn Pits Workshop. Am J Mens Health. 2017;11(6):1653–63.CrossRef Szema A, Mirsaidi N, Patel B. Proposed Iraq/Afghanistan War-Lung Injury (IAW-LI) clinical practice recommendations: National Academy of Sciences’ Institute of Medicine Burn Pits Workshop. Am J Mens Health. 2017;11(6):1653–63.CrossRef
13.
Zurück zum Zitat •• Liu J, Lezama N, Gasper J, Kawata J, Morley S, Helmer D, et al. Burn pit emissions exposure and respiratory and cardiovascular conditions among airborne hazards and open burn pit registry participants. J Occup Environ Med. 2016 58(7). This study shows ongoing evidence for chronic lung disease pulled from burn pit registries. •• Liu J, Lezama N, Gasper J, Kawata J, Morley S, Helmer D, et al. Burn pit emissions exposure and respiratory and cardiovascular conditions among airborne hazards and open burn pit registry participants. J Occup Environ Med. 2016 58(7). This study shows ongoing evidence for chronic lung disease pulled from burn pit registries.
14.
Zurück zum Zitat •• Sharkey JM, Abraham JH, Clark LL, Rohrbeck P, Ludwig SL, Hu Z, et al. Postdeployment respiratory health care encounters following deployment to Kabul, Afghanistan: a retrospective cohort study. Mil Med. 2016;181(3):265–71. This study provides evidence that the burn pits are associated with chronic lung disease. •• Sharkey JM, Abraham JH, Clark LL, Rohrbeck P, Ludwig SL, Hu Z, et al. Postdeployment respiratory health care encounters following deployment to Kabul, Afghanistan: a retrospective cohort study. Mil Med. 2016;181(3):265–71. This study provides evidence that the burn pits are associated with chronic lung disease.
15.
Zurück zum Zitat Coughlin SS, Szema A. Burn pits exposure and chronic respiratory illnesses among Iraq and Afghanistan Veterans. J Environ Health Sci. 2019 Feb 5 (1) Coughlin SS, Szema A. Burn pits exposure and chronic respiratory illnesses among Iraq and Afghanistan Veterans. J Environ Health Sci. 2019 Feb 5 (1)
16.
Zurück zum Zitat Dominici F, Peng RD, Bell ML, et al. Fine particulate air pollution and hospital admission for cardiovascular and respiratory diseases. JAMA. 2006;295:1127–34.CrossRef Dominici F, Peng RD, Bell ML, et al. Fine particulate air pollution and hospital admission for cardiovascular and respiratory diseases. JAMA. 2006;295:1127–34.CrossRef
17.
Zurück zum Zitat Samoli E, Peng R, Ramsay T, et al. Acute effects of ambient particulate matter on mortality in Europe and North America: results from the APHENA study. Environ Health Perspect. 2008;116:1480–6.CrossRef Samoli E, Peng R, Ramsay T, et al. Acute effects of ambient particulate matter on mortality in Europe and North America: results from the APHENA study. Environ Health Perspect. 2008;116:1480–6.CrossRef
18.
Zurück zum Zitat Blasch KW, Kolivosky JE, Heller JM. Environmental air sampling near burn pit and incinerator operations at Bagram Airfield, Afghanistan. J Occup Environ Med. 2016 Aug 58(8S). Blasch KW, Kolivosky JE, Heller JM. Environmental air sampling near burn pit and incinerator operations at Bagram Airfield, Afghanistan. J Occup Environ Med. 2016 Aug 58(8S).
19.
Zurück zum Zitat Weese CB, Abraham JH. Potential health implications associated with particulate matter exposure in deployed settings in southwest Asia. Inhal Toxicol. 2009;21:291–6.CrossRef Weese CB, Abraham JH. Potential health implications associated with particulate matter exposure in deployed settings in southwest Asia. Inhal Toxicol. 2009;21:291–6.CrossRef
20.
Zurück zum Zitat Masiol, M, et al. Airborne dioxins, furans, and polycyclic aromatic hydrocarbons exposure to military personnel in Iraq. J Occup Environ Med. 2016 Aug 58(8). Masiol, M, et al. Airborne dioxins, furans, and polycyclic aromatic hydrocarbons exposure to military personnel in Iraq. J Occup Environ Med. 2016 Aug 58(8).
21.
Zurück zum Zitat Conlin, AM, et al. Birth outcomes among military personnel after exposure to documented open-air burn pits before and during pregnancy. J Occup Environ Med. 2012 June 54(6). Conlin, AM, et al. Birth outcomes among military personnel after exposure to documented open-air burn pits before and during pregnancy. J Occup Environ Med. 2012 June 54(6).
22.
Zurück zum Zitat Department of Veteran Affairs. Report on data from the airborne hazards and open burn pit registry. 2015 June. Department of Veteran Affairs. Report on data from the airborne hazards and open burn pit registry. 2015 June.
23.
Zurück zum Zitat Ladich ER, Lewin-Smith MR, Specht CS, et al. A histopathological study of head and neck specimens from a cohort of Persian Gulf War military veterans. Mil Med. 2002;167(10):864–7.CrossRef Ladich ER, Lewin-Smith MR, Specht CS, et al. A histopathological study of head and neck specimens from a cohort of Persian Gulf War military veterans. Mil Med. 2002;167(10):864–7.CrossRef
24.
Zurück zum Zitat De la Hoz RE, Shohet MR, Cohen JM. Occupational rhinosinusitis and upper airway disease: the World Trade Center experience. Curr Allergy Asthma Rep. 2010;10(2):77–83.CrossRef De la Hoz RE, Shohet MR, Cohen JM. Occupational rhinosinusitis and upper airway disease: the World Trade Center experience. Curr Allergy Asthma Rep. 2010;10(2):77–83.CrossRef
25.
Zurück zum Zitat Helfer TM, Canham-Chervak M, Canada S, Mitchener TA. Epidemiology of hearing impairment and noise-induced hearing injury among U.S. military personnel, 2003–2005. Am J Prev Med. 2010;38:S71–7. Helfer TM, Canham-Chervak M, Canada S, Mitchener TA. Epidemiology of hearing impairment and noise-induced hearing injury among U.S. military personnel, 2003–2005. Am J Prev Med. 2010;38:S71–7.
26.
Zurück zum Zitat Rovig GW, Bohnker BK, Page JC. Hearing health risk in a population of aircraft carrier flight deck personnel. Mil Med. 2004;169:429–32.CrossRef Rovig GW, Bohnker BK, Page JC. Hearing health risk in a population of aircraft carrier flight deck personnel. Mil Med. 2004;169:429–32.CrossRef
27.
Zurück zum Zitat Humes LE, Joellenbeck LM, Durch JS. Noise and Military Service. Implications for Hearing Loss and Tinnitus. Washington, DC: National Academies Press; 2005. Humes LE, Joellenbeck LM, Durch JS. Noise and Military Service. Implications for Hearing Loss and Tinnitus. Washington, DC: National Academies Press; 2005.
28.
Zurück zum Zitat US Government Accountability Office. Hearing loss prevention: improvements to DOD hearing conservation programs could lead to better outcomes. Washington DC: US Government Accountability Office; 2011. US Government Accountability Office. Hearing loss prevention: improvements to DOD hearing conservation programs could lead to better outcomes. Washington DC: US Government Accountability Office; 2011.
29.
Zurück zum Zitat Saunders GH, Griest SE. Hearing loss in veterans and the need for hearing loss prevention programs. Noise Health. 2009;11:14–21.CrossRef Saunders GH, Griest SE. Hearing loss in veterans and the need for hearing loss prevention programs. Noise Health. 2009;11:14–21.CrossRef
30.
Zurück zum Zitat Geckle L, Lee R. Soldier perceptions of deployment environmental exposures. Albuquerque, NM: Paper presented at: Force Health Protection Conference; 2004. Aug Geckle L, Lee R. Soldier perceptions of deployment environmental exposures. Albuquerque, NM: Paper presented at: Force Health Protection Conference; 2004. Aug
31.
Zurück zum Zitat Wells TS, Seelig AD, Ryan MA, et al. Hearing loss associated with US military combat deployment. Noise Health. 2015 Jan-Feb 17(74) 34–42. Wells TS, Seelig AD, Ryan MA, et al. Hearing loss associated with US military combat deployment. Noise Health. 2015 Jan-Feb 17(74) 34–42.
32.
Zurück zum Zitat Saunders GH, Vachhani JJ, Galvez G, Griest SE. Formative evaluation of a multimedia self-administered computerized hearing loss prevention program. Int J Audiol. 2015;54(4):234–40.CrossRef Saunders GH, Vachhani JJ, Galvez G, Griest SE. Formative evaluation of a multimedia self-administered computerized hearing loss prevention program. Int J Audiol. 2015;54(4):234–40.CrossRef
33.
Zurück zum Zitat Banout J, Urban O, Musil V, et al. Agent Orange footprint still visible in rural areas of Central Vietnam. J Environ Public Health. 2014 Feb. Banout J, Urban O, Musil V, et al. Agent Orange footprint still visible in rural areas of Central Vietnam. J Environ Public Health. 2014 Feb.
34.
Zurück zum Zitat Ngo AD, Taylor R, Roberts CL, Nguyen TV. Association between Agent Orange and birth defects: systematic review and meta-analysis. Inter Epidemiol Assoc 2006 Feb. Ngo AD, Taylor R, Roberts CL, Nguyen TV. Association between Agent Orange and birth defects: systematic review and meta-analysis. Inter Epidemiol Assoc 2006 Feb.
35.
Zurück zum Zitat Chang ET, Boffetta P, Adami HO, et al. A critical review of the epidemiology of Agent Orange/TCDD and prostate cancer. Eur J Epidemiol. 2014;29(10):667–723.CrossRef Chang ET, Boffetta P, Adami HO, et al. A critical review of the epidemiology of Agent Orange/TCDD and prostate cancer. Eur J Epidemiol. 2014;29(10):667–723.CrossRef
36.
Zurück zum Zitat Baumann Kreuziger LM, Tarchand G, Morrison VA, et al. The impact of Agent Orange exposure on presentation and prognosis of patients with chronic lymphocytic leukemia. Leuk Lymphoma. 2014;55(1):63–6.CrossRef Baumann Kreuziger LM, Tarchand G, Morrison VA, et al. The impact of Agent Orange exposure on presentation and prognosis of patients with chronic lymphocytic leukemia. Leuk Lymphoma. 2014;55(1):63–6.CrossRef
37.
Zurück zum Zitat Landgren O, Shim YK, Michalek J, et al. Agent Orange exposure and monoclonal gammopathy of undetermined significance: a Ranch Hand Veteran cohort study. JAMA Oncol. 2015;1(8):1061–8.CrossRef Landgren O, Shim YK, Michalek J, et al. Agent Orange exposure and monoclonal gammopathy of undetermined significance: a Ranch Hand Veteran cohort study. JAMA Oncol. 2015;1(8):1061–8.CrossRef
38.
Zurück zum Zitat Sudhakar D, Clagett CL, Zacher LL. Military service and lung disease. J Occup Environ Med. 2014 Oct 56(5S). Sudhakar D, Clagett CL, Zacher LL. Military service and lung disease. J Occup Environ Med. 2014 Oct 56(5S).
39.
Zurück zum Zitat Lange JL, Schwartz DA, Doebbling BN, et al. Exposures to the Kuwait oil fires and their association with asthma and bronchitis among Gulf War Veterans. Environmental Health Perspectives. 2002 Nov 110 (11). Lange JL, Schwartz DA, Doebbling BN, et al. Exposures to the Kuwait oil fires and their association with asthma and bronchitis among Gulf War Veterans. Environmental Health Perspectives. 2002 Nov 110 (11).
40.
Zurück zum Zitat Mumford JL, Lewtas J, Williams K, et al. Mutangenicity of organic emissions from unvented kerosene heaters in a chamber study. J Toxicol Enciron Health. 1992;36:151–9.CrossRef Mumford JL, Lewtas J, Williams K, et al. Mutangenicity of organic emissions from unvented kerosene heaters in a chamber study. J Toxicol Enciron Health. 1992;36:151–9.CrossRef
41.
Zurück zum Zitat Laslof JC, Knox M, Baldeshwieler JD. Presidential Advisory Committee on Gulf War Veteran’s Illnesses: Final Report. 1996 Dec. Laslof JC, Knox M, Baldeshwieler JD. Presidential Advisory Committee on Gulf War Veteran’s Illnesses: Final Report. 1996 Dec.
42.
Zurück zum Zitat Franke K, Paustenbach D. Government and Navy knowledge regarding health hazards of asbestos: a state of the science evaluation (1900 to 1970). Inhal Toxicol. 2011;23:1–20.CrossRef Franke K, Paustenbach D. Government and Navy knowledge regarding health hazards of asbestos: a state of the science evaluation (1900 to 1970). Inhal Toxicol. 2011;23:1–20.CrossRef
43.
Zurück zum Zitat Harrington AD, Schmidt MP, Szema AM, et al. The role of Iraqi dust in inducing lung injury in United States soldiers — an interdisciplinary study. Geohealth. 2017;1(5):237–46.CrossRef Harrington AD, Schmidt MP, Szema AM, et al. The role of Iraqi dust in inducing lung injury in United States soldiers — an interdisciplinary study. Geohealth. 2017;1(5):237–46.CrossRef
44.
Zurück zum Zitat Meo SA, Al-Kheraiji MF, Alfaraj ZF, et al. Respiratory and general health complaints in subjects exposed to sandstorm at Riyadh Saudi Arabia. Pak J Med Sci. 2013;29(2):642–6.CrossRef Meo SA, Al-Kheraiji MF, Alfaraj ZF, et al. Respiratory and general health complaints in subjects exposed to sandstorm at Riyadh Saudi Arabia. Pak J Med Sci. 2013;29(2):642–6.CrossRef
45.
Zurück zum Zitat Krefft SD, Wolff J, Zell-Baran L, et al. Respiratory diseases in Post-911 military personnel following Southwest Asia deployment. J Occup Environ Med. 2020;62(5):337–43.CrossRef Krefft SD, Wolff J, Zell-Baran L, et al. Respiratory diseases in Post-911 military personnel following Southwest Asia deployment. J Occup Environ Med. 2020;62(5):337–43.CrossRef
46.
Zurück zum Zitat Wills JR, Kang C. Chlorine gas: an evolving hazardous material threat and unconventional weapon. West J Emerg Med. 2010;11:151–6. Wills JR, Kang C. Chlorine gas: an evolving hazardous material threat and unconventional weapon. West J Emerg Med. 2010;11:151–6.
47.
Zurück zum Zitat Sudhakar D, Clagett CL, Zacher LL. Military service and lung disease. J Occup Environ Med. 2014 Oct 56(10S). Sudhakar D, Clagett CL, Zacher LL. Military service and lung disease. J Occup Environ Med. 2014 Oct 56(10S).
48.
Zurück zum Zitat Department of the Army Inspector General Special Interest Item Assessment of the Residential Communities Initiatives. 2019 Sept. Department of the Army Inspector General Special Interest Item Assessment of the Residential Communities Initiatives. 2019 Sept.
49.
Zurück zum Zitat Jowers K. New association of privatized housing companies pushing back on some reforms. Military Times. 2019 Sept. Jowers K. New association of privatized housing companies pushing back on some reforms. Military Times. 2019 Sept.
50.
Zurück zum Zitat Wheeler DC, Burstyn I, Vermeulen R, et al. Inside the black box: starting to uncover the underlying decision rules used in a one-by-one expert assessment of occupational exposure in case-control studies. Occup Environ Med. 2013;70:203–10.CrossRef Wheeler DC, Burstyn I, Vermeulen R, et al. Inside the black box: starting to uncover the underlying decision rules used in a one-by-one expert assessment of occupational exposure in case-control studies. Occup Environ Med. 2013;70:203–10.CrossRef
51.
Zurück zum Zitat • Patel CJ, Kerr J, Thomas DC, et al. Opportunities and challenges for environmental exposure assessment in population-based studies. Cancer Epidemiol Biomarkers Prev. 2017;26:1370–80. A comprehensive overview of practices in the military to help identify and study occupational exposures. • Patel CJ, Kerr J, Thomas DC, et al. Opportunities and challenges for environmental exposure assessment in population-based studies. Cancer Epidemiol Biomarkers Prev. 2017;26:1370–80. A comprehensive overview of practices in the military to help identify and study occupational exposures.
52.
Zurück zum Zitat Krahl PL, Benchoff E, Go YM, et al. Advances in comprehensive exposure assessment: opportunities for the US military. J Occup Environ Med 2019, Dec 61(12). Krahl PL, Benchoff E, Go YM, et al. Advances in comprehensive exposure assessment: opportunities for the US military. J Occup Environ Med 2019, Dec 61(12).
53.
Zurück zum Zitat Bradburne C, Lewis JA. Personalizing environmental health: at the intersection of precision medicine and occupational health in the military. J Occup Environ Med. 2017 Nov 59(11). Bradburne C, Lewis JA. Personalizing environmental health: at the intersection of precision medicine and occupational health in the military. J Occup Environ Med. 2017 Nov 59(11).
Metadaten
Titel
A Clinician’s Guide to Occupational Exposures in the Military
verfasst von
Joel Van De Graaff
Jill A. Poole
Publikationsdatum
12.11.2022
Verlag
Springer US
Erschienen in
Current Allergy and Asthma Reports / Ausgabe 12/2022
Print ISSN: 1529-7322
Elektronische ISSN: 1534-6315
DOI
https://doi.org/10.1007/s11882-022-01051-0

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