Review Article
Occupational Lung Diseases among Soldiers Deployed to Iraq and Afghanistan
Anthony M Szema1,2*1New York State Center for Biotechnology Stony Brook University School of Medicine, Stony Brook, NY 11794, USA
2Chief, Allergy Section, Veterans Affairs Medical Center, Northport, NY, 11768, USA
- *Corresponding Author:
- Anthony M Szema
Assistant Professor of Medicine and Surgery
Principal Investigator, New York State Center for Biotechnology
Stony Brook University School of Medicine
Stony Brook, NY 11794, USA
E-mail: anthony.szema@stonybrookmedicine.edu
Received date: March 20, 2013; Accepted date: May 20, 2013; Published date: May 22, 2013
Citation: Szema AM (2013) Occupational Lung Diseases among Soldiers Deployed to Iraq and Afghanistan. Occup Med Health Aff 1:117. doi: 10.4172/2329-6879.1000117
Copyright: © 2013 Szema AM. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Military personnel deployed to Iraq and Afghanistan, from 2004 to the present, has served in a setting of unique environmental conditions. Among these are exposures to burning trash in open air “burn pits” lit on fire with jet fuel JP-8. Depending on trash burned--water bottles, styrofoam trays, medical waste, unexploded munitions, and computers--toxins may be released such as dioxins and n-hexane and benzene. Particulate matter air pollution culminates from these fires and fumes. Additional environmental exposures entail sandstorms (Haboob, Shamal, and Sharqi) which differ in direction and relationship to rain. These wars saw the first use of improvised explosive devices (roadside phosphate bombs),as well as vehicle improvised explosive devices (car bombs), which not only potentially aerosolize metals, but also create shock waves to induce lung injury via blast overpressure. Conventional mortar rounds are also used by Al Qaeda in both Iraq and Afghanistan. Outdoor aeroallergens from date palm trees are prevalent in southern Iraq by the Tigris and Euphrates rivers, while indoor aeroallergen aspergillus predominates during the rainy season. High altitude lung disease may also compound the problem, particularly in Kandahar, Afghanistan. Clinically, soldiers may present with new-onset asthma or fixed airway obstruction. Some have constrictive bronchiolitis and vascular remodeling on open lung biopsy - despite having normal spirometry and chest xrays and CT scans of the chest. Others have been found to have titanium and other metals in the lung (rare in nature). Still others have fulminant biopsy-proven sarcoidiosis. We found DNA probe–positive Mycobacterium Avium Complex in lung from a soldier who had pneumonia, while serving near stagnant water and camels and goats outside Abu Gharib. This review highlights potential exposures, clinical syndromes, and the Denver Working Group recommendations on post-deployment health.
