Pulmonary/Critical Care Service, Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, San Antonio, Texas.
Pulmonary Disease Service, Wilford Hall Ambulatory Surgical Center, Lackland Air Force Base, San Antonio, Texas.
Respir Care. 2019 May;64(5):536-544. doi: 10.4187/respcare.06396. Epub 2019 Jan 8.
There is significant concern about the respiratory health of deployed military service members given the reported airborne hazards in southwest Asia, which range from geologic dusts, burn pit emissions, chemical exposures, and increased rates of smoking. There has been no previous comparison of pre- and post-deployment lung function in these individuals.
Military personnel who deployed to southwest Asia in support of ongoing military operations were recruited from the Soldier Readiness Processing Center at Fort Hood, Texas, from 2011 to 2014. The participants were asked to complete a brief survey on their respiratory health and perform both spirometry and impulse oscillometry studies at baseline with repeated survey and testing after deployment.
Of the 1,693 deployed personnel who completed baseline examinations, 843 (50%) completed post-deployment testing. Post-deployment values demonstrated no statistical or clinical change in spirometry, with an increase in mean ± SD FEV (% predicted) from 95.2 ± 12.6 to 96.1 ± 12.4 ( = .14), increase in mean ± SD FVC (% predicted) from 95.9 ± 11.8 to 96.4 ± 11.9 ( = .32), and increase in mean ± SD FEV/FVC from 81.5 ± 5.9 to 81.8 ± 6.1 ( = .29). Impulse oscillometry values showed statistical improvement with reduction in resistance (at 5 Hz and 20 Hz) and reactance (at 5 Hz). The presence of pre-deployment obstruction, self-reported asthma, smoking history, or increased body mass index also did not change spirometry values after deployment.
To our knowledge, this was the first prospective evaluation of deploying military by using spirometry as an indicator for the possible development of pulmonary disease related to environmental exposures. Pre-deployment testing with spirometry and impulse oscillometry was unable to detect any significant change. In those with abnormal spirometry pre-deployment or asthma history, there was also not identifiable change that indicated worsening lung function.
Utilization of spirometry for the deploying military population had little benefit and did not identify individuals with lung disease after deployment. Routine use was not warranted before or after deployment in the absence of pulmonary symptoms.
由于报道称在西南亚存在地质尘埃、燃烧坑排放物、化学暴露和吸烟率增加等空气传播危害，因此人们对部署的军事人员的呼吸健康状况表示严重关切。此前，尚未对这些人进行部署前后的肺功能比较。
从 2011 年至 2014 年，从德克萨斯州胡德堡的士兵准备处理中心招募了前往西南亚支持正在进行的军事行动的军事人员。要求参与者完成一份关于其呼吸健康的简短调查，并在基线时进行肺活量测定法和脉冲震荡法研究，然后在部署后重复进行调查和测试。
在完成基线检查的 1693 名部署人员中，有 843 名（50%）完成了部署后的测试。肺活量测定法显示，部署后的数值没有统计学或临床变化，平均±SD FEV（%预计值）从 95.2±12.6 增加到 96.1±12.4（=0.14），平均±SD FVC（%预计值）从 95.9±11.8 增加到 96.4±11.9（=0.32），平均±SD FEV/FVC 从 81.5±5.9 增加到 81.8±6.1（=0.29）。脉冲震荡法值显示，在阻力（5 Hz 和 20 Hz）和电抗（5 Hz）方面均有统计学上的改善。部署前存在阻塞、自述哮喘、吸烟史或体重指数增加，也不会改变部署后的肺活量测定法值。
据我们所知，这是首次使用肺活量测定法作为指示与环境暴露相关的肺部疾病发展的可能性的前瞻性评估部署的军事人员。使用肺活量测定法和脉冲震荡法进行的部署前测试无法检测到任何明显的变化。在部署前存在异常肺活量测定法或哮喘病史的人群中，也没有可识别的变化表明肺功能恶化。
在部署前或部署后，肺活量测定法对部署的军事人员没有什么好处，也无法确定是否有肺部疾病。在没有肺部症状的情况下，不建议在部署前或部署后常规使用。
