Department of Otolaryngology-Head and Neck Surgery, Naval Medical Center Portsmouth, Portsmouth, VA 23708, USA.
Department of Otolaryngology-Head and Neck Surgery, James A. Lovell Federal Health Care Center, North Chicago, IL 60064, USA.
Mil Med. 2021 Jul 1;186(7-8):672-681. doi: 10.1093/milmed/usab070.
Burn pits (BPs) have been widely used by the U.S. military for waste disposal while in conflicts abroad. Significant adverse health effects are thought to be linked to BPs, but limited data exist examining the impact on the respiratory tract. The purpose of this systematic review is to characterize these effects on both the upper respiratory tract (URT) and lower respiratory tract (LRT).
A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines on articles published from January 1, 2001, through November 2020. PubMed, EMBASE, and Ovid MEDLINE databases were queried for studies examining the effect of BPs on the URT and LRT of service members.
A total of 288 articles were identified, with nine meeting inclusion criteria. Eight of the nine articles assessed the LRT, one examined the URT alone, and two examined both the URT and LRT. Outcome measures were heterogeneous across all studies, precluding meta-analysis. Patient-reported LRT diagnoses appeared to increase as exposure to BPs increased. There are very limited data assessing the impact of BP exposure on the URT. No association between BP exposure and objective measures of LRT or URT disease was identified.
Service members deployed to combat zones seem to report a significant increase in respiratory diseases following exposure to BPs, although definitive conclusions are limited by multiple airborne exposures and varied reporting methods. Self-reported LRT diagnoses appear to be more prevalent. There is a paucity of data on the effects of BPs on the URT. Objective measures of disease do not appear to correlate with patient reports. Prospective, long-term, and outcome-based studies are necessary to examine the effects of BPs, and other airborne hazards related to deployment, on the URT and LRT of service members.
燃烧坑（BP）已被美国军方广泛用于在国外冲突中处理废物。人们认为，BP 与重大的健康影响有关，但有关呼吸道影响的数据有限。本系统评价的目的是描述这些对上呼吸道（URT）和下呼吸道（LRT）的影响。
根据对 2001 年 1 月 1 日至 2020 年 11 月发表的文章的系统评价和荟萃分析的首选报告项目，进行了系统评价。在 PubMed、EMBASE 和 Ovid MEDLINE 数据库中查询了研究 BP 对服务成员 URT 和 LRT 影响的文章。
共确定了 288 篇文章，其中 9 篇符合纳入标准。这 9 篇文章中有 8 篇评估了 LRT，1 篇单独评估了 URT，2 篇同时评估了 URT 和 LRT。所有研究的结果指标均存在异质性，无法进行荟萃分析。随着 BP 暴露量的增加，患者报告的 LRT 诊断似乎增加。评估 BP 暴露对 URT 影响的数据非常有限。BP 暴露与 LRT 或 URT 疾病的客观指标之间没有关联。
部署到战区的服务成员在接触 BP 后似乎报告呼吸道疾病显著增加，尽管由于多种空气传播暴露和不同的报告方法，因此无法得出明确的结论。自我报告的 LRT 诊断似乎更为普遍。BP 对 URT 的影响的数据很少。疾病的客观指标似乎与患者报告无关。需要进行前瞻性、长期和基于结果的研究，以检查 BP 以及与部署相关的其他空气传播危害对服务成员的 URT 和 LRT 的影响。
