Maccarone Jennifer, Redlich Carrie A, Timmons Andrew, Korpak Anna M, Smith Nicholas L, Nakayama Karen S, Baird Coleen P, Ciminera Paul, Kheradmand Farrah, Fan Vincent S, Hart Jaime E, Koutrakis Petros, Kuschner Ware G, Ioachimescu Octavian C, Jerrett Michael, Montgrain Philippe R, Proctor Susan P, Wendt Christine H, Wongtrakool Cherry, Wan Emily S, Blanc Paul D, Garshick Eric
Pulmonary, Allergy, Sleep and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, West Roxbury, Mass.
Pulmonary Center, Boston University School of Medicine, Boston, Mass.
J Allergy Clin Immunol Glob. 2024 Oct 31;4(1):100367. doi: 10.1016/j.jacig.2024.100367. eCollection 2025 Feb.
Post-9/11 veterans were exposed to environmental and occupational pollutants during deployment.
Our aim was to determine associations between deployment-related exposures and sinusitis and rhinitis.
Between April 2018 and March 2020, veterans with land-based deployment after 9/11 who were living within 25 miles of 6 Department of Veteran Affairs medical centers were randomly chosen by using a Defense Manpower Data Center roster. Participants completed interviewer-administered questionnaires, which included a 32-item deployment exposure battery and self-report of rhinitis and health professional-diagnosed sinusitis. Exposure categories included burn pit smoke, combustion engine exhaust/ground dust, other open combustion sources, toxicants, and military job-related VGDF. Each item was scored on the basis of frequency and duration of exposure; ordinal scores were summed and scaled to 100 within each category. Odds ratios (ORs) were estimated using logistic regression for sinusitis and rhinitis separately. ORs were scaled per 20-point exposure score.
Among the 1960 participants, the incidences of sinusitis and rhinitis with onset during deployment were 2.1% and 3.6%, respectively; the incidences of postdeployment onset were 5.1% and 5.6%, respectively. Toxicant exposure consisted mainly of "applying pesticide, insecticide, or repellent to your own skin or to your own clothing" and was associated with rhinitis with onset during deployment (OR = 1.50 [95% CI = 1.31-1.84]) and onset after deployment (OR = 1.21 [95% CI = 0.93-1.50]). There were no associations with burn pit smoke or other exposure categories.
Veterans with deployment exposures to toxicants were at increased risk of rhinitis, particularly during deployment. The clinical evaluation of postdeployment veterans should address rhinitis as a deployment-related condition.
“9·11”事件后的退伍军人在部署期间接触了环境和职业污染物。
我们的目的是确定与部署相关的暴露与鼻窦炎和鼻炎之间的关联。
在2018年4月至2020年3月期间，使用国防人力数据中心名册从居住在6个退伍军人事务部医疗中心25英里范围内、在“9·11”事件后有陆上部署经历的退伍军人中随机选取参与者。参与者完成了由访谈员管理的问卷，其中包括一个32项的部署暴露量表以及鼻炎和经医疗专业人员诊断的鼻窦炎的自我报告。暴露类别包括燃烧坑烟雾、内燃机废气/地面灰尘、其他露天燃烧源、有毒物质以及与军事工作相关的挥发性伽马射线剂量率。每个项目根据暴露频率和持续时间进行评分；将序数分数相加并在每个类别内缩放到100。分别使用逻辑回归估计鼻窦炎和鼻炎的比值比（OR）。OR按每20分的暴露分数进行缩放。
在1960名参与者中，部署期间发病的鼻窦炎和鼻炎发病率分别为2.1%和3.6%；部署后发病的发病率分别为5.1%和5.6%。有毒物质暴露主要包括“在自己的皮肤或衣服上涂抹农药、杀虫剂或驱虫剂”，并且与部署期间发病的鼻炎相关（OR = 1.50 [95% CI = 1.31 - 1.84]）以及部署后发病的鼻炎相关（OR = 1.21 [95% CI = 0.93 - 1.50]）。与燃烧坑烟雾或其他暴露类别无关联。
接触有毒物质的部署退伍军人患鼻炎的风险增加，尤其是在部署期间。对部署后退伍军人的临床评估应将鼻炎作为与部署相关的病症来处理。
