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• W2765654703 abstract "SESSION TITLE: Environmental and Occupational Health SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, November 1, 2017 at 01:30 PM - 02:30 PM PURPOSE: From 2003-2011 over 70,000 service members were evacuated from Southwest Asia (SWA) for noncombat related diseases and injuries. Pulmonary and respiratory related conditions represented between 3-8% of service members aeromedically evacuated for non-battle etiologies. Pulmonary complaints are common among service members deployed to SWA and the influence the environment has on the development of these symptoms is undefined. There have been numerous cases of acute eosinophilic pneumonia evacuated from theater but the demographics, definitive diagnoses and related medical conditions of the other patients has never been adequately addressed. The purpose of this study is to describe the pulmonary conditions and medical interventions performed on service members evacuated from combat or combat support zones for respiratory complaints. METHODS: The medical records of 300 consecutive patients evacuated from SWA and to Landstuhl Medical Center (LRMC) in Germany were examined. The charts were reviewed for demographics, downrange interventions and environmental exposures and level of care for transport. For those admitted to the hospital, the inpatient records were also used to determine significant procedures and discharge diagnosis. RESULTS: A total of 136 (45.3%) of the evacuated service members were admitted to the hospital. Of those admitted to the hospital 41 (30.1%) were evacuated via critical care air transport teams (CCATT). Fifty of the patients (36.8%) required care in the intensive care unit and 35 were mechanically ventilated for more than 24 hours. The most common diagnoses were pulmonary infection (53, 39.0%), 36 were admitted for a spontaneous pneumothorax (26.5%) and 17 (12.5%) were admitted for acute eosinophilic pneumonia. An empyema was the diagnosis in 13/53 patients with pulmonary infections. Only eight (5.9%) of the patients were evacuated for asthma, and all of these patients reported a previous history of asthma. Smoking was common in this cohort with 80 (60.3%) reporting recent tobacco use. Four (2.9%) of the service members admitted to the hospital were admitted related to direct inhalational exposures that were unique to the employed environment. CONCLUSIONS: Non-traumatic pneumothorax and pulmonary infections account for the majority of the patients evacuated from theater. Common diseases that are seen in the general population also affect service members in a deployed setting. Smoking is known to play a role the development of acute eosinophilic pneumonia, but it also appears to be a risk factor for developing respiratory conditions that lead to being evacuated from theater. The role of smoking should not be discounted when evaluating the respiratory symptoms and complaints of service members following deployment. CLINICAL IMPLICATIONS: Smokers are at higher risk of developing lung disease. Active duty members who are also smokers are more likely to develop infections, eosinophilic pneumonia and other respiratory conditions while deployed. This lead to higher number of medical evacuations for lung disease from theater yielding higher mission costs and decreasing battle readiness and unit cohesion. DISCLOSURE: The following authors have nothing to disclose: Amaya George, Andrew Skabelund, Michael Morris No Product/Research Disclosure Information" @default.
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• W2765654703 date "2017-10-01" @default.
• W2765654703 modified "2023-09-27" @default.
• W2765654703 title "Incidence of Lung Desease in Deployed Service Members Medically Evacuated From to Southeast Asia Between 2003 and 2011" @default.
• W2765654703 doi "https://doi.org/10.1016/j.chest.2017.08.856" @default.
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