TABLE 4-8 Respiratory System Diseases

Study

Design

Population

Outcomes

Results

Adjustments

Comments

Eisen et al., 2005 (Vol. 4)

Population-based, cross-sectional, prevalence, medical evaluation

1061 US deployed vs 1128 nondeployed

Self-reported asthma, bronchitis, or emphysema; obstructive lung disease (history of disease or symptoms plus use of bronchodilators or 15% improvement in FEV1 after bronchodilator use)

Asthma, bronchitis, or emphysema: OR 1.07 (95% CI 0.65-1.77)

Obstructive lung disease: OR 0.91 (95% CI 0.52-1.59)

Age, sex, race, years of education, smoking, duty type, service branch, rank

Low participation rates, especially among nondeployed

Karlinsky et al., 2004 (Vol. 4)

Cross-sectional, medical evaluation

1036 US deployed vs 1103 nondeployed

PFT results classified into five categories: normal, nonreversible obstruction, reversible obstruction, restrictive, small-airways obstruction

No association of PFT-based classifications with deployment status, nor with exposure to nerve agents at Khamisiyah based on 2002 DoD exposure models

 

No adjustment for smoking or other confounders; description of sampling strategy inadequate to evaluate bias; no explanation of “matching” or control of matching in analysis

Gray et al., 1999a (Vol. 4)

Cross-sectional, medical evaluation

527 Gulf War veterans vs 970 nondeployed from 14 US Navy Seabees commands

Cough; shortness of breath; FVC (L); FEV1 (L)

Cough : OR 1.8 (95% CI 1.2-2.8)

Shortness of breath: OR 4.0 (95% CI 2.2-7.3)

FVC (L): 4.96 vs 4.99, p = 0.77

FEV1 (L): 4.05 vs 4.04, p = 0.81

Age, height, race, smoking status

No use of modeled oil-fire exposures

Kelsall et al., 2004b (Vol. 4)

Cross-sectional, medical evaluation

1456 Australian deployed vs 1588 nondeployed

Asthma; bronchitis; FEV1/FVC% < 70%

Asthma: OR 1.2 (95% CI 0.8-1.8);

Bronchitis: OR 1.9 (95% CI 1.2-3.1);

FEV1/FVC% < 70%: OR 0.8 (95% CI 0.5-1.1);

Service type, rank, age, education, marital status

Generally well done; substantial potential for selection bias (response rates: deployed 81%, comparison 57%); no



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