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Overview and Recommendations for Medical Screening and Diagnostic Evaluation for Postdeployment Lung Disease in Returning US Warfighters

Rose, Cecile MD, MPH; Abraham, Joseph ScD, MS; Harkins, Deanna MD, MPH; Miller, Robert MD; Morris, Michael MD; Zacher, Lisa MD; Meehan, Richard MD; Szema, Anthony MD; Tolle, James MD; King, Matthew MD; Jackson, David PhD; Lewis, John PhD; Stahl, Andrea PhD; Lyles, Mark B. DMD, PhD; Hodgson, Michael MD, MPH; Teichman, Ronald MD, MPH; Salihi, Walid DO; Matwiyoff, Gregory MD; Meeker, Gregory MS; Mormon, Suzette MPH, RN; Bird, Kathryn MD, MSPH; Baird, Coleen MD, MPH

Section Editor(s): Teichman, Ron MD, MPH; Guest Editor

Journal of Occupational and Environmental Medicine: June 2012 - Volume 54 - Issue 6 - p 746–751
doi: 10.1097/JOM.0b013e31825297ba
Original Articles

Objective: To review inhalational exposures and respiratory disease risks in US military personnel deployed to Iraq and Afghanistan and to develop consensus recommendations for medical screening and diagnostic referral.

Methods: A Working Group of physicians and exposure scientists from academia and from the Departments of Defense and Veterans Affairs was convened in February 2010.

Results: Despite uncertainty about the number of people affected and risk factors for adverse pulmonary outcomes in this occupational setting, the Working Group recommended: (1) standardized approaches to pre- and postdeployment medical surveillance; (2) criteria for medical referral and diagnosis; and (3) case definitions for major deployment-related lung diseases.

Conclusions: There is a need for targeted, practical medical surveillance for lung diseases and for a standardized diagnostic approach for all symptomatic deployed personnel.

From the Department of Medicine (Drs Rose, Meehan, and Bird), National Jewish Health and University of Colorado Denver; US Army Public Health Command (Drs Abraham, Harkins, and Baird), Aberdeen Proving Ground, Md; Vanderbilt University School of Medicine (Drs Miller, Tolle, and King), Nashville, Tenn; Department of Medicine (Drs Morris and Zacher), Brooke Army Medical Center, Ft Sam Houston, Tex; SUNY Stony Brook School of Medicine (Drs Szema and Salihi), Stony Brook, and Veterans Affairs Medical Center, Northport, NY; US Army Center for Environmental Health Research (Drs Jackson, Lewis, and Stahl), Ft Detrick, Md; US Naval War College (Dr Lyles), Washington, DC; Occupational Health, Office of Public Health (Dr Hodgson), VHA, Department of Veterans Affairs, Washington, DC; War Related Illness and Injury Study Center (Dr Teichman), VA New Jersey Health Care System, Department of Veterans Affairs, East Orange, NJ; Navy Medical Center (Dr Matwiyoff), San Diego, Calif; and US Geological Survey (Mr Meeker and Ms Mormon), Denver, Colo.

Address correspondence to: Cecile Rose, MD, MPH, National Jewish Health, 1400 Jackson St, Denver, CO 80206 mail to:

Author Rose received a Department of Defense grant in 2011; she receives royalties from a contribution to a chapter in an online journal on silicosis. She and her coauthors have no relationships/conditions/circumstances that present potential conflict of interest.

The JOEM Editorial Board and Planners have no financial interest related to this research.

The opinions expressed herein represent those of the authors and do not represent those of the Department of Veterans Affairs or the Department of Defense.

©2012The American College of Occupational and Environmental Medicine