Deployment-Related Respiratory Health: Bridging the Gap between Clinical and Epidemiological Associations and Disease Mechanisms An Official American Thoracic Society Workshop Report

Land-based military deployers to Afghanistan and/or Southwest Asia (SWA) encountered exposure to high concentrations of respirable particulate matter (PM) from multiple sources, including desert dust, burn pit smoke, and military occupations. Adverse lung health effects following deployment have been noted, including upper and lower respiratory tract symptoms, asthma, and small airway and other abnormalities on lung biopsy. The American Thoracic Society (ATS) convened a Workshop in 2018 to review studies assessing post-deployment respiratory health, describe emerging research, and highlight knowledge gaps. Progress on understanding post-deployment health prompted a second ATS Workshop to update current knowledge by 1) reviewing new studies linking exposure assessments to symptoms and/or clinical disease; 2) describing the spectrum of lung pathology reported in previously deployed personnel; 3) evaluating current knowledge of long-term health outcomes after deployment; 4) reviewing data from recent experimental models of deployment-related respiratory diseases (DRRDs); and 5) providing recommendations for future research priorities. Workshop participants agreed that there is substantial evidence linking deployment-related exposures to respiratory symptoms, pulmonary diagnoses, and lung pathology. Knowledge gaps include understanding: 1) the extent and mechanisms through which specific exposures result in impaired pulmonary function, small airways disease, and potentially future chronic pulmonary diseases; 2) the contribution of exposure-related foreign material in the lung to clinical and pathologic findings; and 3) the relationship of pathologic findings to respiratory health, especially those involving small airways.

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Publication Details

Journal
Annals of the American Thoracic Society
Published
2026-06-26
DOI
https://doi.org/10.1093/annalsats/aaoag166
Primary Topic
Fibromyalgia and Chronic Fatigue Syndrome Research
Type
article
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article

Deployment-Related Respiratory Health: Bridging the Gap between Clinical and Epidemiological Associations and Disease Mechanisms An Official American Thoracic Society Workshop Report

Jaime E. Hart, Michael J. Falvo, Carrie A. Redlich, Jennifer Maccarone et al.
Annals of the American Thoracic Society
Fibromyalgia and Chronic Fatigue Syndrome Research
article

Deployment-Related Respiratory Health: Bridging the Gap between Clinical and Epidemiological Associations and Disease Mechanisms An Official American Thoracic Society Workshop Report

Jaime E. Hart, Michael J. Falvo, Carrie A. Redlich, Jennifer Maccarone, Eric Garshick, Andrew J. Hoisington, Vincent S. Fan, Barrak Alahmad, Meredith Franklin, L. Zell-Baran, John J. Osterholzer, Ilona Jaspers, Farrah Kheradmand, Kirk D. Jones, David A. Savitz, Sergey Gutor, Susan Woskie, Johannes Saers, A.M. Sotolongo, S.D. Krefft, Stella E. Hines, Ranu Surolia, Bradley W. Richmond, Paul D. Blanc, Paul Ciminera, Michael R. Lewin‐Smith, Vasiliy V. Polosukhin, Cecile S. Rose, Alexander S. Rabin, Coleen P. Baird, Cecile Rose, Andrew Hoisington, Barrak Alahmad, E Garshick, J E Hart, Michael J Falvo, Johannes Saers, Lauren Zell-Baran, Occupational and Population Health American Thoracic Society Assembly on Environmental
article en

Abstract

Land-based military deployers to Afghanistan and/or Southwest Asia (SWA) encountered exposure to high concentrations of respirable particulate matter (PM) from multiple sources, including desert dust, burn pit smoke, and military occupations. Adverse lung health effects following deployment have been noted, including upper and lower respiratory tract symptoms, asthma, and small airway and other abnormalities on lung biopsy. The American Thoracic Society (ATS) convened a Workshop in 2018 to review studies assessing post-deployment respiratory health, describe emerging research, and highlight knowledge gaps. Progress on understanding post-deployment health prompted a second ATS Workshop to update current knowledge by 1) reviewing new studies linking exposure assessments to symptoms and/or clinical disease; 2) describing the spectrum of lung pathology reported in previously deployed personnel; 3) evaluating current knowledge of long-term health outcomes after deployment; 4) reviewing data from recent experimental models of deployment-related respiratory diseases (DRRDs); and 5) providing recommendations for future research priorities. Workshop participants agreed that there is substantial evidence linking deployment-related exposures to respiratory symptoms, pulmonary diagnoses, and lung pathology. Knowledge gaps include understanding: 1) the extent and mechanisms through which specific exposures result in impaired pulmonary function, small airways disease, and potentially future chronic pulmonary diseases; 2) the contribution of exposure-related foreign material in the lung to clinical and pathologic findings; and 3) the relationship of pathologic findings to respiratory health, especially those involving small airways.

Annals of the American Thoracic Society
Rutgers, The State University of New Jersey (US), United States Army Medical Command (US), University of North Carolina at Chapel Hill (US), University of Maryland, Baltimore (US), Brigham and Women's Hospital (US), Ministry of the Environment, Conservation and Parks (CA), Office of the Secretary of Defense (US), Michael E. DeBakey VA Medical Center (US), United States Department of the Army (US), University of Massachusetts Lowell (US), Harvard University (US), University of California, San Francisco (US), University of Toronto (CA), Örebro University (SE), Brown University (US), University of Michigan (US), VA Boston Healthcare System (US), National Jewish Health (US), University of Alabama at Birmingham (US), Yale University (US), VA New Jersey Health Care System (US), VA Puget Sound Health Care System (US), VA Ann Arbor Healthcare System (US), Office of the Assistant Secretary for Health (US), Michigan Medicine (US), U.S. Army Center for Health Promotion and Preventive Medicine (US), Joint Research Center (BE), Mental Illness Research, Education and Clinical Centers (US), Health Affairs (US), San Francisco VA Health Care System (US), Rocky Mountain MS Center (US), Vanderbilt University Medical Center (US), University of Colorado Denver (US)
Good health and well-being
Openalex Percentile: Top 6%
Fibromyalgia and Chronic Fatigue Syndrome Research
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