Army researchers are looking for Iraq and Afghanistan veterans with breathing difficulties such as shortness of breath or wheezing to study how deployments may affect lung health.
With some combat veterans returning from war with respiratory ailments such as asthma, hyperactive airways and, in some cases, constrictive bronchiolitis — a rare disease involving scarring and inflammation of the smallest airways — Army physicians are starting the third phase of a long-term study into deployment-related pulmonary health.
The Study of Active Duty Military for Pulmonary Disease Related to Environmental Deployment Exposures, or STAMPEDE, seeks to determine what lung diseases may be associated with overseas military operations, said retired Army Col. Michael Morris, a pulmonologist at San Antonio Military Medical Center, Texas.
"There are complicated diagnoses out there," Morris said. "We want to be able to explain to a general medical public the difference between the average citizen and the military population who may have different exposures."
Previous studies done under STAMPEDE include an analysis of the health of 400 soldiers with career-limiting asthma to see whether the incidence of the disease was higher in those who deployed than those who didn't (it wasn't), and a study of 50 service members to evaluate respiratory symptoms after they deployed.
In that research, published last July in the American Journal of Respiratory and Critical Care Medicine, 40 percent of patients showed some evidence of reactive airways after deployment, including eight diagnosed with asthma and two with respiratory issues related to acid reflux.
Six service members also were found to have miscellaneous airway disorders and four other troops displayed diminished capacity to transfer inhaled oxygen into their bloodstreams.
The new STAMPEDE study will be similar to the one with the 50 troops. Morris and his team are seeking active-duty or retired personnel who deployed to a combat zone and developed respiratory symptoms during or shortly after deployment and still have symptoms.
Participants will be required to spend a week in San Antonio or at Walter Reed National Military Medical Center in Bethesda, Maryland.
They also must be able to exercise on a treadmill and have no history of pre-existing lung conditions before deploying, according to Morris.
As part of the research, participants will undergo blood work and chest imaging, electrocardiograms, breathing tests, exercise tests, a vocal cord exam and bronchoscopy.
Morris emphasized that participants also must be eligible for Tricare. While he is in talks with the Veterans Affairs Department's War-Related Injury and Illness Study Center and the South Texas VA Medical Center to offer the study to veterans, he said those discussions are preliminary.
Some veterans of Iraq and Afghanistan have developed debilitating respiratory illnesses after serving in the region. Many blame the military's use of open-air burn pits to dispose of trash in theater, saying the smoke produced by the fires sickened them.
Other studies have shown that particulate matter in the air — fine granules of microscopic dust and sand — may have damaged airways while several veterans who were exposed to a sulfur fire in Mosul, Iraq, in 2003, developed chronic disease.
A study by experts at Vanderbilt University diagnosed 38 soldiers from Fort Campbell, Kentucky, with constrictive bronchiolitis.
But Morris said more research is needed to determine the extent of that diagnosis in service members and explore other possibilities.
"The study from Vanderbilt was biased in favor of one disease, making other people think they have that disease, but it's more complicated than that," Morris said.
Service members or retirees wanting to participate can call the STAMPEDE staff at San Antonio Military Medical Center at 210-916-3976 and at Walter Reed at 301-295-4191.
They also can be reached by email via email@example.com.
Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.