Airway Hyperreactivity in Asymptomatic Military Personnel

Abstract

Asymptomatic airway obstruction has a prevalence of 14% in young military personnel. A significant percentage of individuals also have evidence of worsening obstruction during exercise. These data suggest that screening spirometry may identify early reactive airway disease in asymptomatic individuals and should be considered as a method to identify persons predisposed to developing symptomatic asthma.

Study of Active Duty Military for Pulmonary Disease Related to Environmental Deployment Exposures (STAMPEDE)

“…While asthma may be a disqualifying diagnosis, some asthma patients are given a medical waiver to enter military service, while other asthmatics are retained. Data obtained from new Army recruits identified 14% with asymptomatic AHR based on spirometric findings and exercise testing 30 . Several deployment studies have noted asthma to be a common finding.…”

Airway obstruction in competitive swimmers

“…This may be explained by the phenomenon of "Poor perceivers" of asthma, which has been introduced in previous studies [26][27][28][29]. Some athletes may not recognise the symptoms of airways obstruction, because the changes in pulmonary function in pulmonary disease develop slowly.…”

Military Service and Lung Disease

“…46,47 Furthermore, screening spirometry is not advocated for any asymptomatic population except on a longitudinal basis in certain occupations with direct exposure, which are potentially high risk for lung disease. The routine use of spirometry has many limitations to include overdiagnosis, misinterpretation, technically inadequate studies, and in the case of military personnel-adverse career implications.…”