@article{81d8be64ada7436daa492509f76c17ee,
title = "New-Onset Asthma and Combat Deployment: Findings from the Millennium Cohort Study",
abstract = "Recent reports suggest US military service members who deployed in support of the recent conflicts in Iraq and Afghanistan have higher rates of new-onset asthma than those who did not deploy. However, it is unknown whether combat experiences, in addition to deployment, contribute to new-onset asthma risk. This study aimed to longitudinally determine the risk factors for developing asthma, including combat deployment (categorized as deployed with combat experience, deployed without combat experience, or nondeployed), among participants in the Millennium Cohort Study from 2001 to 2013. A total of 75,770 participants completed a baseline survey and at least 1 triennial follow-up survey on deployment experiences, lifestyle characteristics, and health outcomes. Complementary log-log models stratified by sex were used to estimate the relative risk of developing asthma among participants who reported no history of asthma at baseline. In models with adjustments, those who deployed with combat experience were 24%-30% more likely to develop asthma than those who did not deploy. Deployed personnel without combat experience were not at a higher risk for new-onset asthma compared with nondeployers. Further research is needed to identify specific features of combat that are associated with greater asthma risk to inform prevention strategies.",
keywords = "asthma, combat disorders, longitudinal studies, military personnel, occupational exposure, respiratory system, veterans",
author = "Rivera, {Anna C.} and Powell, {Teresa M.} and Boyko, {Edward J.} and Lee, {Rachel U.} and Faix, {Dennis J.} and Luxton, {David D.} and Rull, {Rudolph P.}",
note = "Funding Information: Author affiliations: The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland (Anna C. Rivera, Teresa M. Powell); Seattle Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington (Edward J. Boyko); Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington (Edward J. Boyko); Division of Allergy and Immunology, Department of Internal Medicine, Naval Medical Center San Diego, San Diego, California (Rachel U. Lee); and Deployment Health Research Department, Naval Health Research Center, San Diego, California (Dennis J. Faix, David D. Luxton, Rudy P. Rull). This work was supported by the Military Operational Medicine Research Program (work unit 60002). We thank the Millennium Cohort Study participants. In addition to the authors, the Millennium Cohort Study Team includes Dr. Richard Armenta; Lauren Bauer, MPH; Dr. Deborah Bookwalter; Satbir Boparai, MBA; Ania Bukowinski, MPH; Carlos Carballo, MS; Dr. Adam Cooper; James Davies; Alex Esquivel, MPH; Dr. Susan Farrish; Toni Rose Geronimo, MPH; Gia Gumbs, MPH; Isabel Jacobson, MPH; Dr. Zeina Khodr; Claire Kolaja, MPH; Cynthia LeardMann, MPH; William Lee; Gordon Lynch; Chris Lo; Denise Lovec-Jenkins; Dr. Rayna Matsuno; Dr. Chiping Nieh; Anet Petrosyan; Dr. Jacqueline Pflieger; Dr. Chris Phillips; Dr. Ben Porter; Dr. Sabrina Richardson; Kimberly Roenfeldt, MAS; Beverly Sheppard; Steven Speigle; Dr. Valerie Stander; Evelyn Sun, MPH; Dr. Daniel Trone; Daniel Vaughan; Jennifer Walstrom; Steven Warner, MPH; Dr. Marleen Welsh; and Kelly Woodall, MPH, from the Deployment Health Research Department, Naval Health Research Center, San Diego, California. We appreciate the support from the Management Information Division, US Defense Manpower Data Center, Seaside, California, and the Military Operational Medicine Research Program, US Army Medical Research and Materiel Command, Fort Detrick, Maryland. A portion of this work was presented at the American Public Health Association Annual Meeting and Expo, October 29 to November 2, 2016, Denver, Colorado; at the Military Health System Research Symposium, August 27–30 2017, Kissimmee, Florida; at the American Academy of Allergy Asthma and Immunology/World Allergy Organization Joint Congress, March 2–5, 2018, Orlando, Florida; and at the Navy and Marine Corps Public Health Conference, March 20–22, 2018, Norfolk, Virginia. I am a military service member (or employee of the US Government). This work was prepared as part of my official duties. Title 17, U.S.C. §105 provides the “Copyright protection under this title is not available for any work of the United States Government.” Title 17, U.S.C. §101 defines a US Government work as work prepared by a military service member or employee of the US Government as part of that person{\textquoteright}sofficial duties. Report No. 18-38 was supported by the Military Operational Medicine Research Program under work unit no. 60002. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of the Army, Department of the Air Force, Department of Veterans Affairs, Department of Defense, or the US Government. Approved for public release; distribution unlimited. Human subjects participated in this study after giving their free and informed consent. This research has been conducted in compliance with all applicable federal regulations governing the protection of human subjects in research (Protocol NHRC.2000.0007). Conflict of interest: none declared. Publisher Copyright: {\textcopyright} The Author(s) 2018. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.",
year = "2018",
month = oct,
day = "1",
doi = "10.1093/aje/kwy112",
language = "English",
volume = "187",
pages = "2136--2144",
journal = "American Journal of Epidemiology",
issn = "0002-9262",
number = "10",
}