Individuals who served in Iraq or Afghanistan had significantly higher rates of new-onset respiratory diseases after deployment compared to non-deployed control peers, based on data from more than 48,000 veterans. The findings were presented at the American College of Allergy, Asthma, and Immunology (ACAAI) 2025 Annual Meeting.

“Veterans deployed to Iraq and Afghanistan were often exposed to airborne hazards such as burn pits and dust storms,” said Patrick Gleeson, MD, an allergist at the University of Pennsylvania Perelman School of Medicine, Philadelphia, in a press release. 

“We found that these exposures may have long-term health impacts, particularly for respiratory diseases that can affect quality of life for years after service,” said Gleeson, who presented the results at the meeting.

Gleeson and colleagues used data from the Veterans Affairs Corporate Data Warehouse and Observational Medical Outcomes Partnership to identify veterans with a single deployment as part of Operation Iraqi Freedom or Operation Enduring Freedom. Participants had at least one outpatient visit prior to deployment with no baseline history of asthma, chronic rhinitis, chronic rhinosinusitis, or nasal polyposis. The mean age of the participants at deployment was 26.7 years, 84% were male, 75% were White, and 11% were Hispanic or Latino. Each was matched with a similar non-deployed veteran control.

The primary outcome was outpatient diagnoses or problem list entries for asthma, chronic rhinitis, chronic rhinosinusitis, or nasal polyposis.

Compared to non-deployed peers, deployed veterans had a 55% increased risk of asthma, a 48% increased risk of nasal polyposis, a 41% increased risk of chronic rhinitis, and a 27% increased risk of chronic rhinosinusitis, based on Cox proportional hazards models (P < .0005 for all).

The findings were limited by the retrospective design. However, “Recognizing the link between deployment and respiratory disease can help guide medical support, policy, and preventive strategies for those affected,” Gleeson said in the press release. 

Study Findings Support Soldiers’ Safety

The current study is important because of the known impact of pollutants and toxins that impact not only lung health, but whole-body health, said Eric Balaban, MD, a pulmonary and critical care fellow at the Temple Lung Center, Philadelphia, in an interview. When deploying military personnel, it is essential to evaluate the air quality risks that come with certain settings, said Balaban, who was not involved in the study. “The better we understand the risks, the better we can control them, so we can protect and sustain our service members,” he said.

The study findings were not unexpected, but the degree of risk was interesting, and informative, said Balaban. “It is not hard to imagine that between vehicle exhaust, sand storms, and dirt that the air quality profile in this study had a negative effect on soldiers’ health,” he said. “These were not negligible increases in risk, and these are conditions that can range from inconveniencing to life-threatening,” he added.

The study results have takeaways for two groups of healthcare providers, Balaban told Medscape Medical News. For health professionals actively serving in the military, the data can raise awareness of risk profiles, so they can design protocols to reduce pulmonary harm to deployed soldiers and strive to conduct operations in ways that keep them as safe as possible, he said. In the civilian clinical setting, the study findings may inform pulmonology screening and preventive care for veterans with a history of deployment to areas where air quality is a significant risk factor, Balaban noted.

Limitations and Next Steps

A key limitation of the current study was the inability to control for some confounding variables, such as rates of smoking, given the high percentage of soldiers who smoke, especially those in their 20s, Balaban told Medscape Medical News. Another important confounding factor is the need to tease out the exact nature of the pulmonary insult, he said. “It is obvious that the airway was probably affected by the environment in the deployment setting," he said. However, identifying whether the main contributing factor was ozone, small particulates, or heavy metals in particulate matter will inform how soldiers can be protected, whether by training differently, using a certain type or grade of mask, or rotating shifts to reduce exposure, he added.

The study received no outside funding. The researchers disclosed no financial conflicts of interest.