Self-Reports of Constrictive Bronchiolitis Among Service Members Participating in the Veterans Administration and Department of Defense Airborne Hazards and Open Burn Pit Registry

SESSION TITLE: Environmental and Occupational Health SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, November 1, 2017 at 01:30 PM - 02:30 PM PURPOSE: Constructive bronchiolitis (CB) is a bronchiolar airway disease of particular concern among military service members post deployment. The identification and proper diagnosis is important both in terms of treatment and understanding the actual disease burden in this population. We hypothesize that service members with self-reported diagnosis of CB will have unique identifiable risk factors when compared to those reporting no diagnosis of CB. METHODS: The Veterans Administration and Department of Defense (VA/DoD) established the Airborne Hazards and Open Burn Pit Registry (AHOBPR) in June 2014 as a voluntary, online survey for military personnel deployed to the Persian Gulf, Afghanistan, and Djibouti after July 1990. As of July 31, 2015, 42,558 individuals who were deployed to Iraq, Afghanistan or the surrounding regions after October 7, 2001, completed the online questionnaire and were included in this analysis. In this nested case control study, we assessed risk factors among service members with and without a self-reported diagnosis of CB, matching by age (+/- 1 year) and sex (male/female). There was a 1:2 match for controls by age and sex. A participant was deemed a case if they responded “yes” to the item, “Have you ever been told by a doctor or other health care professional that you had constrictive bronchiolitis (CB)?”. Controls responded “no” to that item. We characterized cases and controls by military service, exposure, and health condition variables from the survey and used logistic regression models to identify independent associations between these variables (p<0.10 in bivariate analysis) and case status. RESULTS: Overall there are 433 AHOBPR participants who self-reported CB on the registry survey. A majority of the participants reporting CB were male (393 (90.1%)), overweight (BMI 25.0-29.9 kg/m2) (197 (45.2%)), and never smoked (264 (60.6%)). Among cases there is a greater self-report of additional respiratory disease diagnoses than controls: Chronic Bronchitis (61.5% vs. 19.3%), COPD (24.1% vs. 0.2%), and Asthma (47.0% vs. 12.2%). Fewer cases reported current smoking (9.4%) or past smoking (25.5%) compared to controls (current smoking 11.6%, past smoking 29.7%). Quartile of cumulative hours of burn pit smoke exposure was higher among cases compared to controls (highest quartile in cases 25.1%, in controls 11.4%). Logistic regression showed associations between reporting diagnosis of CB and Burn Pit Smoke Exposure (Decile 1 [OR 0.4 (CI 0.2-0.7)] to Decile 4 [OR 1.8 (CI 0.9-3.3)]), dyspnea or decreased exercise tolerance (OR 2.9 (CI 1.9-4.5)), self-reported diagnosis of Asthma (OR 2.3 (CI1.5-3.6)), Chronic Bronchitis (OR 4.3 (CI 2.9-6.3), Emphysema (OR 17.0 (CI 3.2-89.2), and COPD (OR 57.8 (CI 12.7-262.9)). CONCLUSIONS: Registry participants who self-reported a diagnosis of CB had a greater prevalence of other self-reported respiratory conditions in comparison to controls, which may reflect uncertainty or confusion about diagnosed conditions. CLINICAL IMPLICATIONS: When evaulating a patient with a diagnosis of CB consider other diagnoses as well to ensure a complete and accurate assessment. DISCLOSURE: The following authors have nothing to disclose: Nisha Jani, Michael Falvo, Anays Sotolongo, Omowunmi Osinubi, Chin-Lin Tseng, Mazhgan Rowneki, Michael Montopoli, Sybil Morley, Vincent Mitchell, Drew Helmer No Product/Research Disclosure Information