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Am J Epidemiol. 2018 Oct 1;187(10):2136-2144. doi: 10.1093/aje/kwy112.

New-Onset Asthma and Combat Deployment: Findings From the Millennium Cohort Study.

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The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.
Seattle Epidemiologic Research and Information Center, Veterans Affairs Puget Sound Health Care System, Seattle, Washington.
Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington.
Division of Allergy and Immunology, Department of Internal Medicine, Naval Medical Center San Diego, San Diego, California.
Deployment Health Research Department, Naval Health Research Center, San Diego, California.


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.

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