Effects of Deployment Exposures on Cardiopulmonary and Autonomic Function
| Status: | Completed |
|---|---|
| Conditions: | Women's Studies |
| Therapuetic Areas: | Reproductive |
| Healthy: | No |
| Age Range: | 18 - 55 |
| Updated: | 4/21/2016 |
| Start Date: | November 2013 |
| End Date: | December 2015 |
Following deployment to Operations Enduring and Iraqi Freedom and Operation New Dawn
(OEF/OIF/OND), Veterans report breathing problems, difficulty exercising and other symptoms.
These symptoms may be related to deployment exposures, such as regional dust and sand, smoke
from burning trash, and local industry. Studies have reported poor air quality, but very
little is known about the effect that exposure to this polluted air may have on Veterans'
short- and long-term health. Investigators will determine whether deployment-related
exposures have affected respiratory and nervous system function in these Veterans - data
that may then be used to guide rehabilitation. Ultimately, the investigators' long-term goal
is to prevent the development of chronic respiratory conditions in this group of OEF/OIF/OND
Veterans.
(OEF/OIF/OND), Veterans report breathing problems, difficulty exercising and other symptoms.
These symptoms may be related to deployment exposures, such as regional dust and sand, smoke
from burning trash, and local industry. Studies have reported poor air quality, but very
little is known about the effect that exposure to this polluted air may have on Veterans'
short- and long-term health. Investigators will determine whether deployment-related
exposures have affected respiratory and nervous system function in these Veterans - data
that may then be used to guide rehabilitation. Ultimately, the investigators' long-term goal
is to prevent the development of chronic respiratory conditions in this group of OEF/OIF/OND
Veterans.
Evidence is clear that Veterans deployed to Operations Enduring and Iraqi Freedom and
Operation New Dawn (OEF/OIF/OND) have been exposed to high levels of particulate matter (PM)
that exceeded environmental, occupational and military exposure guidelines. PM exposure is
acknowledged as a risk factor for cardiovascular morbidity and mortality, and can increase
the risk of and exacerbate airway disease. The reviewed epidemiology indicates a high
prevalence of newly reported respiratory symptoms in OEF/OIF/OND Veterans that has
significantly affected their deployment duties, including their physical exertion
capability. Despite these retrospective data and limited air sampling reports, prospective
studies are lacking. This pilot study will evaluate cardiorespiratory and autonomic function
in OEF/OIF/OND Veterans as compared to Veterans never deployed to the region.
To evaluate cardiopulmonary function, each Veteran will undergo a standardized exercise
challenge and bronchodilator spirometry. To evaluate autonomic nervous system function,
investigators will examine indices of heart rate variability and cardiovascular reflex
regulation (e.g. baroreflex sensitivity and cerebral autoregulation) during a variety of
tasks.
Data derived from this pilot project will yield important insight on the extent and severity
of cardiorespiratory and/or autonomic impairments - data that may provide intervention
points for attenuating long-term adverse outcomes such as pulmonary and cardiovascular
disease. Through early identification, treatment options (e.g. exercise therapy,
pharmaceutical) may be implemented to enhance physiological function, with the goal of
helping to alleviate symptoms and reduce chronic disease risk.
Operation New Dawn (OEF/OIF/OND) have been exposed to high levels of particulate matter (PM)
that exceeded environmental, occupational and military exposure guidelines. PM exposure is
acknowledged as a risk factor for cardiovascular morbidity and mortality, and can increase
the risk of and exacerbate airway disease. The reviewed epidemiology indicates a high
prevalence of newly reported respiratory symptoms in OEF/OIF/OND Veterans that has
significantly affected their deployment duties, including their physical exertion
capability. Despite these retrospective data and limited air sampling reports, prospective
studies are lacking. This pilot study will evaluate cardiorespiratory and autonomic function
in OEF/OIF/OND Veterans as compared to Veterans never deployed to the region.
To evaluate cardiopulmonary function, each Veteran will undergo a standardized exercise
challenge and bronchodilator spirometry. To evaluate autonomic nervous system function,
investigators will examine indices of heart rate variability and cardiovascular reflex
regulation (e.g. baroreflex sensitivity and cerebral autoregulation) during a variety of
tasks.
Data derived from this pilot project will yield important insight on the extent and severity
of cardiorespiratory and/or autonomic impairments - data that may provide intervention
points for attenuating long-term adverse outcomes such as pulmonary and cardiovascular
disease. Through early identification, treatment options (e.g. exercise therapy,
pharmaceutical) may be implemented to enhance physiological function, with the goal of
helping to alleviate symptoms and reduce chronic disease risk.
Inclusion Criteria:
- Male and female Veterans between 18 - 55 years of age will be identified and screened
for this study.
- Two study cohorts will be recruited and attempts will be made to match group
composition on age, body mass index and smoking history.
- Veterans assigned to the Exposed group must have been deployed to OEF/OIF for a
minimum of 90 consecutive days.
- The Control group will consist of Veterans never deployed to Southwest Asia (i.e.
OEF/OIF, Persian Gulf War) but were deployed during the same time period.
- Each Veteran will complete a detailed exposure history questionnaire to confirm and
support their group assignment.
Exclusion Criteria:
Participants must not meet any of the contraindications to exercise testing as described
in the joint statement from the American College of Cardiology and American Heart
Association. Also, individuals with history of any of the following will also be excluded:
- asthma (pre-military)
- cardiovascular disease
- neurological impairment/disorder
- pregnant
- uncontrollable hypertension (SBP > 160; DBP > 100)
- or have suffered severe/moderate traumatic brain injury within the last three years
- eye/chest/abdominal surgery in last 3 months
- tuberculosis exposure to self or household member
- history of aneurysm or collapsed lung
- history of detached retina
- stroke or heart attack in the last 3 months
- and history of coughing up blood in last three months
(With the exception of hypertension and pregnancy (urine test), all exclusion criteria
will be determined via self-report)
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East Orange, New Jersey 07018
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