Introduction: The aim of this paper was to study whether Swedish soldiers who have served abroad had a higher prevalence of respiratory symptoms than the general population and, if this was the case, also to study whether this was associated with time spent in a desert environment.

Methods: The prevalence of respiratory symptoms among 1,080 veterans from Kosovo and Afghanistan was compared with that in almost 27,000 subjects from a general population sample, using propensity score matching and logistic regression.

Results: The prevalence of wheeze (16.3 vs. 12.3%), wheeze without a cold (11.1 vs. 8.0%), nocturnal coughing (26.6 vs. 20.1%) and chronic bronchitis (12.3 vs. 6.8%) was significantly higher among soldiers than controls (p < 0.05). A dose-response-related association was found between time spent in a desert environment and wheeze, wheeze with breathlessness and wheeze when not having a cold. Having been exposed to desert storms was related to nocturnal cough and chronic bronchitis.

Conclusion: Swedish soldiers who had served abroad had a higher prevalence of wheeze and cough than a control group from the general population. The association between being exposed to a desert environment and respiratory symptoms indicates that further protective measures should be introduced for military personnel serving in a desert environment.

BACKGROUND: Inhalation of small particulate matter (PM 2.5) may be associated with development of respiratory disease. Increased respiratory symptoms have been reported among military staff after service in countries with recurrent desert storms.

OBJECTIVE: The aim was to investigate whether an assignment in a desert environment and exposure to desert storms are associated with negative effects on respiratory health.

METHODS: In two cohorts of Swedish soldiers serving in Mali as part of the United Nations stabilization forces, examination with spirometry, determination of fraction of exhaled nitric oxide (FeNO), and a questionnaire including participant characteristics, symptoms, and exposure was performed before and after service. Ambient air sampling was conducted on-site. Paired t-test was used to compare pre- and post-variables on lung function data, FeNO and symptom level.

RESULTS: Most indoor and outdoor air measurements of dust and silica were within the Swedish occupational exposure limit for PM2.5 and silica (<0.10-2.7 mg/m³ and <0.002-0.40 mg/m³, respectively) as well as for respirable dust and silica (0.056-0.078 mg/m³and 0.0033-0.025 mg/m³, respectively). In the subgroup of participants with reported exposure to desert storms during the stay in Mali, forced expiratory volume in 1 s (FEV₁) was significantly lower after exposure than before the mission (mean litres (SD) 4.21 ± 0.66 vs 4.33 ± 0.72, p = 0.021).

CONCLUSION: Exposure to a desert storm was associated with a decrease in FEV₁. Exposure to small particulate matter may contribute to the development of respiratory disease and thus spirometry should be performed after occupational exposure to desert storms.

OBJECTIVE: Dust exposure is high in several industries. We investigated associations of exposure in paper mills, wood pellet plants and iron foundries with lung function impairment.

METHODS: Respirable silica, inhalable paper dust or inhalable wood dust were collected in personal samples and spirometry was performed. Multiple linear regression analyzed associations with FEV1%pred and FVC%pred.

RESULTS: Wood pellet workers with high exposure to inhalable dust had lower FEV1%pred (95%CI) (-9.4(-16,-2.6)) and FVC%pred (-9.8(-15,-4.0)) compared with lowest exposure level. Workers at paper mills and foundries had no dose-dependent association but lower FEV1%pred and FVC%pred than in workers at wood pellets plants.

CONCLUSIONS: Increased exposure to inhalable wood dust is associated with decreased lung function. Foundry and paper mill workers have generally lower lung function than wood pellet workers. Spirometry should be considered in workers in industries with airborne particulate matter pollution.