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ABOUT RESPIRATORY HEALTH

• Two specific types of respiratory

diseases that can restrict breathing are 

asthma and chronic obstructive pulmonary disease (COPD). 

• Asthma is a chronic inflammatory disorder

of the airways characterized by episodes 

of breathing problems. While it cannot be 

cured, its symptoms can be controlled.

• COPD is characterized by airflow limitation.

The limitation is usually progressive and is 

associated with an abnormal inflammatory 

response of the lungs to noxious particles or 

gases, such as those in cigarette smoke.

• The term COPD includes two main

conditions: emphysema (in which the 

air sacs of the lung are damaged and 

enlarged), and chronic bronchitis (a 

long-lasting cough caused by chronic 

inflammation of the bronchi). Most people 

with COPD have both conditions.

• Veterans may suffer from other

respiratory problems due to exposure 

to respiratory hazards such as infectious 

agents and other environmental 

exposures. Examples of respiratory 

diseases that may be caused by infectious 

agents are tuberculosis, lung cancer, and 

pneumonia. Environmental hazards found 

in war theaters, such as Agent Orange, 

may put Veterans at additional risk of 

respiratory problems.

• Veterans who develop respiratory cancer

(cancer of the lung, bronchus, larynx, 

or trachea) and were exposed to Agent 

Orange or other herbicides during military 

service do not have to prove a connection 

between their disease and their service to 

be eligible to receive VA health care and 

disability compensation.

VA RESEARCH ON RESPIRATORY 

HEALTH: OVERVIEW

• VA researchers are advancing the

understanding, prevention, and treatment 

of numerous respiratory illnesses, ranging 

from the common cold and pneumonia 

to major public health threats such as 

tuberculosis and lung cancer. 

• VA’s Office of Public Health (OPH) works

with all levels of government to prepare for 

possible pandemic influenza (flu) outbreaks.

• Respiratory problems are the leading

cause of death in Veterans and others who 

have spinal cord injury (SCI). VA’s Center of 

Excellence on the Medical Consequences of 

Spinal Cord Injury (SCI), located in the Bronx, 

N.Y., is studying ways to treat complications 

of SCI, including breathing difficulties.

SELECTED MILESTONES AND 

MA JOR EVENTS 

1946 – Developed and tested effective 

therapies for tuberculosis through 

multicenter clinical trials that led to the 

development of the VA Cooperative 

Studies Program

1950 – Concluded there is “strong 

circumstantial evidence” linking cigarette 

smoking with respiratory tract cancers

2013 – Found that sleep apnea and 

poor sleep quality predicted diabetes, 

independent of other diabetes risk factors 

or mental health status.

2014 – Learned that treatment for 

pneumonia that included the antibiotic 

azithromycin (Zithromax) was associated 

with a significantly lower risk of death and 

a slightly increased risk of heart attack

2016 – Developed a blood test to determine 

the causes of upper respiratory illness, to help 

ensure antibiotics are used appropriately 

RECENT STUDIES: SELECTED 

HIGHLIGHTS

• COPD is a progressive disease that

makes it hard to breathe. Patients with 

COPD have a variety of bacterial pathogens 

in their lungs. Researchers at the VA 

Western New York Healthcare System and 

the University of Buffalo demonstrated 

that COPD patients experience significant 

respiratory symptoms when their lungs 

are colonized by bacteria, even when they 

are not having acute respiratory problems. 

VA research on 

RESPIRATORY HEALTH

According to the U.S. Environmental Protection Agency, 

most people take between 17,000 to 23,000 breaths a day. 

For the healthy, this is simple. But for millions of people with 

respiratory problems, breathing is not easy.

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VA researchers are advancing the understanding, prevention, 

and treatment of numerous respiratory illnesses, ranging 

from the common cold and pneumonia to major public 

health threats such as tuberculosis and lung cancer. 

Treating bacterial infections should 

therefore help improve their quality 

of life. (Annals of the American Thoracic 

Society, March 2014)

• Smoking marijuana is not as bad as 

smoking cigarettes when it comes 

to lung disease, researchers with the 

Central Arkansas Veterans Healthcare 

System in Little Rock and the University 

of Arkansas have found. The team found 

a clear linkage between marijuana 

use and chronic bronchitis and large 

airway inflammation, conditions that 

make breathing difficult. However, 

they found no links to emphysema, a 

chronic disease in which the air sacs in 

the lungs are gradually damaged, and 

only weak, if any, links to lung cancer. 

The researchers concluded, however, 

that there is unequivocal evidence that 

habitual or regular marijuana use is 

not harmless, and that doctors should 

caution patients about possible lung 

damage from regular heavy marijuana 

use. (Current Opinion in Pulmonary 

Medicine, March 2014)

• Medical imaging techniques often 

used to diagnose lung cancer are 

not as good at detecting that cancer 

in regions where there is endemic 

infectious lung disease, compared 

with regions where such disease is 

not widespread. Positron emission 

tomography (PET) is a medical imaging 

technique that produces 3-D images 

showing differences between healthy 

and diseased tissue. PET commonly 

uses a radioactive tracer called FDG 

(fluorodeoxyglucose), so the test is 

sometimes called an FDG-PET scan. 

They are often used in combination 

with computed tomography (CT) scans. 

In regions where lung diseases like 

histoplasmosis and blastomycosis are 

common, these diseases may sometimes 

be mistaken for cancer on these imaging 

tests. (Journal of the American Medical 

Association, Sept. 24, 2014) 

• An algorithm to help hospitals and 

public health officials determine 

the earliest stages of flu season has 

been developed by researchers with 

VA and other health care institutions 

throughout the nation. The algorithm, 

called the Above Local Elevated 

Respiratory Illness Threshold (ALERT), 

uses routine information, such as the 

number of influenza cases confirmed 

per week in a region, to determine 

where and when the flu needs to be 

combatted. Having this information 

could help public health officials 

preserve resources while combatting 

the virus. (Clinical Infectious Diseases,

Feb. 15, 2015)

• The standard dose of flu vaccine 

works just as well as a higher dose 

version for patients between the ages 

of 65 to 84, according to researchers 

at the Philadelphia VA Medical Center 

and the University of Pennsylvania. 

However, for Veterans 85 and older, 

the higher dose was better in terms of 

avoiding hospitalization for the flu or 

pneumonia. (Clinical Infectious Diseases,

July 15, 2015)

• Lung cancer screening can actually 

lower smokers’ motivation to quit 

smoking, according to investigators 

with the VA Puget Sound Health Care 

System and the University of Seattle. 

The team interviewed smokers who had 

just undergone lung cancer screening. 

Nearly half found some reason to 

believe that just being screened meant 

that they did not need to stop smoking. 

This assumption is false, as is the 

assumption many study participants 

had that lung cancer was the only 

potential lethal effect of smoking. (JAMA 

Internal Medicine, September 2015)

For more information on VA studies 

on on respiratory health and other 

key topics relating to Veterans’ 

health, please visit 

www.research.va.gov/topics

RESPIRATORY HEALTH

Updated September 2016 • For a digital version of this fact sheet with active links to sources, visit www.research.va.gov/topics