Service and Health Among Deployed Veterans

Study Overview
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Brief Summary
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The purpose of the study is to better understand the health, including lung health, of Veterans who deployed in support of Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), or Operation New Dawn (OND) and other deployments following these Operations.

Detailed Description
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The aim of the study is to characterize the impact of deployment-related pollution exposures during the Post-9/11 Gulf War Era on current respiratory health using objectively ascertained and standardized physiologic and epidemiologic measures. The primary objective in support of this aim is to assess the association of cumulative exposure to PM2.5 during deployments to the U.S. bases and other locations in Central Asia (Afghanistan and Kyrgyzstan), Southwest Asia (Iraq, Kuwait, Qatar, and United Arab Emirates) and Africa (Djibouti) with current measures of pulmonary function. Secondary objectives in support of the aim will examine the association of cumulative exposure to PM2.5 during deployments with the clinical outcome of medically-treated asthma. The investigators will also explore the impact of deployment duration on both pulmonary function and asthma. This study will execute 4 distinct efforts to meet the study objectives: (1) enroll a study cohort of up to 6,200 Veterans who live within the catchment area of 6 VA recruitment sites, conduct an in-person assessment of pulmonary function, and collect data on key covariates; (2) create a spatial-temporal exposure grid of environmental PM2.5 levels averaged per week per 1 square kilometer at locations where military personnel served; (3) link each individual's location and duration (spatial-temporal) history during deployed and non-deployed times with averaged PM exposures during each of these time periods; and (4) conduct association analyses to test hypotheses of deployment-related cumulative PM2.5 exposure and current respiratory health by combining exposure data with data collected from the cohort members and from their military records.

Official Title
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CSP #595 - Pulmonary Health and Deployment to Southwest Asia and Afghanistan

Conditions
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Pulmonary Function

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Served during the Post-9/11 Gulf War Era in a service branch that had land-based deployments (Air Force, Army, and Marine Corps) Deployed to Afghanistan, Kyrgyzstan, Iraq, Kuwait, Qatar, United Arab Emirates, or Djibouti after October 1, 2001 Exclusion Criteria: Active duty at the time of recruitment Impaired decision making capacity No English language proficiency Prisoners
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Post-9/11 Gulf War Era Veterans<br>Military personnel who deployed to Central Asia, Southwest Asia, and Africa during the Post-9/11 Gulf War Era | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Current forced expiratory volume in 1 second (FEV1) | An assessment of pulmonary function obtained through spirometry | Outcome measured at time of in-person study visit (Day 1) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Current forced vital capacity (FVC) | An assessment of pulmonary function obtained through spirometry | Outcome measured at time of in-person study visit (Day 1) | 
| Current FEV1/FVC ratio | An assessment of pulmonary function obtained through spirometry | Outcome measured at time of in-person study visit (Day 1) | 
| Pharmaceutically-treated asthma | Based on medication inventory, the investigators will classify medically-treated asthma therapy into mild, moderate, and severe based on the intensity of asthma therapy as suggested by the Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2015. | Outcome measured at time of in-person study visit (Day 1) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pulmonary, Lung, Military and environmental exposures, Epidemiologic, Observational, Interview or questionnaire, Deployment related, Enduring Freedom, Iraqi Freedom