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Experience with emerging lung diseases from the National Institute for Occupational Safety and Health

Public Domain


Details

  • Personal Author:
    Kreiss, Kathleen
  • Description:
    The reason to better understand exposures associated with health outcomes is to intervene, both to prevent US service members from having exposures and to improve prognosis of those who have developed health conditions in relation to exposure. The role of surveillance is the repeated assessment of health outcomes in a population to assess trends, and there is no reason to repeatedly assess health outcomes unless interventions are undertaken. Surveillance is not a substitute for understanding military respiratory hazards with targeted hypothesis-driven research. Longitudinal surveillance is premature when unexpected health outcomes occur. Such health outcomes need to be acknowledged as unknowns and restated as hypotheses about plausible causes to facilitate research regarding causes and interventions. Targeted epidemiological research studies should test hypotheses about plausible causes of specific health outcomes. Past exposures that were not measured cannot be known, and this is particularly true of the uncharacterized gases that may have caused constrictive bronchiolitis, the bioaerosols in damp indoor spaces that may induce asthma, or the various occupational exposures that will eventually lead to COPD. Indices of exposure can be as simple as deployment in specific locations and dates or information about participation in exposure-generating processes gathered by questionnaires. For constrictive bronchiolitis arising in an indolent way, report of severity of exposures may not be helpful at all because respiratory epithelial toxins may not induce irritant symptoms, even in those with spirometric abnormality. For incident asthma, however, symptoms would have arisen during pertinent exposures in deployment. Prevention of respiratory diseases in service members requires research efforts to assess causality and to evaluate the effectiveness of interventions so that fighting strength can be preserved. These efforts should take precedence over determination of compensation eligibility for service-related health outcomes. In clinical occupational medicine practice, a high level of evidence about proof of cause in the workers' compensation system is needed. The military cannot afford to risk the health of its troops, even if causal associations have not yet been demonstrated. The occurrence of pathological and objective disease requires attempts at intervention. [Description provided by NIOSH]
  • Subjects:
  • Keywords:
  • ISBN:
    9780160927621
  • Publisher:
    Office of The Surgeon General, United States Army
  • Document Type:
    Text
  • Genre:
    Book
  • Place as Subject:
  • CIO:
    National Institute for Occupational Safety and Health (NIOSH)
  • Division:
    DRDS - Division of Respiratory Disease Studies
  • Topic:
    Workplace Safety & Health
  • Location:
    North America
  • Pages in Document:
    183-200
  • NIOSHTIC Number:
    nn:20046233
  • Citation:
    Airborne hazards related to deployment. Baird CP, Harkins DK, eds. Fort Sam Houston, TX: Borden Institute, US Army Medical Department Center and School; Falls Church, VA: Office of The Surgeon General, United States Army, 2015 Apr; :183-200
  • Contact Point Address:
    Kathleen Kreiss, Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Mailstop H-2800, 1095 Willowdale Road, Morgantown, West Virginia 26505
  • Editor(s):
    Baird CP; Harkins DK
  • Federal Fiscal Year:
    2015
  • Peer Reviewed:
    False
  • Source Full Name:
    Airborne hazards related to deployment
  • Collection(s):
  • Main Document Checksum:
    urn:sha-512:b3bb90a007565b65d7c3b8ad4778b2b0145c85c5231faa570b6f4f7914dbfabf29382b0905bb3700a8f1fed044bff4d36b93e32e4c6fb4fde90b9088ad635ac4
  • Download URL:
  • File Type:
    Filetype[PDF - 688.80 KB ]
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