Exposures during deployment tied to long-term respiratory harm in veterans

Results of a study presented at the 2025 annual meeting of the American College of Allergy, Asthma & Immunology (ACAAI) show that U.S. service members deployed in Operation Iraqi Freedom or Operation Enduring Freedom (the U.S. military action in Afghanistan) had significantly elevated risks of developing chronic respiratory conditions compared with nondeployed peers.

Researchers analyzed data from more than 48,000 veterans who served in a single deployment and had no prior history of respiratory disease, matching each with a nondeployed veteran of similar age, sex, race and ethnicity who also lacked pre-existing conditions.

The findings, which were published in the Annals of Allergy, Asthma & Immunology in November, showed that in the decade after their deployment that deployed veterans had a 55% higher risk of new-onset asthma, a 41% higher risk of chronic rhinitis, a 27% increased risk of chronic rhinosinusitis and a 48% higher risk of nasal polyposis.

The study’s lead author, allergist Patrick Gleeson, M.D., noted that many deployed veterans were exposed to airborne hazards such as burn pits and dust storms, which may underlie the increased disease burden

“We found that these exposures may have long-term health impacts, particularly for respiratory diseases that can affect quality of life for years after service,” he said.

The median age at deployment was 26.7 years. A large majority (84%) of the deployed veterans were male, and most (75%) were White individuals.

There is a growing body of evidence linking military service, especially in Southwest Asia, to chronic lung disease. The study noted that toxic lung injury, eosinophilic pneumonia, chronic obstructive pulmonary disease (COPD), bronchiolitis and interstitial lung disease have all emerged over the years as possible conditions related to military deployment.

Because symptoms of such disorders are often nonspecific, with symptoms such as cough, shortness of breath and congestion, diagnosis can be challenging, particularly if providers focus only on combat-zone exposures.

In addition to airborne toxins generated by open burn pits, the report highlights numerous environmental exposures that could contribute to long-term respiratory morbidity, including fine particulate matter from desert dust storms, vehicle exhaust, industrial pollution and emissions from military base operations. The researchers noted that deployed service members were often exposed without access to adequate respiratory protection and frequently under strenuous physical conditions that could amplify inhalation risk. The cumulative nature of these exposures, the authors wrote, may help explain why respiratory diseases develop slowly and may not be immediately evident upon return from deployment.

The study also referenced ongoing concerns expressed by veterans’ advocacy groups that respiratory symptoms are frequently dismissed or misattributed to smoking history, allergies or anxiety, which can delay diagnosis and access to specialty care. Many veterans report undergoing years of evaluation before receiving definitive answers, and some struggle to access pulmonary specialists familiar with deployment exposure profiles. As a result, early detection efforts and refined clinical guidelines were identified as critical needs.

The findings support federal initiatives aimed at expanding research funding and strengthening benefits eligibility frameworks for deployment-related lung diseases. The authors of the study called for comprehensive assessments of deployed veterans who present with respiratory complaints, including detailed exposure history, pulmonary function tests, imaging and serologic evaluation for autoimmune disease when appropriate.

Given the long latency and broad spectrum of conditions associated with deployment, the findings underscore the need for long-term medical surveillance and specialized respiratory care for veterans.

“Recognizing the link between deployment and respiratory disease can help guide medical support, policy and preventive strategies for those affected,” Gleeson said.

The study may also influence future research and healthcare policies concerning veterans, particularly those related to environmental and occupational exposures during routine military service, not only during active combat.

For veterans of the Iraq and Afghanistan military operations, especially those exposed to dust storms, burn pits or other airborne hazards, the risk of developing asthma, chronic rhinitis, rhinosinusitis or nasal polyposis appears to be significantly elevated. Gleeson noted better screening, long-term follow-up and tailored care may help mitigate the long-term health consequences of deployment-related exposures.