Service member demographics.

The role that inhaled particulate matter plays in the development of post-deployment lung disease among US service members deployed to Southwest Asia during the Global War on Terrorism has been difficult to define. There is a persistent gap in data addressing the relationship between relatively short-term (months to a few years) exposures to high levels of particulate matter during deployment and the subsequent development of adverse pulmonary outcomes. Surgical lung biopsies from deployed service members and veterans (DSMs) and non-deployed service members and veterans (NDSMs) who develop lung diseases can be analyzed to potentially identify residual deployment-specific particles and develop associations with pulmonary pathological diagnoses. We examined 52 surgical lung biopsies from 25 DSMs and 27 NDSMs using field emission scanning electron microscopy (FE-SEM) with energy dispersive x-ray spectroscopy (EDS) to identify any between-group differences in the number and composition of retained inorganic particles, then compared the particle analysis results with the original histopathologic diagnoses. We recorded a higher number of total particles in biopsies from DSMs than from NDSMs, and this difference was mainly accounted for by geologic clays (illite, kaolinite), feldspars, quartz/silica, and titanium-rich silicate mixtures. Biopsies from DSMs deployed to other Southwest Asia regions (SWA-Other) had higher particle counts than those from DSMs primarily deployed to Iraq or Afghanistan, due mainly to illite. Distinct deployment-specific particles were not identified. Particles did not qualitatively associate with country of deployment. The individual diagnoses of the DSMs and NDSMs were not associated with elevated levels of total particles, metals, cerium oxide, or titanium dioxide particles. These results support the examination of particle-related lung disease in DSMs in the context of comparison groups, such as NDSMs, to assist in determining the strength of associations between specific pulmonary pathology diagnoses and deployment-specific inorganic particulate matter exposure.

在全球反恐战争期间部署至西南亚的美国军人中，吸入颗粒物在部署后肺部疾病的发生发展中所扮演的角色始终难以明确。目前仍存在显著的数据缺口，无法阐明部署期间相对短期（数月至数年）的高浓度颗粒物暴露与后续不良肺部结局发生之间的关联。可对罹患肺部疾病的部署服役人员及退伍军人（deployed service members and veterans, DSMs）与非部署服役人员及退伍军人（non-deployed service members and veterans, NDSMs）的外科肺活检样本进行分析，以潜在识别残留的部署特异性颗粒物，并建立其与肺部病理诊断的关联。本研究采用场发射扫描电子显微镜（field emission scanning electron microscopy, FE-SEM）结合能量色散X射线能谱（energy dispersive x-ray spectroscopy, EDS），对25名DSMs与27名NDSMs的52份外科肺活检样本开展检测，以明确两组间留存无机颗粒物的数量与组成差异，并将颗粒物分析结果与原始组织病理诊断进行比对。本研究发现，DSMs活检样本中的总颗粒物数量显著高于NDSMs，该差异主要由地质黏土（伊利石、高岭石）、长石、石英/二氧化硅以及富钛硅酸盐混合物所导致。部署至其他西南亚地区（SWA-Other）的DSMs，其活检样本的颗粒物计数高于主要部署至伊拉克或阿富汗的DSMs，该差异主要源于伊利石水平升高。未发现明确的部署特异性颗粒物。颗粒物与部署国家未呈现定性关联。DSMs与NDSMs的个体诊断与总颗粒物、金属、氧化铈或二氧化钛颗粒物的升高水平均无关联。本研究结果支持在包含NDSMs等对照组的背景下，对DSMs的颗粒物相关肺部疾病开展研究，以助力明确特定肺部病理诊断与部署特异性无机颗粒物暴露之间的关联强度。