Background: Recent epidemiologic studies have reported an increased risk for respiratory conditions in service members deployed to Iraq or Afghanistan (1) since 2001 and an increasing prevalence of chronic lung disease in this population (2). Reports of dyspnea and exercise intolerance have mostly been attributed to exposure to airborne hazards, such as burn-pit smoke and particulate matter.

Exposure to blast waves during military deployment has been recognized as the hallmark injury of the wars in Iraq and Afghanistan, and considerable efforts have been made to understand the associated neurologic sequelae. However, less attention has been paid to the lungs, which may be particularly susceptible to blast waves given tissue-density gradients. The exact relationship between blast lung injury and long-term sequelae is unknown; however, animal models show long-term, persistent elevations in oxidative stress and vascular abnormalities after blast exposure (3), which may contribute to respiratory symptoms. Associations between blast exposure and chronic lung diseases in this cohort have recently been suggested (2).

中文翻译：

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美国退伍军人的高炉伤害和心肺症状：国家注册中心的分析

背景：最近的流行病学研究报告说，自2001年以来，部署到伊拉克或阿富汗的服务人员的呼吸系统疾病风险增加（1），并且该人群中慢性肺病的流行率增加（2）。呼吸困难和运动不耐症的报告主要归因于暴露于空气传播的危害，例如烧坑烟雾和颗粒物。

军事部署期间暴露于爆炸波被认为是伊拉克和阿富汗战争的标志性伤害，并且已经做出了巨大的努力来理解相关的神经系统后遗症。但是，对肺的关注较少，在组织密度梯度给定的情况下，肺可能尤其容易受到爆炸波的影响。爆炸性肺损伤与长期后遗症之间的确切关系尚不清楚；然而，动物模型显示，爆炸暴露后，氧化应激和血管异常长期持续升高（3），这可能导致呼吸道症状。最近有人提出在这个队列中爆炸暴露与慢性肺部疾病之间的关联（2）。