Sinusitis and rhinitis among US veterans deployed to Southwest Asia and Afghanistan after September 11, 2001

Abstract

Background

Post-9/11 veterans were exposed to environmental and occupational pollutants during deployment.

Objective

Our aim was to determine associations between deployment-related exposures and sinusitis and rhinitis.

Methods

Between April 2018 and March 2020, veterans with land-based deployment after 9/11 who were living within 25 miles of 6 Department of Veteran Affairs medical centers were randomly chosen by using a Defense Manpower Data Center roster. Participants completed interviewer-administered questionnaires, which included a 32-item deployment exposure battery and self-report of rhinitis and health professional–diagnosed sinusitis. Exposure categories included burn pit smoke, combustion engine exhaust/ground dust, other open combustion sources, toxicants, and military job-related VGDF. Each item was scored on the basis of frequency and duration of exposure; ordinal scores were summed and scaled to 100 within each category. Odds ratios (ORs) were estimated using logistic regression for sinusitis and rhinitis separately. ORs were scaled per 20-point exposure score.

Results

Among the 1960 participants, the incidences of sinusitis and rhinitis with onset during deployment were 2.1% and 3.6%, respectively; the incidences of postdeployment onset were 5.1% and 5.6%, respectively. Toxicant exposure consisted mainly of “applying pesticide, insecticide, or repellent to your own skin or to your own clothing” and was associated with rhinitis with onset during deployment (OR = 1.50 [95% CI = 1.31-1.84]) and onset after deployment (OR = 1.21 [95% CI = 0.93-1.50]). There were no associations with burn pit smoke or other exposure categories.

Conclusion

Veterans with deployment exposures to toxicants were at increased risk of rhinitis, particularly during deployment. The clinical evaluation of postdeployment veterans should address rhinitis as a deployment-related condition.