Sensitisation patterns and burden of uncontrolled respiratory allergy symptoms in military personnel.

Introduction: Military personnel is often deployed in environmentally distinct areas across the globe and thereby exposed to a multitude of new plants, weeds or trees. Sensitisation to inhalant allergens occurs upon exposure in predisposed individuals. This causes frequent problems that may affect the readiness of the personnel.

Methods: Study participants were recruited among the military personnel of the Belgian Army and invited to receive an allergy test by the skin prick automated test (SPAT) device for a panel of 22 inhalant allergens. A questionnaire was completed to retrieve information on demographics, lifestyle, history of allergy, rhinitis and asthma symptoms, as well as treatment and history of deployment.

Results: In total, 160 subjects were included with varying histories of deployment to the Middle East (n=68), Western Africa (n=53), Eastern Europe (n=50), Central Africa (n=47), the USA (n=20) or no international deployment (n=31). A majority of military personnel (79.9%) did not take allergy medication. Applying Allergic Rhinitis and its Impact on Asthma criteria, 26% and 27.9% of untreated soldiers were identified with, respectively, uncontrolled and partly controlled rhinoconjunctivitis. Sensitisation to house dust mite (Dermatophagoides farinae: 29.5%, Dermatophagoides pteronyssinus: 27.5%), timothy grass (28.8%), birch (20.9%), hazel (17.9%) and cat (16.3%) was commonly detected. Also, sensitisation to allergens that are less common in Belgium were detected: Cynodon dactylon (13.1%), Chenopodium alba (6.9%), Phoenix dactylifera (6.2%), Blattella germanica (3.9%), Blomia tropicalis (3.1%) and Salsola kali (1.5%).

Conclusions: Over one-quarter of military personnel not treated with allergy medication were identified with uncontrolled rhinoconjunctivitis. Timely allergy diagnosis and treatment are crucial for optimal performance of military personnel during international deployment and avoid an 'unfit-for-duty'. Allergy testing of an extended allergen panel by SPAT can be efficiently implemented in medical screening programmes for military candidates.

Trial registration number: NCT05807958.