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Respiratory Resource Center

What Military Service Members & Veterans Should Know About COPD

Jan 20, 2020 9:54:00 AM / by Devon Slavens

What Military Service Members & Veterans Should Know About COPD

Those who work in the US military make great sacrifices in service of their country. Those sacrifices often include putting their lives at risk in a number of ways.

 

As a result, military service members and veterans have a higher risk of getting a variety of injuries, diseases, and other serious health problems. One disease that's particularly common among military veterans is a chronic lung condition known as COPD.

 

Veterans are more likely to develop COPD for a variety of different reasons, but a major cause is being exposed to chemicals, smoke, and other lung hazards during service. Fortunately, COPD is becoming more widely acknowledged by the US Department of Veterans Affairs as a major health issue facing US military veterans.

 

Unfortunately, COPD doesn't receive nearly as much public attention as some other health conditions that disproportionately affect military veterans, such as PTSD. As a result, many veterans are not aware of the COPD or the risk factors they possess that could make them vulnerable to the disease.

 

That's why, in this article, we're going to explain what every military service member, veteran, and their loved ones, should know about COPD. We'll discuss why veterans are more at risk, how you can get the disease during service, and how to reduce your risk of developing COPD.

 

We'll also explain what you can do to keep your lungs healthy both during and after military service, and how to recognize the early signs of COPD. That way, you can better protect your lungs from hazardous substances and get early treatment as soon as the first symptoms of the disease appear.

 

Why Do So Many Military Veterans Develop COPD?

 

 

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If you are new to the term, you should know that COPD stands for Chronic Obstructive Pulmonary Disease and that it is a chronic, life-long respiratory disease that makes it difficult to breathe. There is no known cure for the condition, but it can be managed and even slowed down with the right kind of treatment.

 

(Click here to learn more about what COPD is, including what each of the four COPD stages looks like and what kinds of treatment options are available.)

 

The most common cause of COPD is tobacco smoking, but even people who have never smoked a cigarette in their life can still develop the disease. In non-smokers, COPD is often caused by occupational exposure to substances that irritate and damage their lungs.

 

These harmful substances include things like diesel smoke, chemical fumes, and many types of airborne particles and dust. Unfortunately, military veterans are more likely than most people to have come into contact with these types of substances throughout their lives.

 

For instance, many people in the military have to work around smoke and chemical fumes during service. Many who are deployed (especially in the Middle East) also face additional respiratory hazards like heavy air pollution and burn pit smoke.

 

 

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However, exposure to environmental respiratory hazards is not the only reason that veterans are more likely to develop COPD. Significantly more military servicemen and women smoke tobacco compared to the general US population, which no doubt contributes to veterans' high rates of lung diseases, including COPD.

 

However, it's important to realize that COPD is generally caused by cumulative damage to the lungs after long-term exposure to one or more respiratory irritants. Because of this, a single case of COPD can have more than one cause.

 

For example, repeated exposure to exhaust fumes during military service can cause lung damage that increases your risk for COPD later in life, even if it doesn't directly cause the disease. COPD also tends to have a delayed onset, which means that your lungs can be damaged badly enough to develop COPD but not show any symptoms for years—or even decades—after the original cause.

 

 

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Because of this, it is often difficult to pin the blame for the disease on any single factor. In some cases COPD is simply the result of lung damage gradually accumulated over a lifetime of exposure to a variety of different respiratory irritants.

 

This is particularly important for military service members to understand, because a wide variety of military jobs have the potential to expose you to a higher-than-average amount of respiratory hazards. If you are a current or former service member, learning more about these hazards can help you take better care of your health and better understand your personal risk for COPD.

 

How Big is the Risk for Veterans?

 

 

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According to a variety of research studies and observations, veterans face a disproportionately large risk for developing COPD. When compared to those who have never served in the military, studies consistently show higher rates of the disease among veterans.

 

General statistics show that about 16 million people in the US have been diagnosed COPD, which is about 6.5 percent of the entire population over the age of 18. However, experts believe the true number is much higher because a large number of people who have the disease have not yet been diagnosed.

 

Unfortunately, it's difficult to find exact statistics on the numbers and rates of COPD among US military veterans as a whole. However, doctors, researchers, and other experts agree that veterans have a notably higher risk of developing COPD and make up a disproportionately large percentage of those needing treatment for the disease.

 

According to COPD foundation president John W. Walsh, the risk for COPD is nearly three times as high for veterans compared to non-veterans. Research also shows this trend, with one study that reviewed medical data from VA patients finding that more than 8 percent of them had been diagnosed with COPD.

 

However, other studies estimate the actual prevalence of COPD among veterans to be as high as fifteen to twenty percent, and the disease may be even more common in certain populations of veterans. One study, for instance, recruited 326 veterans from a VA medical center in Cincinnati and found that 33 to 43 percent of them met the clinical criteria for COPD.

 

How Military Service Can Put You At Risk for COPD

 

In the next sections, we're going to explain each of the major COPD risks that military service members face in a bit more detail. This will give you a better picture of why veterans are more likely to develop COPD and what you can do to protect yourself from the disease.

 

Exposure to Dust, Fumes, and Fine Particulates

 

 

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Many military troops are exposed to hazardous amounts of sand, dust, and other fine particulates when deployed in certain climates. Because of this, veterans who served in the Persian Gulf, Iraq, Afghanistan, and other dry, dusty environments have a higher risk for respiratory conditions like COPD.

 

Air pollution is another hazard that can irritate and damage your lungs, increasing your risk for COPD and other lung diseases. Unfortunately, air pollution is particularly bad in certain parts of the world where the US military is stationed, including Southwest Asia, Iraq, and Afghanistan.

 

Burn pits are another dangerous source of smoke that could damage your lungs during service. These pits of burning waste were used often by troops deployed in Afghanistan and Iraq, and they frequently contained hazardous chemicals and materials that release dangerous fumes when burned.

 

However, exposure to dust and chemical fumes is not limited to military service members deployed in other countries. Many military occupations have the potential to expose you to high enough levels of fine particulates and fumes to increase your risk for COPD.

 

For example, the US Department of Veterans Affairs recognizes that many military service members may be exposed to toxic vapors when using industrial solvents. These include solutions used for cleaning, stripping paint, de-greasing, and other common tasks military service members perform on a regular basis.

 

 

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Photo by Sgt. Jason W. Fudge

 

Asbestos is another major respiratory hazard that veterans in certain occupations may encounter. Those working in jobs related to mining, milling, insulation work, demolition, carpentry, and constructions are the most likely to have extensive asbestos exposure, which is known to cause COPD.

 

Many service members, both deployed and non-deployed, are also at risk of breathing dangerous amounts of fuel and exhaust fumes while they work. These fumes are widely recognized as a major source of occupational exposure to dangerous particulates and gases that can cause a variety of respiratory diseases, including COPD.

 

Exhaust fume exposure can happen at just about any military job that requires you to work with or near gas and diesel-fueled equipment, including vehicles and machinery. Equipment operators, technicians, engineers, and deployed service members, for instance, may be exposed to harmful fumes from the vehicles and machinery they use to do their jobs.

 

Increased Pressure to Smoke Tobacco

 

 

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Without a doubt, smoking tobacco is the number one cause of COPD. Research shows that nearly 90% of people with COPD are current or former smokers, while only 10 percent have never smoked.

 

Unfortunately, cigarette smoking is an extremely common habit among people serving in the military. This is a problem that's been around since at least the early 1900's, when cigarettes were widely distributed to troops during WWI.

 

For many decades, cigarettes were an integral part of military culture; soldier care packages weren't considered complete if they didn't include a pack. Up until the mid-1970's, cigarettes were even a part of standard military rations, and in the 1980's, nearly 55 percent of military service members still smoked.

 

 

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Smoking is such a deeply entrenched tradition in the military that it still persists to this day, despite the fact that aggressive public health efforts have succeeded in reducing smoking rates significantly among the general US population. The most recent research from 2011 shows that nearly 25% of active duty military personnel smoke (compared to 19 percent of civilians), and nearly forty percent of them didn't start smoking until after they enlisted.

 

The percentage of smokers is even higher among those serving in certain branches of the military. For instance, in 2011, 30.8 percent of service members in the marine corps and nearly 27 percent of those in the army smoked.

 

Even worse, a large number of people who begin smoking in the military will never actually quit, and many continue to smoke for decades after retiring from service. In fact, the most recent research from the CDC has found that a whopping 29.2 percent of veterans smoke.

 

That means that veterans have more than twice the smoking rate of the general US population, which has stayed relatively stable at 14 percent for many years. Since tobacco smoke is the number one cause of COPD, the prevalence of smoking among active military personnel and veterans is one of the major reasons for their higher rates of the disease.

 

Frequent exposure to secondhand smoke can also cause COPD, and it could be another contributing factor to veterans' higher-than-usual risk for the disease. After all, even service members who don't smoke have a high risk of regular second-hand smoke exposure simply from living and working around those who do.

 

Increased Risk From Deployment

 

 

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Photo by Petty Officer 3rd Class Caleb Critchfield

 

 

A number of research studies have found that military veterans who have been deployed have higher rates of respiratory illnesses and diseases, including asthma and COPD. This is likely caused, at least partially, by the fact that service members are more likely to be exposed to environmental hazards like dust and smoke during employment.

 

For instance, one study showed military veterans who served in Iraq and Afghanistan were nearly three times as likely to have asthma and more than 75% more likely to have COPD. Experts believe that many of these respiratory conditions are the result of breathing in sand, dust, and burn pit fumes while deployed in the Middle East.

 

Research also suggests that your risk for respiratory problems may be higher the longer you are deployed. However, studies also show that deployed service members are more likely to smoke than those who have not been deployed.

 

Finally, some military veterans may be at risk for COPD and other respiratory problems due to their proximity to specific hazardous events. These include veterans of Operations Desert Shield and Desert Storm who may have been exposed to dangerous levels of pollution from oil well fires.

 

Here is a list of some specific events recognized as respiratory hazards by the US Department of Veterans Affairs:

  • The 2003 sulfur plant fire in Al Mishraq, Iraq
  • The Atsugi waste incinerator in Atsugi, Japan that released dangerous fumes from burning medical industrial waste
  • Exposure to Agent Orange during the Vietnam War
  • Oil and gas well fires during the Gulf War (specifically operation desert shield and operation desert storm)
  • Burn pits used at military sites
  • Environmental exposure to sand, dust, and other particulate matter during deployment

 

 

What Can Military Service Members Do to Protect Their Lungs?

 

 

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It is not uncommon for military service members to have to work in hazardous conditions. This includes working around dust, smoke, and exhaust fumes, as well as handling a variety of hazardous chemicals and materials.

 

All of these things can pose a risk to your lungs, but there are certain things you can do to significantly reduce that risk. Simply taking the right safety precautions and avoiding tobacco smoke, for example, can protect you from most of the major respiratory hazards you're likely to encounter during service.

 

Even veterans who are no longer in active service can protect their lungs by quitting smoking and continuing to avoid respiratory hazards throughout their lives. Early detection is also important, which is why it's vital for veterans with respiratory problems to get tested for COPD.

 

Follow Proper Safety Precautions and Procedures

 

 

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When you're working in hazardous environments or with hazardous materials, you should do everything you can to protect yourself from both immediate and long-term health risks. In order to do that, you need to wear the proper safety equipment and follow every safety procedure carefully.

 

For example, you should always check chemical product labels for health warnings and instructions, and seek out other safety information before handling any chemical or material that could be hazardous. You should also know any applicable safety procedures and follow them to the letter every single time you do the task.

 

It's especially important to utilize all safety equipment that's available and appropriate, such as gloves, goggles, masks, and respirators, before you handle dangerous materials or work near a respiratory hazard. If your work site doesn't have the proper safety supplies, you should alert your supervisor to the problem and request the needed equipment.

 

 

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However, you must make sure that you use the right kind of safety equipment for the specific hazard you face, otherwise you won't be protected. Many types of masks and respirators are only designed to protect you from a specific type of respiratory hazards, such as a certain size of ultra-fine particle or a type of chemical fume.

 

For more information on occupational respiratory hazards and what kind of safety equipment to use, refer to the OSHA technical manual on respiratory protection. You can view this on the US Department of Labor's website here.

 

It's particularly important to be safe with chemicals you use routinely, as repeated exposure is much more likely to damage your lungs than a one-time mistake. The temptation to cut corners and skip safety procedures also tends to be higher the more often you do a task; that's why maintaining your diligence is vital, especially the longer you work.



All of these safety rules also apply to veterans and civilians when working both at home and in the private sector. Always take the proper steps and wear the proper safety gear when you work around anything, including common household chemicals, that could harm your lungs.

 

Certain chemicals are more hazardous than others, and you should be familiar with all the dangerous materials and solutions you could be exposed to while you work. Be particularly cautious with chemicals and solvents like cleaning products, de-greasers, paint strippers, paint thinners, and other common chemical solutions.

 

 

Major respiratory hazards that require safety precautions:

  • Asbestos
  • Most chemical cleaning products
  • Paint fumes
  • Paint thinners and strippers
  • Other chemical solvents
  • Exhaust fumes
  • Dust, chemical dusts, and other sources of fine, airborne particles

 

 

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Photo by Airman 1st Class Cary Smith

 

 

Specific chemicals deemed hazardous by the US Department of Veterans Affairs:

  • Benzene and other aromatic hydrocarbons
  • Vinyl chloride
  • Perchlorate
  • Perfluorooctane sulfonate
  • Tetrachloroethylene
  • Trichloroethylene

 

Quit Smoking, or Avoid Starting in the First Place!

 

 

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Despite all of the respiratory hazards that military service members face, plain old tobacco smoke is still the primary cause of COPD among veterans. Because of this, avoiding or quitting smoking is the most important thing you can do to protect yourself from COPD.

 

Of course, this is easier said than done; smoking is pervasive among both service members and veterans, and it's extremely difficult to stop once you've started. Former smokers also have a higher risk of relapsing while serving in the military, and the risk is even higher for those that get deployed.

 

But even though serving in the military can make it especially challenging to avoid smoking and secondhand smoke, it's one of the most important things you can do to safeguard your health. If you are an active service member or veteran who already smokes, it's still never too late to quit!

 

 

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Photo by Airman 1st Class Joshua R. Maund

 

Even though quitting is difficult, the good news is that you don't have to do it alone. There is a plethora of quit-smoking programs and services available to help you get the support you need to successfully quit.

 

These include phone hotlines, online support groups, educational guides, mobile support apps, and more. There are even a number of quit-smoking programs in place specifically for current military service members and veterans, some of which are only available through TRICARE and other Department of Defense programs.

 

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Here is a list of some of the available services with links to help you get started:

  • TRICARE beneficiaries can receive tobacco cessation medications and personal counseling from approved TRICARE providers.
  • Call the CDC's quit smoking hotline to talk to a counselor trained to help smokers quit: 1-800-QUIT-NOW (800-784-8669)
  • Veterans can utilize the Smoke Free Vet website to access a range of services, including: the “Stay Quit Coach” mobile application, online chat with quit smoking specialists, a mobile text message smoking cessation program, tools for creating your own quit-smoking plan, and online support groups for veterans who want to quit smoking.
  • TRICARE-eligible beneficiaries can access the Department of Defense's “YouCanQuit2” program: Here you can access a variety of helpful quit-smoking resources online, including personalized advice from support coaches and a live chat system.
  • Smoke Free Text Messaging Program: This program offers practical advice, encouragement, and motivation to quit smoking via text messages via a 6-8 week mobile smoking cessation program.
  • Tips from Former Smokers Campaign: Learn, get advice, and be inspired by real stories from former smokers who were able to quit. You can also click here to see tips and stories specifically from military service members and veterans.
  • You can access a variety of service-specific resources online, including the Army Public Health Center, Operation Tobacco-Free Marine, and the Tobacco Cessation Program from the Coast Guard's Office of Work-Life Programs
  • Visit the CDC's website or smokefree.gov for even more quit smoking resources, including Smokefree Women, SmokefreeTXT, and more.

 

Quitting smoking has a huge number of benefits, not only for your health, but for your mood, your energy levels, and your overall lifestyle. It also reduces your risk for COPD and a wide variety of serious health problems including heart disease, lung cancer, and stroke.

 

Even if you're not ready to quit cold turkey yet, you can still get some health benefits by reducing the number of cigarettes (or other tobacco products) you smoke. You can also take the time to familiarize yourself with quit-smoking resources so you'll have a place place to start if you decide you want to quit smoking in the future.

 

It's also worth it to find things you can do to reduce the harms of smoking to yourself and others. For example, if you avoid smoking indoors and other places where second-hand smoke can linger, you can reduce the risk of exposing yourself and others to the harmful toxins for prolonged periods of time.

 

Know the Risk Factors and Get Tested Early

 

 

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While COPD cannot be cured, it can be treated to reduce symptoms and slow down the progression of the disease. That's why early detection is key; the sooner you get diagnosed, the sooner you can get treatment, and the better your health will be.

 

Getting treatment in the early stages of the disease allows you to control your symptoms better and might even slow lung function decline. Early treatment can help you keep more of your lung function for longer and give you the opportunity to make healthy lifestyle changes while your COPD is still mild.

 

All of these things can help you stay more active and healthy even as the disease gets worse, but, unfortunately, COPD is notoriously difficult to detect in the beginning stages. The earliest symptoms are often mild and easy to ignore; it can, for instance, begin with nothing more than occasional breathlessness or mild, chronic cough.

 

It can take years for the symptoms to get severe enough to trigger concern, which is why many people don't get diagnosed until the disease has progressed past the early stages. Even then, many people still fail to recognize their symptoms as early signs of COPD or mistakenly assume that they are a normal part of aging.

 

 

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Because of this, experts believe that the number of people with COPD in the US is about double the number that is currently diagnosed. They estimate that about 12 million people have COPD but don't know it, which is why better education, awareness, and early detection is key.

 

If you are a military service member or veteran, it's important to look out for the signs and symptoms of COPD as you get older, especially past the age of 45. Since veterans are more likely than most people to develop the disease, it's even more vital to understand the risk factors and know how to identify the early symptoms.

 

We've already discussed many of the risk factors that veterans have as a result of their service, such as breathing in dust, smoke, and chemical fumes. Your risk is also much higher if you currently smoke tobacco, have a history of smoking, or a history of long-term exposure to second-hand smoke.

 

Here are some of the major risk factors for COPD that you should be aware of:

  • A history of severe asthma
  • Frequent lung infections during childhood
  • Current smoking or a history of smoking
  • Frequent exposure to secondhand smoke
  • Prolonged exposure to air pollution
  • Occupational exposure to dust, smoke, and toxic fumes including paint fumes, cleaning chemical fumes, and exhaust fumes
  • Genetic disorders (cystic fibrosis and alpha-1-antitrypsin deficiency, also known as AAT deficiency)

 

If you have any of these risk factors, then you need to be particularly careful about looking out for COPD symptoms and getting tested as early as possible if they appear. If you see your doctor for respiratory symptoms, make sure to tell him about your risk factors so he can more accurately estimate your likelihood of developing COPD.

 

When looking out for the early signs of COPD, there are two main things to look out for: a chronic cough that doesn't go away (especially one that produces mucus), and feeling more breathless than usual when you do physical activities like exercising, walking, and going up stairs. These symptoms are most concerning if they last for a very long time, won't go away on their own, and have no other known cause.

 

 

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Here are some of the early signs and symptoms of COPD to look out for:

  • A chronic cough that lasts for several months straight and never completely goes away
  • Extra mucus in your airways (especially in combination with a chronic cough that brings up mucus)
  • Feeling short of breath more easily than usual when you do physical activities (especially if you feel breathless often during normal activities like walking, climbing stairs, or doing chores around the house)
  • Chest tightness and soreness
  • Unexplained fatigue
  • Difficulty sleeping because of symptoms like coughing, breathlessness, or chest tightness.

 

Most of the time, these symptoms don't start appearing until after the age of 45, although they sometimes begin much earlier or later. If you recognize any of them in yourself of others, it's important to see a doctor right away.

 

Your doctor will record your symptoms, ask you questions, and take some basic measures of your physical health in order to determine how likely you are to have COPD. Then, he may decide to do more extensive testing, which usually involves a chest x-ray and some simple lung function tests.

 

To learn more about how to recognize the early signs and symptoms of COPD, check out our guide “How to Know If You Should Get Tested for COPD.” You can also use the quick COPD screening tool from the COPD Foundation's website to get a better idea of your risk for the disease.

 

Conclusion

 

If you are a current military service member or veteran, it's important to recognize that your risk for COPD may be much higher than average. You should also be aware of the many risk factors and respiratory hazards that can cause COPD; if you can recognize them, you'll have a much better chance to avoid them and minimize your chances of developing the disease.

 

Be especially cautious when working in any kind of civilian or military occupation that could expose you to dust, exhaust, pollution, and chemical fumes on a frequent basis. Any time you can't avoid them, always make the effort to protect your lungs with proper safety equipment and other precautions.

 

You should also remember that, despite the dangers of military service, smoking is still the number one reason that military veterans develop COPD. If you care about your health, then avoiding tobacco smoke is just as important as avoiding the many other environmental hazards that can damage your lungs.

Topics: COPD, Medication and Treatment, Respiratory Resource Center

Devon Slavens

Written by Devon Slavens