Sinusitis and rhinitis among United States Veterans deployed to Southwest Asia and Afghanistan post 9/11
Abstract: Background: Post 9/11 Veterans were exposed to environmental and occupational pollutants during deployment. Objective: Determine associations between deployment-related exposures and sinusitis and rhinitis. Methods Between April 2018 - March 2020, Veterans with land-based deployment post-9/11 living within 25 miles of 6 Veteran Affairs (VA) Medical Centers were randomly chosen 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 vapors, gas, dust, or fumes. Each item was scored based on 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 1,960 participants, the incidence of sinusitis and rhinitis with onset during deployment was 2.1% and 3.6%, respectively; post-deployment was 5.1% and 5.6%, respectively. Toxicants exposure mainly consisted 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 post-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 post-deployment Veterans should address rhinitis as a deployment-related condition.