Abstract Introduction We investigated the associations between self-reported and job exposure matrix (JEM) assigned civilian occupational exposure to vapors, gases, dusts or fumes (VGDF) with respiratory symptoms among Veterans with previous military deployment to Southwest Asia, Djibouti, Afghanistan, or Kyrgyzstan. We hypothesized that VGDF by either measure would be associated with increased risk of adverse respiratory outcomes but also that participants with both JEM-based exposure and self-reported VGDF might have more robustly positive associations with these endpoints. Methods Participants in a cross-sectional study of U.S. Veterans completed an interviewer-administered questionnaire ascertaining civilian occupational VGDF exposure. In a secondary analysis, we also employed a JEM to categorize likelihood (none, somewhat likely or highly likely) for occupational VGDF exposure based on self-reported occupation and industry of longest held job. Adjusted generalized linear models with a logit link tested independent and conjoint self-reported and JEM-assigned VGDF associations with dyspnea, chronic bronchitis (CB), or wheeze. In a sensitivity analysis, we restricted to participants with at least five years of civilian employment. Results Among 1,887 participants, mean age(SD) was 38.7(13.1) years; 1,671(88%) were male. Median duration of longest held civilian occupation was 6 years. The prevalence of JEM-assigned VGDF exposure (somewhat or highly likely) or, alternatively, any self-reported civilian occupational VGDF were both 31%; there was modest agreement between them (kappa 0.48). Point estimates were elevated for any dichotomous endorsement of self-report or JEM-assigned VGDF with all respiratory endpoints. Self-reported VGDF exposure was associated with elevated odds of CB (odds ratio OR 1.29; 95% Confidence Interval CI 0.86 to 1.80). Combined somewhat or highly likely JEM VGDF exposure was associated with elevated odds of CB (odds ratio OR 1.86; 95% Confidence Interval CI 0.97 to 2.39). In a sensitivity analysis among participants with at least five years of employment the association was similar (OR 1.80; 95% CI 1.06 to 2.63). In modeling of the conjoint outcomes, JEM-based VGDF alone was positively associated with CB (OR 1.84; 95% CI 1.23 to 2.66), as was combined JEM-based and self-reported VGDF (OR 1.85; 95% CI 0.78 to 2.64), while self-reported VGDF alone was not positively associated with CB (OR 0.96; 95% CI 0.37 to 2.12) (Table). Conclusions Civilian occupational VGDF exposure (assessed either by JEM or self-report) was common in this cohort of Veterans. Based on JEM assignment, VGDF was associated with increased odds of CB, underscoring the need to consider civilian occupational factors when assessing Veterans’ health. This abstract is funded by: VA Office of Research and Development (ORD) Cooperative Studies Program (CSP) #595 and PACT Act Toxic Exposure Funds through the VA ORD Military Exposures Research Program. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States Government.
Mohazzab-Hosseinian et al. (Fri,) studied this question.