Prevalence of acute respiratory tract diseases among soldiers deployed for military operations in Iraq and Afghanistan.

Respiratory diseases are one of the most common health problems among service personnel assigned to contemporary military operations which are conducted in areas characterized by adverse environmental conditions. This article reviews the results of the studies into the prevalence of acute respiratory tract diseases among soldiers of the Polish Military Contingent deployed to Iraq and Afghanistan. The article also discusses a number of factors which increase the prevalence of diseases diagnosed in the population of soldiers on a military mission in different climatic and sanitary conditions. Retrospective analysis was based on medical records of Polish troops treated on an outpatient basis in Iraq in 2003-2004 (n = 871) and in Afghanistan in 2003-2005 (n = 400), 2009 (n = 2,300), and 2010 (n = 2,500). The intensity rates were calculated and were then used to calculate the prevalence of diseases per 100 persons in a given population of the military personnel. We found that acute respiratory tract diseases were one of the most common health problems treated in outpatient medical facilities in all four study populations. The incidence rate was 45.6 cases in Iraq in 2003-2004, and in Afghanistan it amounted to 61.8 in 2003-2005, 45.3 in 2009, and 54.8-100 persons in 2010. In conclusion, the prevalence of respiratory diseases was closely related to the environmental factors, such as sand and dust storms, extreme temperature changes, unsatisfactory sanitary conditions, and common disregard of basic principles concerning disease prevention.

Lung function in divers.

Correct lung function is indispensible to perform work underwater. Thus, spirometric tests of lung function remain an important element in the process of selecting candidates for professional diving. Studies conducted in the population of divers identified the phenomenon called 'large lungs', which is often associated with spirometric indices characteristic of obstructive impairment of lung function. This study investigated selected parameters of lung function in the population of divers and candidates for professional divers. Fifty two male subjects were examined as part of the selection process. Basic spirometric tests: forced expiratory volume in 1 s (FEV1; dm(3)), forced vital capacity (FVC; dm(3)), forced expiratory flow in the range 25-75 % of FVC (FEF25-75; dm(3) s(-1)), and FEV1/FVC (%) were compared with compared with the predicted reference values estimated by the European Coal and Steel Community. The results demonstrate differences in FVC and FEF25-75 in divers, which may correspond to functional hyperinflation. The effects of 'large lungs' observed in divers, if persisting for an extended period of time, may lead to lung ventilation impairment of the obstructive type.

The effect of air and nitrox divings on platelet activation tested by flow cytometry.

BACKGROUND: Nitrogen (N2) microbubbles activate the blood platelets and coagulaltion system. HYPOTHESIS: Breathing nitrox rather than air may reduce the level of platelet activation associated with decompression. METHODS: We tested platelet counts and the expression of functional membrane molecules on platelets in 10 divers subjected to saturated compression in nitrox at 4 ATA and in 9 divers subjected to compression in air at 2.8 ATA. Blood samples were taken before and immediately after the test. We measured the percentages of microplatelets, platelet aggregates and platelets bearing the activation marker C-D62P, and bearing molecules forming receptors for fibrinogen (CD61) and for von Willebrand factor (CD42b) using flow cytometry and specific monoclonal antibodies. Symptoms for DCS were also evaluated. RESULTS: DCS symptoms were not noted in either the nitrox or air group. In both groups we observed a marked increase in the percentage of activated platelets bearing CD62P molecules and an enhanced number of microplatelets and a marked drop in the platelets count in the blood of (divers in the air group. CONCLUSION: In all divers we observed certain changes in the platelet system, nevertheless decompression in nitrox resulted in a lesser degree of platelet activation. Though this study cannot exclude platelet activation as an etiological factor in DCS, the findings suggest platelet activation can occur in the absence of observable sign of DCS. Thus, platelet activation may be too sensitive a marker to serve as a predictor of DCS.

Effect of saturated air and nitrox diving on selected parameters of haemostasis.

The objective of the study was to evaluate decompression stress after air and nitrox saturated divings on the basis of the parameters of haemostasis. Before and after each diving the following examinations were performed: blood platelet count, aggregation, fibrinogen level and coagulation factors VII, X and XII. After the air saturated dives a slight reduction of factor X and XII and of fibrinogen was observed. Evaluation of haemostatis may be one of the basic elements in the assessment of decompression sickness risk.