Respiratory and Cardiovascular Response during Electronic Control Device Exposure in Law Enforcement Trainees.

OBJECTIVE: Law enforcement represents a large population of workers who may be exposed to electronic control devices (ECDs). Little is known about the potential effect of exposure to these devices on respiration or cardiovascular response during current discharge. METHODS: Participants (N = 23) were trainees exposed to 5 s of an ECD (Taser X26(®)) as a component of training. Trainees were asked to volitionally inhale during exposure. Respiratory recordings involved a continuous waveform recorded throughout the session including during the exposure period. Heart rate was calculated from a continuous pulse oximetry recording. RESULTS: The exposure period resulted in the cessation of normal breathing patterns in all participants and in particular a decrease in inspiratory activity. No significant changes in heart rate during ECD exposure were found. CONCLUSION: This is the first study to examine breathing patterns during ECD exposure with the resolution to detect changes over this discrete period of time. In contrast to reports suggesting respiration is unaffected by ECDs, present evidence suggests that voluntary inspiration is severely compromised. There is no evidence of cardiac disruption during ECD exposure.

Overview and recommendations for medical screening and diagnostic evaluation for postdeployment lung disease in returning US warfighters.

OBJECTIVE: To review inhalational exposures and respiratory disease risks in US military personnel deployed to Iraq and Afghanistan and to develop consensus recommendations for medical screening and diagnostic referral. METHODS: A Working Group of physicians and exposure scientists from academia and from the Departments of Defense and Veterans Affairs was convened in February 2010. RESULTS: Despite uncertainty about the number of people affected and risk factors for adverse pulmonary outcomes in this occupational setting, the Working Group recommended: (1) standardized approaches to pre- and postdeployment medical surveillance; (2) criteria for medical referral and diagnosis; and (3) case definitions for major deployment-related lung diseases. CONCLUSIONS: There is a need for targeted, practical medical surveillance for lung diseases and for a standardized diagnostic approach for all symptomatic deployed personnel.

Cardiovascular evaluation of electronic control device exposure in law enforcement trainees: a multisite study.

OBJECTIVE: Occupational health risk with regard to training exercises is a relatively under studied domain for law enforcement officers. One potential health risk is exposure to electronic control devices (ECDs). METHODS: Seven different training facilities in six states participated. Law enforcement trainees (N = 118) were exposed to Taser International's (Scottsdale, AZ) X26 for up to 5 seconds. RESULTS: There was no evidence of cardiac or skeletal muscle breakdown. Exposure did not adversely affect electrocardiogram (ECG) morphology obtained 24 hours after exposure in 99 trainees. For two trainees with preexisting ECG abnormalities, ECG morphology differed in the post-ECD samples. CONCLUSIONS: The results from this large, multisite study suggest that, for most trainees, ECD exposure does not represent a significant health risk. Further investigation is warranted for cardiac vulnerability and potential interactions with ECD exposure.

Chronic widespread pain, mental health, and physical role function in OEF/OIF veterans.

OBJECTIVE: Describe the associations among pain, mental health concerns, and function in veterans of Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF). DESIGN: Retrospective review of self-reported, standardized clinical intake surveys. SETTING: A multidisciplinary deployment health clinic at a Veterans Affairs (VA) medical center. PATIENTS: The first 429 veterans of OEF/OIF presenting for clinical evaluation at a deployment health clinic. OUTCOME MEASURES: Function, measured with the Role Physical (RP) scale of the Veterans RAND (VR)-36 survey, was compared for veterans with and without chronic widespread pain (CWP). RESULTS: After controlling for age, sex, and positive screens for depression and post-traumatic stress disorder (PTSD), the presence of CWP had a significant, clinically relevant, and independent effect on VR-36 RP (-6.2 points, DeltaR(2) = 0.052, P < 0.001). Mean VR-36 RP normed score was 43.3 (standard deviation 11.9). CWP was common (29%), as were positive mental health screens (PTSD 53%, depression 60%, alcohol misuse 63%). CONCLUSIONS: In this sample of OEF/OIF veterans, the majority of whom reported good or better general health, CWP was common and related to poorer physical role function, independent of comorbid mental health concerns.

Health and exposure concerns of veterans deployed to Iraq and Afghanistan.

OBJECTIVE: We report the clinical concerns of US veterans of Operations Iraqi Freedom and Enduring Freedom evaluated at the New Jersey War-Related Illness and Injury Study Center (NJ WRIISC) between June 2004 and January 2006. METHODS: We conducted a retrospective chart review of veterans' health and exposure concerns. RESULTS: Veterans (n=56) reported an average of 4 (standard deviation [SD] = 2.1; range, 0-9) physical health concerns, and 2.7 (SD=2.3; range, 0-10) exposure concerns. The majority of veterans (55%) had a mental health concern, most commonly, posttraumatic stress disorder. The most common exposure concerns were depleted uranium, multiple vaccinations, and poor air quality. Greater proportions of Reserve veterans reported genitourinary concerns and exposure to smoke from burning trash than active duty veterans. CONCLUSIONS: Veterans of military operations in Southwest Asia have deployment-related health and exposure concerns that will need to be addressed by their ambulatory care physicians.