Following reports of unexplained shortness of breath from 56 soldiers returning from Iraq, 29 have been diagnosed with bronchiolitis. Bronchiolitis is a disease that affects the small airways of the lungs, and is often associated with organ transplant, rheumatoid arthritis, or, as in this case, toxic inhalation.

The soldiers, form Fort Campbell, Ky, were experiencing unexplained shortness of breath upon exertion.

“All of the soldiers were physically fit at the time of deployment. On return, none of those diagnosed with bronchiolitis met physical training standards. In almost every case they were declared unfit for duty and were medically boarded with a service connected disability,” says Robert Miller, MD, principle investigator of the research.

Following normal results from chest x-rays and computerized tomography, 31 of the soldiers underwent surgical lung biopsies, with 29 resulting in a diagnosis of bronchiolitis. Most of the soldiers diagnosed with the disease had prolonged exposure to sulfur dioxide from a sulfur mine fire near Mosul, Iraq in 2003. The Mosul sulfur fire is considered a combat-related event where toxic levels of sulfur dioxide in the air were confirmed.

However, some of the soldiers who were diagnosed with bronchiolitis were not exposed to the sulfur at the Mosul fire. “We are concerned that there may be many unidentified exposures putting soldiers at risk of developing bronchiolitis,” says Matthew Kind, MD, pulmonary and critical care fellow at Vanderbilt University.