22 peer-reviewed studies linked to asthma (diagnostic code 6602), from PubMed and the U.S. National Library of Medicine. Each citation links to its source.
Cohort study
The impact of burn pit waste segregation practices on respiratory and cardiovascular health risks among US military veterans deployed to Iraq and Afghanistan.Environmental Health · 2025
- Veterans at bases with less stringent burn pit waste segregation had higher asthma and cardiopulmonary risk
- Dose-response/exposure-quality evidence
- Strengthens biological plausibility
Stronger PACT Act causation arguments by exposure-response gradient
View on PubMed ↗Systematic review
Global, regional, and national burden of asthma and atopic dermatitis, 1990-2021, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021.Lancet Respir Med · 2025
- An estimated 260 million people had asthma worldwide in 2021; cases projected to reach 275 million by 2050.
- Modifiable risk factors accounted for 29.9% of global asthma DALY burden, with occupational asthmagens the second-largest contributor after high BMI.
- Highest age-standardised asthma DALY rate was in south Asia (465 per 100,000).
Quantifies asthma's large and persistent global disability burden and the role of occupational asthmagens, contextualizing why asthma is a high-volume, high-impact disability claim.
View on PubMed ↗Cohort study
Deployment to Military Bases With Open Burn Pits and Respiratory and Cardiovascular Disease.JAMA Network Open · 2024
- Deployment to bases with open burn pits associated with higher asthma incidence
- Objective deployment exposure data combined with VA health records
- One of largest cohort studies directly linking burn pit deployment to asthma
High-quality direct evidence supporting PACT Act presumptive service connection for asthma
View on PubMed ↗Cohort study
Longitudinal changes in lung function following post-9/11 military deployment in symptomatic veterans.Respiratory Medicine · 2024
- Accelerated longitudinal lung function decline in symptomatic post-9/11 deployers
- Spirometry decline beyond expected age-related
- Persistent post-deployment airway disease including asthma phenotypes
Longitudinal physiologic evidence of deployment-related airway disease
View on PubMed ↗Review
Current understanding of the impact of United States military airborne hazards and burn pit exposures on respiratory health.Particle and Fibre Toxicology · 2024
- Comprehensive review of military airborne hazards and burn pit effects on respiratory health
- Synthesizes mechanistic, epidemiologic, and clinical evidence including asthma
- Highlights PACT-Act-relevant exposure science
Comprehensive recent synthesis supporting asthma and other respiratory service connection
View on PubMed ↗Clinical guideline
Respiratory Health after Military Service in Southwest Asia and Afghanistan. An Official American Thoracic Society Workshop Report.Annals of the American Thoracic Society · 2019
- ATS synthesis of respiratory effects of SWA/Afghanistan deployment
- Asthma, chronic bronchitis, sinusitis, rare pneumonitis as deployment-associated
- ATS consensus on need for clinical evaluation
Authoritative consensus cited in VA C&P examination references
View on PubMed ↗Cohort study
New-Onset Asthma and Combat Deployment: Findings From the Millennium Cohort Study.Am J Epidemiol · 2018
- Service members who deployed WITH combat experience were 24%-30% more likely to develop new-onset asthma than non-deployers, after adjustment.
- Deployed personnel WITHOUT combat experience were not at higher risk of new-onset asthma versus non-deployers.
- Risk was estimated longitudinally among participants with no asthma history at baseline, isolating combat exposure as the driver.
Provides large-cohort evidence that combat deployment itself, not deployment alone, elevates new-onset asthma risk, directly supporting service connection for asthma in combat veterans.
View on PubMed ↗Randomized trial
Effect of azithromycin on asthma exacerbations and quality of life in adults with persistent uncontrolled asthma (AMAZES): a randomised, double-blind, placebo-controlled trial.Lancet · 2017
- Add-on azithromycin reduced asthma exacerbations from 1.86 to 1.07 per patient-year versus placebo (IRR 0.59).
- 61% of placebo vs 44% of azithromycin patients had at least one exacerbation, confirming high residual exacerbation rates despite controller therapy.
- Azithromycin significantly improved asthma-related quality of life.
Confirms that a large fraction of treated asthma patients still exacerbate on guideline therapy, documenting the persistent symptomatic burden that justifies disability compensation.
View on PubMed ↗Randomized trial
Dupilumab efficacy and safety in adults with uncontrolled persistent asthma despite use of medium-to-high-dose inhaled corticosteroids plus a long-acting β2 agonist: a randomised double-blind placebo-controlled pivotal phase 2b dose-ranging trial.Lancet · 2016
- Dupilumab significantly increased FEV1 versus placebo (e.g., +0.26 L mean difference at 200 mg every 2 weeks) regardless of baseline eosinophil count.
- Dupilumab reduced annualised severe exacerbation rates by roughly 70% in the overall population.
- Patients were uncontrolled DESPITE medium-to-high-dose ICS plus LABA, defining a treatment-refractory population.
Shows that even on standard inhaler therapy many asthma patients remain uncontrolled, evidencing the persistent functional impairment central to higher disability ratings.
View on PubMed ↗Cross-sectional
Prevalence of respiratory diseases among veterans of Operation Enduring Freedom and Operation Iraqi Freedom: results from the National Health Study for a New Generation of U.S. Veterans.Military Medicine · 2014
- Elevated prevalence of asthma, chronic bronchitis, sinusitis, and rhinitis in OEF/OIF deployers
- National-sample VA study
- Population-level respiratory burden in post-9/11 veterans
Population-level evidence supporting asthma/rhinitis service connection in OEF/OIF veterans
View on PubMed ↗Cohort study
The effects of exposure to documented open-air burn pits on respiratory health among deployers of the Millennium Cohort Study.Journal of Occupational and Environmental Medicine · 2012
- Linked documented burn pit deployment to incident respiratory symptoms and diagnoses
- Foundational large-cohort evidence
- Heavily cited in subsequent burn pit policy
Foundational evidence supporting burn-pit service-connection for asthma
View on PubMed ↗Meta-analysis
Deployment as a Risk Factor of Rhinologic Disease: Systematic Review and Meta-Analysis.Military Medicine · 2026
- Systematic review and meta-analysis identifying deployment as risk factor for chronic rhinosinusitis and rhinitis
- Pooled effect estimates showed elevated risk in deployed
- Highest-tier evidence quality
Highest-tier evidence supporting service connection of chronic sinusitis and rhinitis to deployment
View on PubMed ↗Cross-sectional
Sinusitis and rhinitis among US veterans deployed to Southwest Asia and Afghanistan after September 11, 2001.Journal of Allergy and Clinical Immunology: Global · 2025
- Elevated prevalence of chronic sinusitis and rhinitis among SWA/Afghanistan deployers
- Linked sinusitis/rhinitis to airborne hazard exposures
- Direct evidence supporting service connection
Direct evidence base for VA presumptive service connection under PACT Act for sinusitis and rhinitis
View on PubMed ↗Review
Military burn pit exposure and airway disease: Implications for our Veteran population.Ann Allergy Asthma Immunol · 2023
- Toxic burn-pit compounds (dioxins, polyaromatic hydrocarbons, particulate matter) may cause or exacerbate upper and lower airway disease.
- Preclinical models demonstrate burn-pit-induced airway dysfunction and inflammation, though human causality remains hard to prove.
- The VA established the Airborne Hazards and Open Burn Pit Registry in 2014 to track affected veterans.
Summarizes the biological plausibility for burn-pit-induced airway disease, supporting environmental causation arguments for asthma claims in deployed veterans.
View on PubMed ↗Cohort study
Burn Pit Exposure Is Associated With Increased Sinonasal Disease.Journal of Occupational and Environmental Medicine · 2022
- Burn pit exposure significantly associated with chronic rhinosinusitis in veterans
- Quantified increased odds of sinonasal disease in exposed cohort
- Direct burn-pit-to-sinusitis evidence link
Directly supports PACT Act presumptive service connection for chronic sinusitis
View on PubMed ↗Cross-sectional
Respiratory illness among Gulf War and Gulf War era veterans who use the Department of Veterans Affairs for healthcare.American Journal of Industrial Medicine · 2020
- Documented elevated chronic sinusitis and other respiratory conditions in Gulf War veterans using VA care
- Compared Gulf War deployers vs era non-deployers
- Long-term respiratory burden from Gulf War service
Supports presumptive service connection for sinusitis among Gulf War veterans
View on PubMed ↗Cross-sectional
Exercise-Induced Bronchoconstriction in Iraq and Afghanistan Veterans With Deployment-Related Exposures.Mil Med · 2020
- Positive exercise-induced bronchoconstriction in 16.7% and probable EIB in 41.7% of deployed veterans without prior asthma.
- At testing, veterans reported persistent cough (58%), wheeze (38%), and shortness of breath (38%) years after deployment.
- High self-reported deployment exposure to dust/sand, burn-pit smoke, and vehicle exhaust on most or all days.
Documents persistent asthma-like airway reactivity and respiratory symptoms in deployed veterans, supporting objective evaluation of post-deployment asthma claims.
View on PubMed ↗Systematic review
Prevalence and attributable health burden of chronic respiratory diseases, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.Lancet Respir Med · 2020
- Chronic respiratory diseases were the third leading cause of death in 2017 (7.0% of all deaths).
- Asthma is one of the major chronic respiratory diseases contributing to global prevalence and disability-adjusted life-years.
- Smoking was the leading risk factor for chronic respiratory disease-related disability across all regions for men.
Situates asthma within the overall chronic-respiratory disability burden and identifies smoking as a major modifier relevant to veteran comorbidity assessment.
View on PubMed ↗Cohort study
Afghanistan and Iraq War Veterans: Mental Health Diagnoses are Associated with Respiratory Disease Diagnoses.Mil Med · 2018
- 14% of post-deployment veterans were diagnosed with a respiratory condition; asthma incidence was 1,450 per 100,000 person-years.
- Among veterans with respiratory conditions, 77% also had a mental-health diagnosis.
- Any mental-health diagnosis was associated with increased odds of any respiratory diagnosis (adjusted OR 1.41), with mental-health-then-respiratory being the stronger direction.
Demonstrates the high co-occurrence of asthma and mental illness in deployed veterans, relevant to comorbidity-based claims and integrated care.
View on PubMed ↗Meta-analysis
Co-morbid psychological dysfunction is associated with a higher risk of asthma exacerbations: a systematic review and meta-analysis.J Thorac Dis · 2016
- Comorbid psychological dysfunction significantly raised asthma exacerbation risk (adjusted RR 1.06), including hospitalizations (RR 1.22) and ED visits.
- Depression specifically increased exacerbation risk (RR 1.07) and asthma hospitalizations (RR 1.26).
- The adverse effect was significant only when psychological dysfunction persisted beyond one year.
Links mental-health comorbidity to worse asthma outcomes, supporting secondary-condition and aggravation arguments common in veteran asthma-plus-PTSD/depression claims.
View on PubMed ↗Review
Airborne hazards exposure and respiratory health of Iraq and Afghanistan veterans.Epidemiol Rev · 2015
- Reviewed 2001-2014 literature; found higher prevalence of respiratory symptoms and illness consistent with airway obstruction among deployers.
- Most studies were retrospective/observational with symptom-report and medical-encounter outcomes; few had objective pre/post lung-function data.
- Concluded the association between chronic lung disease and airborne-hazard exposure needs further longitudinal objective study.
Establishes the airborne-hazards exposure-to-respiratory-symptom link across the deployed population that underpins many asthma service-connection claims.
View on PubMed ↗Systematic review
Diagnosis and management of work-related asthma: American College Of Chest Physicians Consensus Statement.Chest · 2008
- Work-related asthma includes occupational asthma (sensitizer- or irritant-induced) and work-exacerbated asthma of preexisting disease.
- Work-related asthma should be considered in ALL patients with new-onset or worsening asthma, with careful occupational history.
- Early diagnosis and exposure removal yield better prognosis; diagnostic tools include serial peak flow, methacholine and specific inhalation challenge.
Provides the authoritative framework that occupational/irritant exposures can induce or worsen asthma, directly supporting occupational and environmental service-connection theories.
View on PubMed ↗