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Burn Pits: The "Agent Orange" of the Iraq War

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Images A, B and D are photomicrographs showing some of the pathological and histological features seen in the 38 Iraq War Veterans from the 101st Airborne Division, Fort Campbell, Kentucky from Dr. Matthew King’s biopsy resulting in the diagnosis of constrictive bronchiolitis.

These veterans were referred to Dr. King and Vanderbilt University Medical Center after they failed to meet Army Physical Fitness 2-mile run standards and complained of exercise-induced dyspnea. Many, but not these veterans had been exposed to the 2003 Al-Mishraq Sulfur Mine Fire in Iraq (King et al., 2011).

Dr. Matthew S. King, Dr. Robert Miller – Vanderbilt University Medical Center New England Journal of Medicine - 365(3):222-230, "Constrictive Bronchiolitis in Soldiers Returning from Iraq and Afghanistan (2011)"

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"Constrictive bronchiolitis" is a small airway fibrotic respiratory disease involving the mid-bronchiole region. Constrictive bronchiolitis is rarely seen in young, healthy, athletic adults and is mostly associated with organ transplant rejection and rheumatoid arthritis (Pictured left: normal lung far left, lung with constrictive bronchiolitis on the right).


In previous cases, constrictive bronchiolitis often yields normal results in HRCT, PFT and CPET imaging and has been diagnosed exclusively by way of thoracoscopic lung biopsies. Dr. Miller states...


“it is known to result from toxic inhalation, with sulfur dioxide (SO2) being one of the most notable exposures linked to the disease” (Miller, 2013, p. 4) in addition to nitrogen oxide, inorganic dust, fly ash and diacetyl used in flavoring butter (King et al., 2011).


This disorder is progressive, incurable and the prognosis is often poor.