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Clinically Speaking: Questions and Answers About Managing Asthma in the Military

Learn how you can manage asthma, how it will affect your military career and more

Since an asthma diagnosis after the age of 13 can disqualify you from entering military service, you might think the condition would be rare among active-duty service members. But asthma does exist in the military.

We reached out to Col. Ada Stewart, M.D., US Army Reserve, to get some answers about why asthma can first appear after enlistment, how it can be managed and whether its diagnosis can derail a military career.

Why might a servicewoman develop asthma in the military?

Asthma symptoms can first appear if someone is exposed to triggers they’ve never experienced before — like a new exercise program, cold air or unfamiliar allergens. Triggers vary for everyone. Even bad air quality, which people are sometimes exposed to on deployment, can trigger asthma’s characteristic symptoms of coughing, wheezing and difficulty breathing. And that can lead to a post-enlistment diagnosis. If you have asthma in your family history but have never been diagnosed, asthma could be possible under the circumstances that trigger it.

Will I be kicked out of the military if I develop asthma while serving?

The general answer is no, but this also depends on what branch of the military you’re in. Also, every case is different. If your asthma is not well-controlled, getting worse and preventing you from doing your job, you’ll be referred for a medical evaluation to determine whether you meet military readiness or are fit for your position. A lot depends on the severity of the case.

What is considered well-controlled asthma?

Well-controlled means you’re able to perform all your daily activities and duties with no limits. It means not having to use a rescue inhaler and, if you’re on preventive medication, being stable on that medication with no worsening symptoms. You want to be at a point where asthma is not affecting your daily activities.

What treatments and therapies are available for asthma?

There are several treatments for asthma available, and they generally fall into two categories. There are short-acting rescue agents like inhalers, which are used to stop an attack as it’s happening. There are also long-acting maintenance medications like oral and inhaled steroids. Oral steroids are generally used when asthma is worsening. These are used to prevent attacks from happening.

How do I prevent asthma attacks, especially on missions, trainings and deployments? Do I need to do anything special to manage asthma on deployments?

It depends on where you’re going, but in general, you’ll want to make sure that you can follow your treatment regimen while deployed and try to avoid triggers. When I was stationed at Fort Bliss seeing soldiers who were returning from overseas, I saw a lot of respiratory problems triggered by air quality. In some countries in the Middle East, for example, you can experience huge dust storms. In your readiness evaluation, you’d work with your medical team to discuss where you’re going, what the environment is like and what opportunities you’d have to get healthcare.

Will I be kicked out of the military if my asthma gets worse?

If your asthma is getting worse, you’ll be evaluated and given a spirometry, which is a test to determine how well you’re breathing and how well your lungs are working. In the Army, there’s a whole page of criteria doctors use to determine whether a service member can no longer serve because of their asthma. These criteria generally include considerations like whether you’re using your inhaler more, whether you’ve had to step up medication and are having to regularly use oral steroids, whether you can’t complete your required physical training, whether you’ve required emergency care and whether you’re missing too much time on duty because of your asthma. It’s not just one doctor who will determine your case: Each case is reviewed by a board of medical professionals before any action is taken.

Asthma is generally not a career-ending disease, but it must be managed well, with treatment and avoidance of triggers. Work with your medical team to monitor your specific triggers and find solutions that work well for your asthma.

This educational resource was created with support from AstraZeneca.

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