LAUSR

Background: Asthma-like symptoms are common in those under physical duress. It has been demonstrated that 21% of athletes with presumed asthma had no objective evidence at assessment (1). Military personnel who develop symptoms of asthma are frequently declared unfit for service pending medical review. This has ramifications for the recruit and leads to avoidable healthcare costs. Aims: · To know the percentage of recruits referred with asthma who have objective evidence at assessment. · To understand the effects of treatment on the ability to return to unrestricted duties in military personnel. Methods: A retrospective review of military personal with a presumed diagnosis of asthma (July 2012 to June 2016). Diagnosis based on more than a 12% improvement of forced expiratory volume in one second (FEV1) to inhaled short acting beta agonist (SABA) and/or a positive methacholine challenge test. Asthma treatment was adjusted in line with British Thoracic Society (BTS) guidelines. Results: 40% (48/121) of presumed asthmatics had no objective evidence of asthma. 60% (44/73) of those with asthma were on no treatment or SABA only. Appropriate treatment meant that post-review 46/50 (92%) patients who were temporarily downgraded were subsequently recommended for unrestricted duties. Conclusions: At referral, the majority of recruits were on no medication or inhaled SABA only. Appropriate treatment allowed a return to unrestricted duties in most cases. Prompt referral for investigation and titration of treatment is likely to reduce time out of service. 1) Dickinson JW et al. Impact of changes in the IOC-MC asthma criteria: a British perspective. Thorax. 2005;60(8):629-32.