Asthma in the army: a retrospective study and review of the natural history of asthma and its implications for recruitment.

In an attempt to define the problem of asthma in the British Army and to relate it to recruiting policy, records were obtained for all discharges from the Army and all admissions to hospital for 48 hours or more with a principle diagnosis of asthma over four years. There were approximately 50 medical discharges from asthma per year, representing about 1 in 3400 of the held strength of the Army and 6.3% of the discharges from all medical causes. The average number of non-effective days before discharge was about 20 and those discharged were generally young (57% aged 20 years or less), of short service (47% less than 2 years service) and of low rank (86% privates, apprentices or juniors). Three hundred and fifty two individuals were admitted to hospital on 415 occasions in 4 years, of whom 82 were eventually discharged from the service for medical reasons. Average non-effective days for this group was 11. There was only one death. Of 108 discharged soldiers who were eventually shown to have a history of asthma in childhood (HAC), this was identified at recruit examination in only 43%. Before enlistment, only 20% were referred for consultant opinion and only 6% had exercise testing. 28% were probably current asthmatics on entry. From available records, age of remission of childhood asthma was most commonly 10-14 years (64%). Relapse was commonest at age 17-21 years (76%) with 25% of relapses occurring at 18 years.(ABSTRACT TRUNCATED AT 250 WORDS)