Chronic respiratory disease

Malignant neoplasm of the lung - Chronic respiratory disease Factor

Note: This factor applies only to reasonable hypothesis cases.

Asthma

Asthma comprises repeated attacks of wheezing, panting and shortness of breath.  The attacks last from a period of a few minutes to a few hours and are relieved either spontaneously or by medication.  There may be no evidence of the disease between attacks, but pulmonary function tests may have noted the presence of "reversible airways disease".  This term is used to denote the fact that the effects of the asthma are reversed when specific therapy for the condition is inhaled.  The medication generally used is Ventolin, and the test confirms the diagnosis of asthma.

Bronchitis with a wheeze may only indicate a smoking problem, whilst a wheeze might indicate an isolated attack of hay fever or relate to an attack of congestive cardiac failure.  For correct diagnosis it is necessary to ensure that all symptoms of the disease were present in the initial attack and that there have been recurring attacks which have followed the initial pattern with greater or lesser degree of severity.

If a veteran or member had asthma he or she would have needed medical attention at some time.  Such medical treatment would normally be recorded in doctors' notes and/or hospital records.  However, these records may have been destroyed or can no longer be obtained.  Because some of the symptoms associated with asthma may be caused by other conditions, you should seek medical advice if the presence of asthma at a particular time is not confirmed by medical records.

Further information about the diagnosis of asthma can be found in the Diagnostic protocol contained in the Research module of CCPS.

Chronic bronchitis

Chronic bronchitis means a respiratory tract disorder characterised by excessive mucus production sufficient to cause cough and sputum production with expectoration for at least three months of at least two consecutive years which is not attributable to other respiratory diseases.

Emphysema

RMA definition

In the SOP for Chronic bronchitis and emphysema the RMA defines emphysema as "a bilateral and diffuse respiratory tract disorder which is characterised by distension of airspaces distal to the terminal bronchiole with destruction of alveolar septa, and without obvious fibrosis. This definition excludes isolated emphysematous bleb and surgical, traumatic, unilateral, focal or localised emphysema, and Swyer-James syndrome (also known as MacLeod's syndrome or hyperlucent lung syndrome)."

Establishing a history of emphysema

Specific spirometric or other evidence is not required.  Spirometry results will generally be available (either provided or obtained for assessment purposes).  If that spirometry does not show the usual obstructive pattern associated with emphysema, ie FEV1 £ 85% of predicted and FEV₁/FVC) ratio £ 75%, then the diagnosis should not be confirmed without other evidence in support and further investigation should be undertaken.

A history of emphysema should be recorded in doctor’s notes and/or hospital records.  However, if these records cannot be obtained, a reliable history of appropriate symptoms or medical treatment at a particular time generally will be accepted, provided this is not negated by other evidence.  Seek medical advice if it is unclear whether the claimed symptoms and treatment at that time can be attributed to emphysema rather than to some other condition.

Last reviewed for CCPS 18 July 2007.

Preliminary questions [3807]

31716 there is some evidence that a chronic respiratory disease may be a factor in the development of the condition under consideration.

5981     the veteran has had a chronic respiratory disease at some time.

3808     the veteran has had asthma at some time.

or

3819     the veteran has had emphysema at some time.

or

5982     the veteran has had chronic bronchitis at some time.

5986     the veteran had the identified illness or injury, a chronic respiratory disease, at least five years before the clinical onset of the condition under consideration.

5984     the veteran has established the causal connection between the identified illness or injury, a chronic respiratory disease, and operational service for the clinical onset of malignant neoplasm of the lung.

Clinical onset and operational service [5984]

5987     the identified illness or injury, a chronic respiratory disease, is causally related to operational service.