Defence Medical Services

Mr N Smith,

c/o

Your Ref:

Our Ref: 12-11-2008-072557-002

Date:13 Nov 08

Dear Mr Smith,

Thank you for your recent request to the Ministry of Defence under the Freedom of Information Act. You asked the following:

I would like to know if there are any members of our Armed Forces that suffer from asthma. I am looking in particular at serving personnel as opposed to the civilian workforce. If there are members of the Armed Forces serving personnel that suffer from asthma, please could this be broken down in to the following: 1) Number of officers, 2) Number of other ranks, 3) Number of sufferers in the British Army, 4) Number of sufferers in the Royal Navy (including Royal Marines), 5) Number of sufferers in the Royal Air Force.

I would also like to enquire re: the MOD policy in relation to its service personnel, and what action would be taken should a member of service personnel be diagnosed/or suffer from asthma which was not diagnosed at the recruitment phase, specifically whether they would be discharged or whether they would be posted to other duties. I am not looking for any names, I would simply like the figures of personnel involved.

The Ministry of Defence does not maintain a central record of personnel who are currently diagnosed with an asthmatic condition. The information requested could only be obtained by examination of the individual medical records of each individual. These records can only be viewed for non-clinical reasons with the express consent of each individual concerned in order to protect patient confidentiality, and would therefore involve disproportionate cost. Under Section 12 of the Freedom of Information Act public authorities are not obliged to disclose information where the estimate for preparing this information would exceed the appropriate limit of £600. To answer your request would exceed this limit.

Guidance on the medical standards for members of the Armed Forces is set out in Joint Service Publication 346 (JSP346): A Joint Service System of Medical Classification. As well as providing guidance on standards required for new recruits, JSP346 also lays down procedures should serving personnel subsequently develop a medical condition that could affect their operational deployability. The relevant section on respiratory conditions (including asthma) states as follows:

4.36. Serving personnel developing respiratory conditions such as wheezing diatheses (inclusive of asthma), hay fever, recurrent spontaneous pneumothorax, chronic bronchitis, emphysema, bronchiectasis, and tuberculosis, which either degrades the functional capacity and performance, and, or fails to respond satisfactorily to treatment, may require to be permanently graded P3 (Medically fit for duty with minor employment limitations) or P7 (Medically fit for duty with major employment limitations), or recommended for medical discharge, (subject to single Service policy). The measurements achieved by respiratory function testing do not necessarily on their own give an indication of the overall functional capacity or fitness of an individual. The latter, when appropriate, can best be assessed in a physiological measurements laboratory. Work limitation arises most commonly from the sensation of breathlessness and whilst of a subjective nature, grading should reflect this.

4.37. Special work problems and restrictions. Certain work environments or safety critical areas require high standards of respiratory fitness, e.g. aircrew, divers, rescue services, submariners and trades involving positive pressure breathing apparatus, or work in hyper/hypo-baric atmospheres.

Asthma. Whilst the entry standards given in Chapter 3 reduce the incidence of asthma within the military population (i.e. achieves the ‘healthy worker effect’), there are likely to be certain personnel who develop latent asthma for a variety of reasons (i.e. atopic, exercise induced, idiopathic or occupational). All asthma, in the first instance, should be managed following normal clinical practices. It is essential that a high index of suspicion is maintained regarding the differentiation of occupational asthma from the non-occupational causes.

(1) Any work involving potential skin or respiratory sensitisers should be subject to a risk assessment, together with appropriate pre- and intra- employment health surveillance/screening of the individual. Certain employment groups (e.g. painters, printers, welders, healthcare, and laboratory workers) are at increased risk of developing occupational asthma.

(2) Occupational asthma is an industrial prescribed disease and as such is eligible for compensation. The diagnosis is made by exclusion and should only be made following extensive and appropriate investigation by a consultant respiratory physician in liaison with a Service consultant occupational physician. Those with suspected or proven occupational asthma should be excluded from working with the hazardous material or process. Those found to have pre-existing or inherent susceptibility to asthma, may continue to work in said environments provided strict adherence is paid to controls, working practices and health surveillance.

Whatever the aetiology of the asthma, the individual should be medically graded appropriate to their employment, residual function and the requirement for supportive therapy. Individuals requiring maintenance therapy should normally be graded P3.

A key element in the JSP guidance is that examining medical officers should consider each individual on his or her own merit and apply their clinical judgement individually. Every effort will be made to retain individuals in service, subject to the restrictions above.

I hope this is helpful.

Yours sincerely

Defence Medical Services Department Secretariat

If you are unhappy with this response or you wish to complain about any aspect of the handling of your request, then you should contact DMSD in the first instance. If informal resolution is not possible and you are still dissatisfied then you may apply for an independent internal review by contacting the Director of Information Exploitation, 6th Floor, MOD Main Building, Whitehall, SW1A 2HB (e-mail ). Please note that any request for an internal review must be made within two calendar months of the date on which the attempt to reach informal resolution has come to an end.

If you are still unhappy following an internal review, you may take your complaint to the Information Commissioner under the provisions of Section 50 of the Freedom of Information Act. Please note that the Information Commissioner will not normally investigate your case until the MOD internal review process has been completed. Further details of the role and powers of the Information Commissioner can be found on the Commissioner's website, http://www.ico.gov.uk.

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