Exposure to sandstorms and trash burning in open pits in Iraq and Afghanistan has led to lung problems for those who have returned from overseas tours and Afghanistan, and the military is struggling with how to address the phenomenon. Now, the Department of Defense is reviewing its policy of not requiring mandatory lung tests for troops amid growing outside pressure to take a harder look at what two wars in perennially dusty, sometimes toxic climates have done to soldiers’ lungs and how to better handle these issues in the future.

Other service members are in similar situations, because unlike many fire departments and industries where workers face potential lung problems, the military doesn’t require the tests until after troops report problems.

Returning veterans and contractors have brought lawsuits against their employers and the U.S. government, citing exposure to burn pits, where troops typically burn all their trash while on deployment, including plastics, human waste and things like batteries. Congress has ordered the VA to establish a burn-pit registry by January, where vets from Iraq, Afghanistan and the Gulf Wars can log on and document their concern about health problems tied to the exposure..

Nearly two million troops have deployed to Iraq and Afghanistan since 2001. About 14% of deployed troops complained of lung problems, according to research cited in a 2012 article in the Journal of Occupational and Environmental Medicine. Separate research showed 6.6% of troops who had deployed to Iraq had VA-diagnosed asthma, higher than the figure for troops not deployed to those countries.