An increasing number of civilian workers who worked for defense contractors in Iraq and Afghanistan are reporting respiratory illness. Reported in US Servicemen and women in 2011 in a presentation to the American Thoracic Society an increasing number of veterans were suffering from respiratory illness from a variety of sources including sand dust, smoke from burn pits, aerosolized metals and chemicals from IEDs, blast overpressure from shock waves to the lungs, indoor and outdoor allergens (pollens and molds). Named “Iraq-Afghanistan War lung injury” (IAW-LI) these serious respiratory problems were reported at a rate seven times higher than in soldiers deployed elsewhere. These respiratory conditions are not limited to soldiers but also to those civilian employees of defense contractors working in Iraq and Afghanistan. While the subject of multidistrict litigation in a suit against KBR, representing both soldiers and civilians for Burn Pit exposures, those who suffer who were employed by civilian contractors have Defense Base Act claims, whether covered by the Burn Pit litigation or not. These claims extent beyond the Burn Pit exposures and include Tuberculosis, sand dust exposures, exposures to aerosolized metals and chemicals, blast shock wave exposures, and indoor and outdoor allergens unique to or in excessive quantity in those environments. Many of these conditions, while treatable, can cause serious and permanent injury and impairment and are compensable under the Defense Base Act, a federal law providing workers’ compensation protection to civilian employees of US Government contractors, not only in Iraq and Afghanistan, but throughout the world (outside of the US). As the operations wind down in the Middle East it is expected that more and more claims from both veterans and civilians deployed there for respiratory disease will emerge. For returning civilians, care should be taken to not only timely obtain appropriate and proper medical evaluation and care (be sure to provide the doctor the history of work in the Middle East and exposures to the toxins described above, where applicable) but to seek to protect one’s legal rights to medical and compensation benefits by timely pursuing a Defense Base Act claim. There are specific timelines for notice and claim that must be followed to not jeopardize one’s rights. Further information can be obtained by contacting the closest Office of Workers’ Compensation Programs (http://www.dol.gov/owcp/ ) or experienced legal counsel.