Long-term pulmonary complications of sulphur mustard gas exposure in Iranian chemical war victims

ABSTRACT

Sulphur Mustard [SM] is a major threat around the world not only on the battle field but also to civilian population. It has been used by Iraqi troops against Iranian veterans and resulted in severe inhalation injury and pulmonary complications in Iranian soldiers. To determine the long-term pulmonary sequelae of SM gas exposure on Iranian veterans of Iraqi -Iran conflict, chemical victims of Babol, who have been referred for follow up examination to Shaheed Beheshti Hospital clinic [were studied]. A total of 220 male chemical exposed victims and 92 age matched healthy controls were studied. Diagnosis of SM-related disease was confirmed on the basis of prior history of SM gas exposure and excluding other unrelated diseases. The results were regarded positive if the FEVI% or FVC% or absolute FEVI volume increased by 15%, 20% or 180 ml respectively compared with baseline value. In statistical analysis, the frequency of respiratory signs and symptoms, radiographic changes of chest radiographs, and the proportion of persons with abnormal PFT results were determined and compared with age matched controls. Emphysema in 2%, cor pulmonale in 4% and severe respiratory disease requiring permanent supportive treatment in 4.5% of patients. Abnormal radiographic findings were detectable in 64% of chest radiographs which were remarkable in only 13%. Obstructive airway disease was detected in 110 [50%] patients and 11 [5.4%] controls [P<0.0001]. The degree of obstruction was mild, moderate or severe in 13.5%,73% and 13.5% of patients and 80%, 20% and 0% of controls respectively. Restrictive airway disease was observed in 22 [10%] patients and 11 [12%] controls [P=NS]. Normal PFT was seen in 40% of patients and 83% of controls [P<0.0001]. Only 30% of patients with obstructive airway disease were responsive to bronchodilator test. The findings of the present study show that, a remarkable number of Iranian veterans are suffering from chronic lung diseases several years after exposure to SM gas