The effect of chemical warfare on respiratory symptoms, pulmonary function tests and their reversibility 23–25 years after exposure

Abstract

Pulmonary complications due to mustard gas exposure range from no effect to severe bronchial stenosis. Pulmonary function tests (PFTs) and respiratory symptoms in chemical war victims were studied 23-25 years after exposure to sulfur mustard (SM). Respiratory symptoms were evaluated in a sample of 142 chemical war victims and 120 control subjects with similar age from the general population using a questionnaire including questions on respiratory symptoms in the past year. PFT values were also measured in chemical war victims before and 15 min after the inhalation of 200 µg salbutamol and baseline PFT in controls. All chemical war victims (100%) reported respiratory symptoms. Wheezing (66.19%), cough (64.78%), and chest tightness (54.4%) were the most common symptoms and only 15.5% of chemical war victims reported sputum (p < 0.01 for sputum and p < 0.001 for other symptoms compared with control group). In addition, 49.3% of chemical war victims had wheeze in chest examination, which were significantly higher than control group (p < 0.001). The severity of respiratory symptoms was also significantly higher than control subjects (p < 0.05 for sputum and p < 0.001 for other symptoms). All the PFT values were also significantly lower in chemical war victims than that in control subjects (p < 0.001 for all cases). In addition, all the PFT values improved significantly after the inhalation of 200 µg salbutamol (p < 0.05-p < 0.001). These results showed that chemical war victims, 23-25 years after exposure to chemical warfare have higher frequencies and severity of respiratory symptoms. PFT values were also significantly reduced among chemical war victims, which showed reversibility due to the inhalation of 200 µg salbutamol.

Carvacrol ameliorates haematological parameters, oxidant/antioxidant biomarkers and pulmonary function tests in patients with sulphur mustard‐induced lung disorders: A randomized double‐blind clinical trial

“…The results of previous studies showed that SM exposure led to chronic bronchitis, pulmonary fibrosis and bronchiectasis in 197 veterans, 10 years after exposure, 43,44 and reduction in PFT values and increased respiratory symptoms 23-25 years after exposure. 45 Furthermore, the relaxant effect of CAR on the tracheal smooth muscle of guinea pigs 46,47 and its inhibitory effect on muscarinic 17 and histamine H 1 receptors 16 as well as its stimulatory effect on β2-adrenoreceptors in tracheal smooth muscle were shown. 48 The relaxant effect of CAR on airway smooth muscle (bronchodilatory effect) supports the results of the present study.…”

“…The results of previous studies showed that SM exposure led to chronic bronchitis, pulmonary fibrosis and bronchiectasis in 197 veterans, 10 years after exposure, and reduction in PFT values and increased respiratory symptoms 23‐25 years after exposure …”

Mustard Gas Inhalation Injury

“…All of these compounds have shown improvement in SM-and CEESinduced lung injury. [48][49][50][51] These results indicate not only the complex toxic mechanisms of action of these vesicating agents but also the need for future research in this area in order to identify more selective anti-inflammatory agents as well as possible combinations of pharmacologic antagonists targeting other affected pathways.…”

The effect of vitamin E on lung pathology in sulfur mustard-exposed guinea pigs

“…Epithelial damage of the airways has also been reported in chemical warfare victims (Bahadori et al, 1989; Emad et al, 1995). Reduction of pulmonary function (Boskabady et al, 2015) and increase in airway responsiveness to methacholine (Mirsadraee et al, 2005) and salbutamol (Boskabady et al, 2008) following exposure to SM were also shown. Treatments suggested for respiratory disorders caused by SM are sodium thiosulfate, cysteine, dexamethasone, and vitamin E (Hosseini et al, 1989; Somani and Babu, 1989).…”