Long-term pulmonary complications in sulfur mustard victims of Sardasht, Iran

Abstract

Sulfur mustard (SM) has widely been used against the military and civilians during the Iraq-Iran war (1980–1988). It mostly affects the respiratory system. A large historical cohort study was designed to evaluate the pulmonary status of non-military victims in Sardasht, Iran, in comparison with a matched control group 20 years after a single massive exposure. The exposed group was divided into two subgroups of hospitalized and non-hospitalized based on the severity of the injuries indicated by hospitalization a few days following exposure. All participants’ respiratory symptoms and signs were evaluated by internists. Dyspnea (n = 261; P = 93.2%) was the most common symptom. Chronic cough, cough severity, sputum, hemoptysis, dyspnea, pattern of dyspnea, severity of dyspnea (P <0.001 for all), and chest pain (P = 0.003) were statistically significantly different between the two groups. Wheezing was the most common pulmonary finding (11.4%). There was also a statistically significant difference in the auscultation of wheezing (P = 0.045) and rhonchi (P = 0.018) between the hospitalized and control groups. Considering objective findings, pulmonary involvement was observed in 24.3% (n = 68, P = 0.007).

Keywords::

• Sulfur mustard
• respiratory complications
• FEV1
• pulmonary function test
• Sardasht-Iran Cohort Study

Acknowledgments

This study was performed by Immunoregulation Research Center of Shahed University, and Janbazan Medical and Engineering Research Center (JMERC) and supported by the Iranian Foundation of Martyr and Veterans Affairs and Ministry of Health and Medical Education. We would like to thank all the participants who took part in this study very kindly. We also kindly thank Dr. Mohsin Reza Heidary for his critical reading of this manuscript and helpful comments.

Declaration of interest: The authors report no conflicts of interest.