Long-term hematological consequences of sulfur mustard on civilians of Sardasht 20 years after exposure

Abstract

Sulfur mustard (SM) is a vesicant or blistering chemical agent that possesses mutagenic and carcinogenic properties and alkylates DNA. Little is known about the long-term effects of sulfur mustard on blood cells. The aim of this study is to examine the long-term effects of SM on peripheral blood cells in SM victims of the Iraq-Iran war (1980–1988). This study, which is a part of Sardasht Iran Cohort Study (SICS) was designed in two groups: exposed (372 participants from Sardasht) and control (128 unexposed people from Rabat). The exposed group was divided into hospitalized and not hospitalized subgroups based on the severity of lesions at exposure time. A comparison was made between the study groups’ overall blood exams. The hospitalized group had significantly higher numbers of red blood cells (p = 0.003) than not hospitalized and the control groups. The exposed group had significantly higher HCT and MCV (P = 0.007) than the control group. Exposure group had significantly lower numbers of PLT (P = 0.001), WBC (P = 0.006) and PMN (P = 0.001) than the control group but from clinical viewpoint this difference is not valuable. Further, lymph cells (P = 0.001) in the exposed group were significantly higher than in the control group. Our research findings suggested the probability of severe damage to bone marrow and predisposing to infection in other organs (especially lung) due to exposure to SM in the exposed group.

Keywords::

• Sulfur mustard
• long-term effect
• peripheral blood cells
• hematology
• Sardasht-Iran Cohort Sudy

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.