Evaluation of Bronchial Hypersensitivity in Veterans With Sulfur Mustard Gas-Induced Skin or Eye Manifestations Without Respiratory Symptoms: 15 Years After Exposure

Abstract

The authors evaluated the prevalence of bronchial hypersensitivity in subjects who had confirmed exposure to sulfur mustard gas (SMG) but no overt respiratory manifestations. They chose 30 patients who had proven skin or eye manifestations secondary to SMG, and performed baseline and provocative pulmonary function testing with cold air and methacholine. The authors performed the same procedure on 30 control volunteers. After challenge testing with cold air and methacholine, bronchial hypersensitivity was detected in 7 (23.3%) and 9 (30%) of cases, respectively. Only 1 control subject showed hypersensitivity after provocation testing with cold air (p = approximately .05); the same control subject showed a positive challenge testing result with 10 mg/ml of methacholine (p < .02). The kappa coefficient for evaluating the effectiveness of the cold air, as a provocative agent for challenge testing, was 93.3%.

Keywords:

• bronchial hypersensitivity
• cold air challenge testing
• methacholine challenge testing
• reactive airway dysfunction syndrome
• sulfur mustard gas