Pulmonary Complications of Chemical Warfare 15 Years after Exposure

Authors

1 Department of Internal Medicine, Mazandaran University of Medical Sciences and Health Services

2 Department of pulmonary Medicine,

3 Department of pathology, Mashad University of Medical Sciences and Health Services, MASHAD- IRAN

Abstract

Introduction: Chemical weapons, (mainly mustard gas-MG) were heavily used by Iraq against Iranian soldiers between 1984-1986. It has acute effects on respiratory tract in the form of tracheobronchitis and ARDS, whereas chronic respiratory complications include chronic bronchitis, bronchiectasis, asthma and pulmonary fibrosis. There are few reports about human victims. Some of them describe acute effects while our purpose is to define chronic sequelae and their microbiologic, radiologic and physiologic behavior. Materials and Methods: Fourty four chemical weapon injured patients with moderate to severe disability were selected by AMA criteria (1). All of them underwent history taking and physical examination, ABG, spirometry, CXR, HRCT, bronchoscopy and BAL for cytology and quantitative culture. Results: Of fourty four patients; 29(66%) had diagnosis of chronic bronchitis by ATS criteria (2), 8 (18%) and 7 (16%) had diagnosis of bronchiectasis and asthma respectively. The most common HRCT finding was ground glass appearance. In one-fourth of patients BAL culture was positive and revealed unusual organisms (S.aureus, S.coagulase negative, E.coli)., BAL neutrophils were increased in bronchiectatic group (258±136 hpf) vs. (96±49 hpf), (148±133 hpf) (p

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