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Progressive delayed respiratory complications of sulfur mustard poisoning in 43 Iranian veterans, three decades after exposure

TitleProgressive delayed respiratory complications of sulfur mustard poisoning in 43 Iranian veterans, three decades after exposure
Publication TypeJournal Article
Year of Publication2018
AuthorsDarchini-Maragheh E., Balali-Mood M., Malaknezhad M., Mousavi S.R
JournalHum Exp Toxicol
Volume37
Issue2
Pagination175-184
Date PublishedFeb
ISBN Number0960-3271 (Linking)
Accession Number29320941
Keywords*Veterans Health, Adolescent, Adult, bronchiectasis, Bronchiectasis/*chemically induced/diagnosis/physiopathology, Bronchiolitis, Bronchiolitis/*chemically induced/diagnosis/physiopathology, Chemical Warfare Agents/*poisoning, Cough/chemically induced/physiopathology, Cross-Sectional Studies, Disability Evaluation, Dyspnea/chemically induced/physiopathology, Forced Expiratory Volume, Humans, Inhalation Exposure/*adverse effects, Iran, Lung/diagnostic imaging/*drug effects/physiopathology, Male, Middle Aged, Mustard Gas/*poisoning, Poisoning, Pulmonary Fibrosis/*chemically induced/diagnosis/physiopathology, pulmonary function test, Risk Factors, Spirometry, Sulfur Mustard, Time Factors, Tomography, X-Ray Computed, Vital Capacity, Young Adult
Abstract

The most common delayed complication of sulfur mustard (SM) poisoning has been observed in the respiratory tracts. It was thus aimed to investigate the delayed respiratory complications in SM-exposed patients around 25 years before the study. Forty-three veterans with more than 25% disability of due to SM poisoning were investigated. Clinical examinations as well as pulmonary function test (PFT) were performed. High-resolution computed tomography (HRCT) of the lungs was done as clinically indicated. Triad of chronic cough, dyspnea, and expectoration were the most common symptoms that were recorded in 88.2%, 88.2%, and 64.7% of the patients, respectively. PFT abnormalities were detected in 44.18% of the patients. Restrictive pattern was the most common (41.86%), while pure obstructive pattern did not detect at all. Mixed pattern was significantly correlated with higher disability percentages among the veterans ( p < 0.001). Significant reverse correlation between the disability percentages and forced expiratory volume in 1 s/forced vital capacity ratio was obtained ( p = 0.010, r = -0.389). Air trapping was the most common abnormality in HRCTs (50%). Bronchiectasis (25%), pulmonary fibrosis (25%), and ground-glass attenuation (16.66%) were other common HRCT findings. Comparing with the previous studies on these patients, more restrictive and mixed pattern were observed. Moreover, bronchiolitis, bronchiectasis, and lung fibrosis were the main pathological findings in these patients.

URLhttps://www.ncbi.nlm.nih.gov/pubmed/29320941
DOI10.1177/0960327117694072
Short TitleProgressive delayed respiratory complications of sulfur mustard poisoning in 43 Iranian veterans, three decades after exposure

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