Mustard Gas Effects on Iranian Veterans After 20 Years as Shown on Chest High-resolution Computed Tomography: A Follow-up Study

Seid Kazem Razavi Ratki, Nasim Namiranian, Abdu-Reza Sadrarhami, Ali Ahmadi Dahaj, Mohammad Sobhan Ardakani, Reza Nafisi Moghadam

Abstract

Introduction: Mustard gas is a known chemical weapon that was used in the 1980-1988 Iran- Iraq War. It causes many health problems, including serious respiratory damage. In this study, we used high-resolution computed tomography to assess the pulmonary complications after 20 years of veterans of the Iran-Iraq War who were exposed to mustard gas.

Materials and Methods: This was a follow-up study conducted on 200 Iranian veterans with a history of exposure to mustard gas at least 20 years previously. High-resolution computed tomography was performed on all veterans and was interpreted by two independent expert radiologists who were blinded to the study. The frequency of high-resolution computed tomography ndings was reported. Data were analyzed with statistical package for the social sciences version 20 software.

Results:One hundred twenty veterans (60%) showed HRCT abnormalities. The most frequent high-resolution computed tomography ndings were diffuse hyper-aeration, 63 (52.5%); interstitial opacity, 50 (41.7%); parenchymal opacity, 26 (21.7%); bronchiectasis, 15 (12.5%); sub-pleural air trapping, 13 (10.8%); and local brosis, 10 (8.3%). Generally, lower lobes were more frequently affected.

Conclusion: This study showed a high frequency of abnormal high-resolution computed tomography ndings in veterans who were exposed to mustard gas, and most abnormalities were irreversible. These ndings included diffuse hyper-aeration, interstitial opacity, parenchymal opacity, bronchiectasis, sub-pleural air trapping, and local brosis.

Keywords

Mustard Gas, Chemical Weapon, Iran, Veterans

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References

References:

Bullman T, Kang H. A fifty year mortality follow-up study of veterans exposed to low level chemical warfare agent, mustard gas. Annals of epidemiology. 2000;10(5):333-8.

Franz DR, Jahrling PB, Friedlander AM, McClain DJ, Hoover DL, Bryne WR, et al. Clinical recognition and management of patients exposed to biological warfare agents. Jama. 1997;278(5):399-411.

Razavi SM, Ghanei M, Salamati P, Safiabadi M. Long-term effects of mustard gas on respiratory system of Iranian veterans after Iraq-Iran war: a review. Chinese Journal of Traumatology. 2013;16(3):163-8.

Khateri S, Ghanei M, Keshavarz S, Soroush M, Haines D. Incidence of lung, eye, and skin lesions as late complications in 34,000 Iranians with wartime exposure to mustard agent. Journal of occupational and environmental medicine. 2003;45(11):1136-43.

Hefazi M, Attaran D, Mahmoudi M, Balali-Mood M. Late respiratory complications of mustard gas poisoning in Iranian veterans. Inhalation toxicology. 2005;17(11):587-92.

Hassan ZM, Ebtekar M, Ghanei M, Taghikhani M, Daloii MRN, Ghazanfari T. Immunobiological consequences of sulfur mustard contamination. Iranian Journal of Allergy, Asthma and Immunology. 2006;5(3):101-8.

Dacre JC, Goldman M. Toxicology and pharmacology of the chemical warfare agent sulfur mustard. Pharmacological reviews. 1996;48(2):289-326.

Balali‐Mood M, Hefazi M. The pharmacology, toxicology, and medical treatment of sulphur mustard poisoning. Fundamental & clinical pharmacology. 2005;19(3):297-315.

Bakhtavar K, Sedighi N, Moradi Z. Inspiratory and expiratory high-resolution computed tomography (HRCT) in patients with chemical warfare agents exposure. Inhalation toxicology. 2008;20(5):507-11.

Wada S, Miyanishi M, Nishimoto Y, Kambe S, Miller R. Mustard gas as a cause of respiratory neoplasia in man. The Lancet. 1968;291(7553):1161-3.

Austin J, Müller N, Friedman PJ, Hansell DM, Naidich DP, Remy-Jardin M, et al. Glossary of terms for CT of the lungs: recommendations of the Nomenclature Committee of the Fleischner Society. Radiology. 1996;200(2):327-31.

Ghanei M, Fathi H, Mohammad MM, Aslani J, Nematizadeh F. Long-term respiratory disorders of claimers with subclinical exposure to chemical warfare agents. Inhalation toxicology. 2004;16(8):491-5.

Bagheri M, Hosseini S, Mostafavi S, Alavi S. HIGH‐Resolution CT in chronic pulmonary changes after mustard gas exposure. Acta Radiologica. 2003;44(3):241-5.

Ghanei M, Mokhtari M, Mohammad MM, Aslani J. Bronchiolitis obliterans following exposure to sulfur mustard: chest high resolution computed tomography. European journal of radiology. 2004;52(2):164-9.

Emad A, Rezaian GR. The diversity of the effects of sulfur mustard gas inhalation on respiratory system 10 years after a single, heavy exposure: analysis of 197 cases. CHEST Journal. 1997;112(3):734-8.

Bijani K, Moghadamnia A. Long-term effects of chemical weapons on respiratory tract in Iraq–Iran war victims living in Babol (North of Iran). Ecotoxicology and environmental safety. 2002;53(3):422-4.

Biederer J, Schnabel A, Muhle C, Gross W, Heller M, Reuter M. Correlation between HRCT findings, pulmonary function tests and bronchoalveolar lavage cytology in interstitial lung disease associated with rheumatoid arthritis. European radiology. 2004;14(2):272-80.

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