It is well documented that inhalation of sulfur mustard causes injury of the respiratory system. While all of the reports and surveys thoroughly document long-term pulmonary effects after significant exposure to mustard, there is no direct evidence that addresses the issue of long-term respiratory effects in individuals who were exposed to very low level of mustard and suffered no acute respiratory tract injury. The aim of this study is to evaluate the respiratory histopathological findings in the veteran claiming exposure to CWA during Iran-Iraq war.
We studied 395 subjects which were selected among all those who were in chemically contaminated areas with chemical warfare agents (CWA) and had been registered for an annual checkup. Background data were collected. All subjects underwent diagnostic bronchoscopy and biopsy which was performed and interpreted by one pneumatologist and one pathologist.
Subjects were 395 men with the mean age of 41.46 (SD, 5.43) years which exposed to CWA averagely 18.7 (SD, 1.74) years ago. In the bronchoscopic evaluation 363 patients (91.8%) had no lesion and were normal. 16 patients (4.5%) had mucopurulaent secretions. Bronchoscopic findings did not relate to the cigarette consumption (p=0.62) and length time after exposure (p=0.44) but age (p=0.03). Minimal to moderate changes of interstitial fibrosis were the most prevalent abnormal changes (75%) which was not related to cigarette smoking (p=0.9), age (p=0.24) and the time after exposure (p=0.21).
This study shows that findings of gross bronchoscopy is not suggestive and characteristic for the patients exposed CWA and near all patients had normal bronchoscopy. Our results also showed that a major proportion of patients showed interstitial fibrosis in their specimens.
There is no characteristic finding in the bronchoscopy of patients exposed to CWA.
Abbas Nemati, None.