Original Article

Pulmonary Complications of Mustard Gas Exposure: A Study on Cadavers

Abstract

Sulfur mustard gas is one of the chemical warfare gases that roughly about 45000 soldiers continue to suffer long-lasting consequences of exposure during the Iran-Iraq war between 1980 and 1988. According to the common pulmonary lesions due to this gas exposure, we studied gross and microscopic pulmonary lesions in cadavers and also assessed the main causes of mortality caused by mustard gas exposure. A case-series study was performed on hospital record files of 100 cadavers that were exposed with documented sulfur mustard gas during the Iran-Iraq war from 1979 to 1988 and autopsied in legal medicine organization In Tehran between 2005 and 2007 and gross and microscopic pathological findings of autopsied organs such as hematological, pulmonary, hepatic, and renal changes were evaluated. All cases were male with the mean age of 43 years. The time interval between the gas exposure and death was almost 20years. The most frequent pulmonary complication was chronic bronchitis in 81% of autopsied cadavers. Other pulmonary findings were progressive pulmonary fibrosis (9%), pulmonary infections and tuberculosis (29%), malignant cellular infiltration (4%), and aspergilloma (1%). According to the chronic progressive lesions caused by mustard gas exposure such as pulmonary lesions and also its high mortality rate, suitable programming for protection of the gas exposed persons and prohibiting chemical warfare are recommended.

Bagheri MH, Hosseini SK, Mostafavi SH, Alavi SA. Highresolution CT in chronic pulmonary changes after mustard gas exposure. Acta Radiol 2003; 44:241-5.

Willems, J. L. Clinical management of mustard gas csualties. Ann Med Mil Belg 1989; 3:1-61.

Cox BM. Torald Sollmann's studies of mustard gas. Mol Interv 2007; 7:124-8.

Kehe, K. and Szinicz, L. Medical aspects of sulphur mustard poisoning. Toxicol 2005; 214, 198–209.

Shulman LN. The biology of alkylating-agent cellular injury. Hematol Oncol Clin North Am 1993; 72:325-35.

Afshinniaz F, Ghanei M. Relationship of the chronic respiratory symptoms with spirometric and laboratory parameters. Isfahan University of Medical Sciences, Isfahan, Iran, 1996. Dissertation.

Steinritz D, Emmler J, Hintz M, Worek F, Kreppel H, Szinicz L, Kehe K. Apoptosis in sulfur mustard treated A549 cell cultures. Life Sci 2007; 80:2199-201.

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 1997; 112:734-8.

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. J Occup Environ Med 2003; 45:1136-43.

Emad A, Emad Y. Increased in CD8 T lymphocytes in the BAL fluid of patients with sulfur mustard gas-induced pulmonary fibrosis. Respir Med 2007; 101:786-92.

Hefazi M, Attaran D, Mahmoudi M, Balali-Mood M. Late respiratory complications of mustard gas poisoning in Iranian veterans. Inhal Toxicol 2005 ;17:587-92

Boskabady MH. Airway responses to salbutamol after exposure to chemical warfare. Respiratory 2007.

Ghanei M, Moqadam FA, Mohammad MM, Aslani J. Tracheobronchomalacia and air trapping after mustard gas exposure. Am J Respir Crit Care Med 2006; 173:304-9.

Easton DF, Peto J, Doll R. Cancers of the respiratory tract in mustard gas workers. Br J Ind Med 1988; 45:652-9.

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IssueVol 49, No 4 (2011) QRcode
SectionOriginal Article(s)
Keywords
Mustard gas Lung injuries Mortality Cadaver

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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Taghaddosinejad F, Fayyaz AF, Behnoush B. Pulmonary Complications of Mustard Gas Exposure: A Study on Cadavers. Acta Med Iran. 1;49(4):233-236.