Occurrance of Emphysema and Accuracy of Pulmonary Function Test (PFT), ‎Comparing with Chest High Resolution Computed Tomography (HRCT), in ‎Smokers with History of Exposure to Toxic Fumes

Objective. To study the occurrence of emphysema and accuracy of Pulmonary Function Test ‎‎(PFT), comparing with chest High Resolution Computed Tomography (HRCT), in smokers with ‎history of exposure to toxic fumes (Sulfur Mustard SM). Material and Methods. This was a cross sectional study (2003 - 2004) on 20 symptomatic ‎smokers with mild SM exposure (Group I) and 20 smokers without SM exposure (Group II). ‎PFT and CHEST HRCT were performed for all patients to detect emphysema. Sensitivity, ‎specificity, and positive and negative predictive values were calculated for PFT. Results. PFT did not diagnose emphysema in group I while CHEST HRCT diagnosed five ‎patients (sensitivity= 0). Group II developed emphysema (11 of 20, 55%) more frequently than ‎group I (5 of 20, 20%, p<0.05). No α1-antitrypsin deficiency was found in all 70 individuals. Conclusions. Smokers with an additional risk factor, such as exposure to toxic fumes, develop ‎emphysema at younger ages while they have normal PFT. CHEST HRCT should be regarded as ‎a useful tool in the early diagnosis of emphysema in such cases.‎