Chronic pulmonary complications in Iraq-Kurdistan chemical weapons victims

The Iraqi government performed numerous chemical attacks against north-west of Iran and Iraq non-military civilians during 1980-88. The aim of this survey was to investigate the long term respiratory complications among chemical injury victims of Iraqi Kurdistan region. This cross-sectional descriptive study was performed in year 2008 on Iraqi Kurdish chemical injury victims who were invited by public invitation and 479 eligible patients entered the study by census sampling method. Then, physical examination, spirometry and thoracic high-resolution computed tomography were carried out on patients. Blistering after chemical weapon exposure was used to identify the significant exposure to sulfur mustard and patients were divided into two groups of having blisters and without blisters. Results of the two groups were compared by SPSS 16 software using Kolmogorov -Smirnov test, independent t-test, exact Fissure test, Chi square test and multivariate regression. Among 479 participants, 45.7% were male and 54.3% were female. The mean age was 43.1 ± 13.7. Spirometry was abnormal in 15.2% of patients and air trapping was present on CT scan in 46.6% cases and there was no significant difference between patients with blisters (n=278) and without a history of blistering. However, Blistering after chemical weapon exposure associated with more respiratory symptoms and worse lung function especially among Halabja inhabitants. Iraqi Kurdish chemical injury victims suffer from severe respiratory complications which may reflect the absence of essential preventive training for reduction of contact with chemicals and early treatment after incidents.