[ OSH-Link Home
| IVI Online
| Comments ]
The relationship between lower respiratory tract inflammation, changes in lung function, and severity of exposure to toxic gas among victims of the Bhopal chemical industrial crisis was evaluated. Sixty patients exposed to methyl-isocyanate (624839) on December 2, and 3, 1984, displayed respiratory symptoms of cough and dyspnea on exertion. The patients underwent pulmonary function tests, chest radiographs, and bronchoalveolar lavage (BAL) performed an average of 2.8 years after exposure. Patients were classified with respect to their exposure as severe (41 patients), moderate (13 patients), or mild (six patients). Seven of 13 moderately exposed patients showed radiographic abnormalities, compared with 29 of 41 severely exposed patients. Overall, mean forced vital capacity (FVC) and forced expiratory volume (FEV) were significantly lower in exposed patients compared to predicted values. Severely exposed patients had significantly elevated total cell counts in the lower respiratory tract compared with normal controls. BAL fluid analysis showed that in severely exposed patients, alveolar macrophages and neutrophils were significantly higher than in controls. Absolute macrophage and absolute lymphocyte counts increased significantly as severity of exposure increased. The ratio of FEV to FVC declined significantly as severity of exposure rose. The relative risk of having radiographic abnormality in persons with abnormal FEV was five times higher than in those with normal FEV. Percentages and absolute numbers of neutrophils and lymphocytes in BAL fluid negatively correlated with FEV and FVC. The authors conclude that pulmonary function measurements correlate negatively with lower respiratory tract lymphocytes and neutrophils, and these cells may contribute to respiratory morbidity independent of smoking.
European Respiratory Journal, 9(10):1977-1982, 1996. (18 references)
You can do a search of the OSH-DB database and get a list of articles on any topic of interest on our Visitor Search Page. Access to read the articles is limited to OSH-DB subscribers.