RELATIONSHIP BETWEEN LUNG INFLAMMATION, CHANGES IN LUNG-FUNCTION AND SEVERITY OF EXPOSURE IN VICTIMS OF THE BHOPAL TRAGEDY

Citation
Vk. Vijayan et K. Sankaran, RELATIONSHIP BETWEEN LUNG INFLAMMATION, CHANGES IN LUNG-FUNCTION AND SEVERITY OF EXPOSURE IN VICTIMS OF THE BHOPAL TRAGEDY, The European respiratory journal, 9(10), 1996, pp. 1977-1982
Citations number
19
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Respiratory System
ISSN journal
0903-1936
Volume
9
Issue
10
Year of publication
1996
Pages
1977 - 1982
Database
ISI
SICI code
0903-1936(1996)9:10<1977:RBLICI>2.0.ZU;2-4
Abstract
The world's worst chemical industrial disaster, which occurred at Bhop al on 2-3 December, 1984, resulted in considerable respiratory morbidi ty in the exposed population. Therefore, a study was planned to evalua te the relationship between lower respiratory tract inflammation, lung function and severity of exposure. Sixty patients exposed to methyl i socyanate and presenting with respiratory symptoms were studied using bronchoalveolar lavage (BAL) 1-7 yrs after the accident, Pulmonary fun ction tests included forced vital capacity (FVC) and forced expiratory volume in one second (FEV(1)). An index of severity of exposure was d erived retrospectively on the basis of the acute symptoms in the victi ms themselves or the occurrence of death among their family members. T otal lung inflammatory cells (p<0.01) and absolute numbers of macropha ges (p=0.01) and lymphocytes (p<0.05) increased as severity of exposur e increased. FEV(1)/FVC % (p=0.05) was also significantly lower as sev erity of exposure increased. Moderately exposed subjects had significa ntly lower FEV(1)/FVC % (p<0.05) compared to those mildly exposed. In nonsmokers, BAL neutrophils, both percentage and absolute numbers, sho wed significant negative correlations with FEV(1) % predicted (r(s)=-0 .350, p<0.05; and r(s)=-0.374, p<0.01, respectively). Neutrophil perce ntage was negatively correlated with FEV(1)/FVC % (r(s)=-0.378; p<0.01 ). Absolute lymphocytes had significant negative correlations with FVC % pred (r(s)= -0.318; p<0.05). Macrophages had significant positive c orrelations with FVC % pred (r(s)=0.322; p<0.05) and FEV(1) % pred (r( s)=0.433; p<0.01). Radiographic abnormalities (International Labour Or ganization (ILO) classification) were associated with decline in FEV(1 ) % pred (p<0.05). This study suggests that pulmonary function abnorma lities occur in gas-exposed subjects as a consequence of an abnormal a ccumulation of lung inflammatory cells (lymphocytes and neutrophils), and that the intensity of lung inflammation and reduction in pulmonary function are greater in severely exposed subjects. As it has been obs erved that decline in pulmonary function is associated with radiograph ic abnormalities, there is a suggestion that injury following toxic ga s exposure can lead to irreversible lung damage.