Prevention and Treatment of Respiratory Consequences Induced by Sulfur Mustard in Iranian Casualties: A Review

Abstract

Background: About 100,000 Iranian have been exposed to chemical weapons during Iraq‑Iran conflict (1980‑88). After being spent of more than two decades, still about 30,000 of them are under follow‑up treatment. The main aim of this study was to review various preventive and therapeutic methods for injured patients with sulfur mustard in different phases.

Methods: For gathering information, we have used the electronic databases including Scopus, Medline, ISI, IranMedex, Irandoc sites. According to this search strategy, 104 published articles associated to respiratory problems and among them 50 articles related to prevention and treatment of respiratory problems were found and reviewed.

Results: There is not any curative treatment for sulfur mustard induced lung injuries, but some valuable experienced measures for prevention and palliative treatments are available. Some useful measures in acute phase include: Symptomatic management, oxygen supplementation, tracheostomy in laryngospasm, use of moist air, respiratory physical therapy, mucolytic agents and bronchodilators. In the chronic phases, these measures include: Periodic clinical examinations, administration of inhaled corticosteroids alone or with long‑acting beta 2 agonists, use of antioxidants, magnesium ions, long term oxygen supplement, therapeutic bronchoscopy, laser therapy, and use of respiratory tract stents.

Conclusions: Most treatments are symptomatic but using preventive points immediately after exposure could improve following outcomes.

Keywords: Chemical warfare, lung injury, mustard gas