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Background: The aim of this study was assessment of the chronic effects of sulfur mustard (SM) among victims., Methods: In this cohort study, 355 SM-exposed subjects from Sardasht, and 123 controls from Rabat, both from West Azerbaijan Province, Iran were included. The spirometric evaluation and the global initiative for chronic obstructive lung disease (GOLD) classification were applied for all. Serum levels of urea, creatinine (Cr), and uric acid (UA) and glomerular filtration rate (GFR) were assessed. Data analysis was conducted using IBM SPSS., Results: All were male, with a mean age of 43.7±10.7 and 41.6±9.9 years in case and control groups, respectively. The case group had significantly higher values of Cr ( P <0.001) and UA ( P =0.018) than the control group. This was also the case in the Cr level ( P <0.001) in subjects without pulmonary dysfunction, between both groups. There was significant difference in the GFR ( P =0.047) between both groups and between subgroups with pulmonary dysfunction in the case and control groups ( P =0.045), as well as between SM-exposed subjects with and without pulmonary dysfunction ( P =0.009). Serum Cr, UA, sUA/Cr ratio, and BUN as well as the GFR did not have any significant correlation with forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio., Conclusion: Despite significantly high levels of Cr and UA in the case group, no significant correlation was found between serum Cr, UA, sUA/Cr ratio, BUN, and GFR with spirometric values. Further studies are required to reveal the underlying molecular and clinical significance of these findings., Competing Interests: Conflict of interest The authors declare that there is no conflict of interests.

The aim of this study was to evaluate possible association between ophthalmic complications in sulfur mustard (SM) exposed patients with mild ocular injuries and serum soluble adhesion molecules. Serum levels of sICAM-1, sL-selectin, sP-selectin and sE-selectin in 367 SM-exposed individuals with or without eye injuries were checked and compared with 128 unexposed controls. All participants underwent ocular examinations. Serum sICAM-1 level in SM exposed with blurred vision, was significantly (p=0.021) higher than in SM exposed with no blurred vision. Serum sL-selectin level was significantly (p=0.024) higher in SM exposed with photophobia than SM exposed with no photophobia. Serum P-selectin level in exposed without any slit lamp findings was significantly (p=0.003) lower than the matched control groups. Similar finding was seen in exposed group without ocular problem compared with the control groups. Serum sE-selectin level in exposed with normal ocular condition except for photophobia and blurred vision was significantly (p<0.05) higher than the matched controls. Serum E-selectin level in exposed with photophobia condition was significantly (p=0.047) higher than the control group with photophobia. In conclusion it seems that the changes in the E- and P-selectins is a regulatory mechanism for inhibition of SM induced ocular problems, although the local levels are more important and further investigations required in more severe ocular problems in SM exposed patients., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Purpose: Delayed keratitis is the most dangerous ocular complication of sulfur mustard (SM) exposure. This study aimed to evaluate the role of tear and serum levels of interleukin-8 (IL-8) in SM exposed subjects., Design and Methods: In this historical cohort study, the experimental group included 370 participants who had been exposed to SM 20 years prior. Data were compared with those of 128 unexposed participants as the control group. After completing a thorough systemic and ocular examination, serum IL-8 levels in all exposed and controls were compared. According to the statistical calculation, tear IL-8 levels, were compared in randomly selected 48 exposed and 37 controls. Based on the ocular findings, the selected subjects were divided into two subgroups, normal subjects include those participants who had no ocular signs and abnormal subjects, were those who had at least one or more ocular signs., Results: Bulbar conjunctiva and limbal tissues evaluation in all participants showed a significantly higher number of abnormalities in exposed group than in the control group (P=0.004 and P=0.048 respectively). Serum IL-8 levels in all exposed were significantly lower than the matched controls (P=0.002). Tear IL-8 levels in the selected exposed were significantly lower than in the selected controls (P=0.030). In exposed group with normal conditions of the lids, bulbar conjunctiva, cornea, tear status, limbus, slit lamp findings and final ophthalmic assessment, tear IL-8 levels were significantly lower than in the matched controls (P=0.022, 0.037, 0.027, 0.050, 0.039, 0.029, 0.045 respectively). With respect to the global ophthalmic assessment, tear fluid IL-8 levels in the abnormal controls were significantly lower than in the normal controls (P=0.049), but this decrease in secretion of tear IL-8 were not encountered in abnormal exposed (P=0.415)., Conclusion: Tear IL-8 secretion was significantly inhibited in the unexposed controls with ocular surface abnormalities, while these inhibitory responses were not encountered in SM-exposed cases with ocular surface abnormalities.

Purpose: Ocular and pulmonary involvement are the most important complications of sulfur mustard (SM) that may happen many years after exposure. This study aims to evaluate the severity of ocular involvement and the correlation between late ocular and lung complications in patients exposed to SM., Methods: This descriptive cross-sectional study was conducted on SM lung-injured war veterans. Status of pulmonary involvement was categorized into normal, mild, moderate, and severe based on the "Forced Expiratory Volume in first second (FEV1)".Status of ocular involvement was also categorized into normal, mild, moderate, and severe, based on the slit lamp findings. Correlation between pulmonary and ocular involvements was evaluated by Spearman rank correlation test., Results: Totally, 292 war veterans with clinical pulmonary involvement were included in the study. Status of pulmonary involvement was 3.8% normal, 11.2% mild, 16.1% moderate, and 68.9% severe. Status of the ocular involvement was 68.2% normal, 13.8% mild, 5.4% moderate, and 12.6% severe. Among all patients, 96.3% had pulmonary involvement and 32.5% had ocular involvement. There was a positive correlation between the severity of ocular and pulmonary involvements (p = 0.049 and r = 0.122)., Conclusion: The results of this study showed that although there was a positive correlation between the severity of pulmonary and ocular involvement, this correlation was weak. This might be due to the nature of the studied population or differences in the tissue susceptibilities, gas types, or exposure patterns.