Abstract
Background: Graniteville, SC was the site of a train accident on January 6th, 2005 which led to the largest chlorine gas spill (60 tons) in the US history. Aim: In order to assess long term effects of high concentration chlorine inhalation on lung health diagnostic pulmonary function tests (PFTs) are being provided to former Avondale millworkers of Graniteville. Methods: We obtained PFT data on millworkers who were tested annually from 1980 till the closure of the mill in 2006. We selected millworkers who had at least 2 PFTs done before chlorine exposure and were tested in the year 2012-13 (N=108). We classified exposure based on whether or not millworkers were present in Graniteville at the time of accident (Exposed=23, Unexposed=85). We compared the % predicted values of pulmonary function parameters between exposed and unexposed in an interrupted time-series analysis using random effects model. Results: There was a decrease in % predicted FVC over time (p-value: 0.019) in millworkers who were exposed to chlorine as compared to those unexposed after controlling for smoking history. The mean % predicted FVC was 79.1 in exposed as compared to 92.0 in unexposed (p-value: 0.04). The differences in % predicted FVC before chlorine exposure were not significant between two groups. However, the exposed group showed a significant decline in % predicted FVC as compared to unexposed (p-value: 0.03). We also found that millworkers exposed to chlorine were more likely to have FEV1/FVC ratios above the predicted FEV1/FVC (OR=1.78, CI 95%: 1.08-2.95, p-value: 0.024) after controlling for smoking history and obesity. Conclusion: Our findings suggest that exposure to high concentration of chlorine gas leads to a longitudinal decrease in % predicted FVC along with increase in FEV1/FVC ratios which is suggestive of potential restrictive disease. However, further research with more definitive exposure classification is needed to confirm our findings.
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