Abstract
Respiratory morbidities remained significant for the last four decades among the survivors of the Bhopal gas disaster. We hypothesized that lung function abnormalities, especially small airway dysfunctions, were responsible for the ongoing respiratory morbidities. We conducted a cross-sectional study between 2018 and 2020 in the severely exposed cohort of the Bhopal gas disaster. A standardized questionnaire was used to record their respiratory symptoms. The forced oscillometry (FOT) and spirometry were utilized for assessing lung functions. Univariate and multivariate logistic regression analyses were used to examine the association. Of 916 enrolled individuals (men: 442, mean age: 55.2±12.3 years), 558 participated in lung function assessments. Breathlessness was the most common complaint (71.7%), followed by cough (15.1%). The R5>upper limit of normal (ULN), R5-19>ULN, and X5<lower limit of normal (LLN) were observed in 29.3%, 23.3%, and 21.2% participants, respectively. Normal, obstructive, and restrictive spirometry was observed in 46.2%, 26.1%, and 27.7%, participants, respectively. FOT parameters were abnormal in 25.3% individuals with normal spirometry. Individuals with obstructive spirometry had the highest risk of having abnormal FOT parameters (adjusted odds ratio [adj OR]:3.93, 95% confidence interval [CI]: 2.24-6.89). Breathlessness showed a significant association with abnormal R5 (adj OR: 1.81; 95% CI: 1.13-2.91) and obstructive spirometry (adj OR: 2.26; 95% CI: 1.29-3.95). Assessment of small airway functions along with spirometry are useful to identify complex lung function abnormalities in cases of toxic inhalation.
Highlights
Bhopal gas disaster is one of the worst chemical disasters in the world
Individuals with obstructive spirometry had the highest risk of abnormal forced oscillation technique (FOT) parameters
Breathlessness showed a significant association with abnormal resistance at 5 Hz (R5) and obstructive spirometry
Summary
On 3rd December 1984, toxic gases were leaked at Bhopal (capital of state Madhya Pradesh, India) from a nearby pesticide plant. Several thousand individuals were exposed to these toxic gases, and many died. Cohorts for that study were assembled by randomly recruiting individuals from both gas-affected and non-affected areas. The stratification of mild, moderate, and severely exposed cohorts was based on the recruited subjects' residential addresses. We hypothesized that lung function abnormalities, especially small airway dysfunction (SAD), are responsible for persistent respiratory symptoms. Respiratory morbidities remained major morbidities among the survivors of the Bhopal gas disaster. We hypothesized that underlying lung function abnormalities, especially small airway dysfunctions (SAD), were responsible for persistent respiratory morbidity
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