Long Term Ocular Effects of Mustard Gas Poisoning: A Cross-Sectional Study in Iraqi Kurdish Civilians

Abstract

Background: Iraqi forces utilized a range of chemical weapons including sulfur mustard (SM) and other unknown chemical warfare agents against Iraqi Kurdish civilians in the 1980s. Little data exist regarding the chronic and delayed destructive lesions in the ocular organ caused by this exposure. The aim of this study was to evaluate and validate the severity of eye injuries in Kurdish subjects with chronic and delayed-onset mustard gas lesions. Methods: This cross-sectional study conducted by simple random sampling on 303 people who had history of exposure to chemical weapons in February 2009 in Sulaimany, Iraq. Medical history, symptoms, ocular conditions, clinical course, and treatment measures were reviewed. Statistical analysis was accomplished using SPSS/18, Chi-square test. Results: The present samples comprised of 49.8% were male and 50.2% were female. The mean age of the patients was 43.7 ± 13.1. Ophthalmic symptoms including tearing (96.7%), itching (96.0%), red eye (95.4%), blurred vision (84.2%), and vision loss (37.3%) were most common in subjects from Halabja, who also made up the majority of participants. Moderate to severe mustard gas keratitis was seen in 12.9% subjects (n=39), and severe complications were most common in subjects from Dukan. Conclusion: The investigation findings suggest that the need of Iraqi Kurdish chemical warfare victims with moderate to severe ophthalmologic complications for the provision of healthcare and follow-up is urgent. Further research also is necessary to measure the results of follow-up on Kurdish victims with mustard gas keratitis.