目的:芥末硫(SM)是一种化学武器剂,在伊伊拉克战争(1980-1988)期间被伊拉克军队广泛使用,导致伊朗军事人员和平民暴露。然而,关于SM暴露对死亡率的长期影响的信息有限且相互矛盾.这项研究旨在确定在伊朗-伊拉克战争期间暴露于SM气体的个人的标准化死亡率(SMR)。
方法:这是一项回顾性随访研究。
方法:数据来自伊朗退伍军人和烈士事务基金会(VMAF),涉及在伊朗-伊拉克战争(1980-1988)期间至2019年3月30日接触SM的所有确诊个体。死亡率,计算了累积死亡率和具有95%置信区间(CI)的SMR,以评估化学战幸存者(CWS)的死亡率,并将结果与一般伊朗人口进行了比较。使用Kaplan-Meier曲线分析总生存期,采用对数秩检验比较不同类别的生存概率。
结果:在48,067个确认的CWS中,截至研究期结束(2019年3月30日),共有4358人(9.1%)死亡,死亡时的平均年龄为55.5±14.4岁。总的来说,在39年的随访中,暴露于SM的人群的所有死因死亡率均低于一般伊朗人群(SMR:0.70,95%CI:0.68-0.72).然而,原因特异性SMR分析显示肝癌死亡率(SMR:1.98,95%CI:1.59-2.45),中毒(SMR:1.92,95%CI:1.52-2.38),呼吸系统疾病(SMR:1.59,95%CI:1.46-1.73)和多发性骨髓瘤(SMR:1.72,95%CI:1.06-2.62)比一般人群高约2倍.
结论:这项研究提供了有关SM暴露在受伊伊拉克战争影响的伊朗人群中的死亡率影响的有价值的见解。结果强调了继续监测和支持暴露于SM的个人的重要性,特别是在管理和解决与肝癌相关的高风险的背景下,中毒,呼吸系统疾病和多发性骨髓瘤。可能需要进一步的研究和干预措施来减轻受影响人群的这些特定健康挑战。
OBJECTIVE: Sulphur mustard (SM) is a chemical weapon agent that was extensively used by Iraqi troops during the Iran-Iraq war (1980-1988), resulting in exposure among Iranian military personnel and civilians. However, there is limited and conflicting information about the long-term mortality effects of SM exposure. This
study aimed to determine the standardised mortality ratios (SMRs) in individuals exposed to SM gas during the Iran-Iraq war.
METHODS: This was a retrospective follow-up
study.
METHODS: Data were obtained from the Veterans and Martyr Affair Foundation of Iran (VMAF) regarding all confirmed individuals who were exposed to SM during the Iran-Iraq war (1980-1988) up to 30 March 2019. The mortality rate, cumulative mortality and SMR with 95 % confidence intervals (CIs) were calculated to assess mortality in chemical warfare survivors (CWS), and results were compared with the general Iranian population. Overall survival was analysed using the Kaplan-Meier curve, and the log-rank test was employed to compare survival probability across different categories.
RESULTS: Among the 48,067 confirmed CWS, a total of 4358 (9.1 %) individuals had died by the end of the
study period (30 March 2019), with a mean age of 55.5 ± 14.4 years at the time of death. Overall, at the 39-year follow-up, the mortality rate due to all causes of death for people who were exposed to SM was lower than the general Iranian population (SMR: 0.70, 95 % CI: 0.68-0.72). However, cause-specific SMR analysis showed that the mortality rate due to liver cancer (SMR: 1.98, 95 % CI: 1.59-2.45), poisonings (SMR: 1.92, 95 % CI: 1.52-2.38), respiratory disorders (SMR: 1.59, 95 % CI: 1.46-1.73) and multiple myeloma (SMR: 1.72, 95 % CI: 1.06-2.62) were approximately twofold higher in CWS than the general population.
CONCLUSIONS: This
study provides valuable insights into the mortality effects of SM exposure among the Iranian population affected by the Iran-Iraq war. The results emphasise the importance of continued monitoring and support for individuals exposed to SM, particularly in the context of managing and addressing the heightened risks associated with liver cancer, poisonings, respiratory disorders and multiple myeloma. Further research and interventions may be necessary to mitigate these specific health challenges in the affected population.