title: Delayed eye and other consequences from exposure to methyl isocyanate: 93% follow up of exposed and unexposed cohorts in Bhopal.
abstract: A follow up study three years after exposure to methyl isocyanate in 93% of exposed survivors and "control" residents in 10 Bhopali communities showed an excess of eye irritation, eyelid infection, cataract, and a decrease in visual acuity among the exposed people. Breathlessness was twice as common in the heavily exposed clusters as those with lower exposure, a trend that could not be explained by different age or smoking patterns (OR 2.05, 95% CI 1.36-3.08). Case referent analysis of outpatient attendances at Bhopal Eye Hospital, considering patients with severe refractive errors and astigmatism as "controls," showed a 40% increased risk of trachoma, 36% increased risk of other lid infections, and 45% increased risk of irritant symptoms among previously exposed people. "Bhopal eye syndrome" may thus include full resolution of the initial interpalpebral superficial erosion, a subsequent increased risk of eye infections, hyperresponsive phenomena (irritation, watering, and phlyctens), and possibly cataracts. It remains to be confirmed whether this reflects a more generalised disease as a consequence of previous exposure to methyl isocyanate or whether it is only the eye that is affected.
authors.affiliation: TUC Centenary Institute of Tropical Medicine, London School of Hygiene & Tropical Medicine.
authors.forename: N
authors.initials: N
authors.lastname: Andersson
authors.forename: M K
authors.initials: MK
authors.lastname: Ajwani
authors.forename: S
authors.initials: S
authors.lastname: Mahashabde
authors.forename: M K
authors.initials: MK
authors.lastname: Tiwari
authors.forename: M K
authors.initials: MK
authors.lastname: Muir
authors.forename: V
authors.initials: V
authors.lastname: Mehra
authors.forename: K
authors.initials: K
authors.lastname: Ashiru
authors.forename: C D
authors.initials: CD
authors.lastname: Mackenzie
mesh_terms: D000062:Accidents, Occupational; D000293:Adolescent; D000328:Adult; D002386:Cataract / Q000139:chemically induced; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003485:Cyanates / Q000506:poisoning*; D004781:Environmental Exposure; D005128:Eye Diseases / Q000139:chemically induced*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D007223:Infant; D017953:Isocyanates; D008297:Male; D008875:Middle Aged; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D003485:Cyanates; D017953:Isocyanates; C008461:methyl isocyanate