Respiratory morbidity 10 years after the Union Carbide gas leak at Bhopal: a cross sectional survey. The International Medical Commission on Bhopal.
OBJECTIVE
To examine the role of exposure to the 1984 Bhopal gas leak in the development of persistent obstructive airways disease.


METHODS
Cross sectional survey.


METHODS
Bhopal, India.


METHODS
Random sample of 454 adults stratified by distance of residence from the Union Carbide plant.


METHODS
Self reported respiratory symptoms; indices of lung function measured by simple spirometry and adjusted for age, sex, and height according to Indian derived regression equations.


RESULTS
Respiratory symptoms were significantly more common and lung function (percentage predicted forced expiratory volume in one second (FEV1), forced vital capacity (FVC), forced expiratory flow between 25% and 75% of vital capacity (FEF25-75), and FEV1/FVC ratio) was reduced among those reporting exposure to the gas leak. The frequency of symptoms fell as exposure decreased (as estimated by distance lived from the plant), and lung function measurements displayed similar trends. These findings were not wholly accounted for by confounding by smoking or literacy, a measure of socioeconomic status. Lung function measurements were consistently lower in those reporting symptoms.


CONCLUSIONS
Our results suggest that persistent small airways obstruction among survivors of the 1984 disaster may be attributed to gas exposure.
Cullinan
P
P
Department of Occupational and Environmental Medicine, Imperial College (National Heart and Lung Institute), London.
Acquilla
S
S
Dhara
V R
VR
D000062:Accidents, Occupational; D000293:Adolescent; D000328:Adult; D000393:Air Pollutants / Q000009:adverse effects*; D002617:Chemical Industry; D003371:Cough / Q000139:chemically induced / Q000453:epidemiology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004190:Disasters; D004417:Dyspnea / Q000139:chemically induced / Q000453:epidemiology / Q000503:physiopathology; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007194:India / Q000453:epidemiology; D017953:Isocyanates / Q000506:poisoning*; D008173:Lung Diseases, Obstructive / Q000139:chemically induced* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012135:Respiratory Sounds; D014797:Vital Capacity
D000393:Air Pollutants; D017953:Isocyanates; C008461:methyl isocyanate