title: Incidence of cancer in Iranian sulfur mustard exposed veterans: a long-term follow-up cohort study.
abstract: BACKGROUND
  It is estimated that during the Iraq-Iran war of the 1980s, over 100,000 Iranians (military or civilian) were exposed to sulfur mustard (SM), and a considerable proportion of them are still suffering with long-term consequences of exposure. The aim of the present article is to address carcinogenesis of SM following these acute exposures.
  
  
  METHODS
  Using a cohort study, we estimated and compared the incidence rates of malignant disorders in 7,570 veterans exposed to SM and 7,595 unexposed comrades in a 25-year follow-up period. We also determined the hazard ratio of cancer occurrence for SM exposure during the follow-up period.
  
  
  RESULTS
  Cancer incidence was significantly increased with exposure to SM. The incidence rate ratio of cancer for SM exposure was 1.81 (95 % CI 1.27-2.56), and the age-adjusted incidence rate ratio was 1.64 (95 % CI 1.15-2.34).The hazard ratio of cancer was 2.02 (95 % CI 1.41-2.88).
  
  
  CONCLUSIONS
  Present study suggests carcinogenesis of SM following acute exposure during war. With respect to this finding, it is reasonable to improve care programs such as routine screening schemes for exposed veterans.
authors.affiliation: Department of Vascular Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. zafarghandi@tums.ac.ir
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Zafarghandi
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Soroush
authors.forename: Mahmood
authors.initials: M
authors.lastname: Mahmoodi
authors.forename: Kourosh Holakouie
authors.initials: KH
authors.lastname: Naieni
authors.forename: Ali
authors.initials: A
authors.lastname: Ardalan
authors.forename: Amir
authors.initials: A
authors.lastname: Dolatyari
authors.forename: Farahnaz
authors.initials: F
authors.lastname: Falahati
authors.forename: Majid
authors.initials: M
authors.lastname: Mirmohammadkhani
authors.forename: Batool
authors.initials: B
authors.lastname: Mousavi
authors.forename: Mostafa
authors.initials: M
authors.lastname: Ghanei
mesh_terms: D000328:Adult; D002619:Chemical Warfare Agents / Q000633:toxicity; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009151:Mustard Gas / Q000633:toxicity*; D009369:Neoplasms / Q000139:chemically induced* / Q000453:epidemiology*; D016273:Occupational Exposure / Q000009:adverse effects / Q000706:statistics & numerical data; D013997:Time Factors; D014728:Veterans / Q000706:statistics & numerical data*; D014857:Warfare; D055815:Young Adult
chemical_list: D002619:Chemical Warfare Agents; D009151:Mustard Gas