title: Annual change in spirometric parameters among patients affected in Bhopal gas disaster: A retrospective observational study.
abstract: BACKGROUND
  The involvement of respiratory system due to inhalation of methyl isocyanate (MIC) during Bhopal gas disaster was particularly severe. We retrospectively evaluated the annual changes in spirometric parameters among those who were affected in this disaster (exposed survivors) and had respiratory symptoms.
  
  
  METHODS
  Spirometry reports of exposed survivors that were carried out in our institution were retrospectively reviewed and we identified 252 subjects who had performed spirometry at least twice with interval of more than one year. The annual changes in spirometric indices of them were calculated.
  
  
  RESULTS
  The average age of study population was 55.7 years and 72% were male. Annual decline of FEV1 ≥ 40 ml/yr was observed among 48% exposed survivors. The mean annual decline of FEV1 among symptomatic exposed survivors with initial normal spirometry was 91 ml (95% CI: 52 ml to 130 ml) and this was more than the patients with initial obstructive pattern. Among fifty four patients with initial normal spirometry, ten patients (18.5%) developed obstructive and two patients (5%) developed restrictive lung function abnormalities during follow up spirometry.
  
  
  CONCLUSIONS
  The exposed survivors with chronic respiratory symptoms had accelerated decline in lung function and they are at higher risk of developing obstructive lung function.
authors.affiliation: Department of Pulmonary Medicine, Bhopal Memorial Hospital and Research Centre, Raisen Bye Pass Road, Bhopal, India.
authors.forename: Sajal
authors.initials: S
authors.lastname: De
keywords: Annual changes; Bhopal gas disaster; Methyl isocyanates; inhalational injury; spirometry