Abstract

The aim of this study was to determine the occurrence of emphysema and accuracy of Pulmonary Function Test (PFT), comparing with chest High Resolution Computed Tomography (HRCT), in smokers with history of exposure to toxic fumes (Sulfur Mustard; SM). This was a cross sectional study (2003-2004) on 20 symptomatic smokers with mild SM exposure (Group 1) and 20 smokers without SM exposure (Group 2). PFT and chest HRCT were performed for all patients to detect emphysema. Sensitivity, specificity and positive and negative predictive values were calculated for PFT. Spirometry did not diagnose emphysema in group 1 while chest HRCT diagnosed five patients (sensitivity = 0). Group 2 developed emphysema (11 of 20, 55) more frequently than group 1 (5 of 20, 20, p<0.05). No alpha-1 antitrypsin deficiency was found in all 70 individuals. We conclude that smokers with an additional risk factor, such as exposure to toxic fumes, develop emphysema at younger ages while they have normal PFT. Chest HRCT should be regarded as a useful tool in the early diagnosis of emphysema in such cases.