Airway responses to salbutamol after exposure to chemical warfare

BACKGROUND AND OBJECTIVES: Increased airway responsiveness to beta-agonists is noted in asthmatics and smokers. The lung may be exposed to chemical warfare agents such as mustard gas and pulmonary complications of exposure range from no effect to severe bronchial stenosis. There is little understanding of airway hyperresponsiveness to beta-agonist drugs in chemical war victims and this study examined airway responsiveness to salbutamol in victims of chemical warfare. METHODS: The threshold concentrations of inhaled salbutamol required for a 20% change in FEV(1) as PC(20), or a 35% change in specific airway conductance (sGaw) as PC(35) were measured in 22 persons exposed to chemical warfare and 15 normal control subjects. RESULTS: In 11 of the 22 subjects PC(20) salbutamol could be measured and in 15 of the 22 subjects PC(35) salbutamol could be measured. This group of patients was the responder group (PC(20) = 10.79 and PC(35) = 8.55 mg/L) and in them the concentration of salbutamol needed for a response was significantly lower than that required in normal controls (PC(20) = 237.68 and PC(35) = 88.72 mg/L, P < 0.001). There was a significant correlation between FEV(1) and PC(20) salbutamol (r = 0.815, P < 0.001). CONCLUSIONS: These results showed increased airway responsiveness to salbutamol in most subjects exposed to chemical warfare; this was correlated with airway calibre.