Respiratory Morbidities and Lung Function Abnormalities in Survivors of Bhopal Gas Disaster: A Cross-Sectional Study
Abstract Background Respiratory morbidities remained major morbidities among the survivors of the Bhopal gas disaster. We hypothesized that underlying lung function abnormalities, especially small airway dysfunctions (SAD), were responsible for persistent respiratory morbidity. Material and methods We conducted a cross-sectional study between 2018 and 2020 in the severely exposed cohort of the Bhopal gas disaster. A standardized questionnaire was used to collect respiratory symptoms. The forced oscillation technique (FOT) and spirometry were used for assessing lung functions. Univariate and multivariate logistic regression analyses were used to examine the association. Results Total 916 individuals (men: 442) participated. The mean age was 55.2 ± 12.3 years. Breathlessness was a predominant respiratory complaint (71.7%), followed by cough (15.1%). Five hundred fifty-eight individuals participated in lung function assessment. The R5 > ULN (upper limit of normal), R5 − 19 >ULN, and X5 < LLN (lower limit of normal) were observed in 29.3%, 23.3%, and 21.2% participants, respectively. Normal, obstructive, and restrictive spirometry was observed in 46.2%, 26.1%, and 27.7% of participants, respectively. Abnormalities in FOT parameters were observed in 25.3% of individuals with normal spirometry. Individuals with obstructive spirometry had the highest risk of abnormal FOT parameters (adj OR:3.93, 95% CI: 2.24–6.89). Breathlessness showed a significant association with abnormal R5 (adj OR: 1.81; 95% CI: 1.13–2.91) and obstructive spirometry (adj OR: 2.26; 95% CI: 1.29–3.95). Conclusion Assessment of small airway functions, in addition to spirometry, will help to identify complex lung function abnormalities in the population exposed to toxic inhalation.