Long-term Health Outcomes Among Survivors Exposed to Sulfur Mustard in Iran

Key Points Question What are the long-term health complications associated with sulfur mustard exposure, and are there differences associated with exposure levels or demographic characteristics? Findings In this cohort study of 64 190 chemical warfare survivors of the Iran-Iraq War from 1980 to 1988 registered in the Veterans and Martyr Affair Foundation database, there were sex differences in the frequencies of eye and skin complications among survivors of sulfur mustard exposure. Lung complications were more apparent in later years following sulfur mustard exposure in survivors who had no initial signs of distress, and these complications were observed more among persons who were not evacuated or hospitalized than among those who were. Meaning Differences in health complications may be due to distinct physiological responses or levels of chemical exposure, and close monitoring even decades after sulfur mustard exposure is required to detect late pulmonary complications.