• P Cullinan, S Acquilla, and V R Dhara.
• Department of Occupational and Environmental Medicine, Imperial College (National Heart and Lung Institute), London.
• BMJ. 1997 Feb 1; 314 (7077): 338-42.

ObjectiveTo examine the role of exposure to the 1984 Bhopal gas leak in the development of persistent obstructive airways disease.DesignCross sectional survey.SettingBhopal, India.SubjectsRandom sample of 454 adults stratified by distance of residence from the Union Carbide plant.Main Outcome MeasuresSelf reported respiratory symptoms; indices of lung function measured by simple spirometry and adjusted for age, sex, and height according to Indian derived regression equations.ResultsRespiratory symptoms were significantly more common and lung function (percentage predicted forced expiratory volume in one second (FEV1), forced vital capacity (FVC), forced expiratory flow between 25% and 75% of vital capacity (FEF25-75), and FEV1/FVC ratio) was reduced among those reporting exposure to the gas leak. The frequency of symptoms fell as exposure decreased (as estimated by distance lived from the plant), and lung function measurements displayed similar trends. These findings were not wholly accounted for by confounding by smoking or literacy, a measure of socioeconomic status. Lung function measurements were consistently lower in those reporting symptoms.ConclusionOur results suggest that persistent small airways obstruction among survivors of the 1984 disaster may be attributed to gas exposure.

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