Gulf War and Health Volume 11: Generational Health Effects of Serving in the Gulf War (2018) / Chapter Skim
Currently Skimming:
11 Moving Forward
11 Moving Forward
Pages 471-482
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 471... ...
. As such, none of the Gulf War and Health volumes have specifically addressed whether generational health effects are attributable to a toxicant, other potentially harmful exposures, or deployment in general.
|
From page 472... ...
Those areas are: • the effects that may occur in germ cells, embryos, fetuses, neonates, infants, or children following preconception exposures; • the long-term health outcomes in children who have been prenatally exposed to potentially harmful substances; and • the occurrence, if any, of adverse effects in grandchildren and subsequent generations as a result of veterans' deployment exposures. In addition, compared with studies on male reproduction, there are relatively few studies on the effects of the toxicants of concern on female reproduction.
|
From page 473... ...
The direct or indirect effects of prenatal exposures on the somatic cells of the embryo or fetus -- that is, all the cells in the body other than reproductive cells -- can lead to reproductive and developmental effects, but these should not be confused with effects on the germ cells that produce the sperm and oocytes which combine to form an embryo, for it is these changes that may give rise to transgenerational health effects. Toxicants and harmful exposures that directly or indirectly affect reproduction and development act through a variety of pathways, whereas, based on current knowledge, the toxicants capable of inducing generational effects are limited to genetic and epigenetic mechanisms in germ cells.
|
From page 474... ...
The resulting extensive collection of pre-deployment data and specimens will require significant and extensive coordination, as detailed elsewhere in this volume, but it is a crucial requirement that medical staff and investigators establish a reference framework against which post-deployment exposures and health status can be evaluated. As discussed in Chapter 9, one practical option would be to build upon the existing DoD Serum Repository.
|
From page 475... ...
The Volume 11 committee reiterates the concerns of earlier Gulf War and Health committees about the lack of precise exposure information for veterans or information on exposures at military locations, such as the Khamisiyah munitions depot containing sarin that was below the detection levels of the personal monitors yet still produced symptoms, or installations with burn pits. This uncertainty about exposures continues to significantly hamper the ability of DoD and VA to characterize hazards and to determine whether deployment exposures reached high levels of concern.
|
From page 476... ...
Air Force security personnel at Bagram Airfield in Afghanistan to determine pollutant levels associated with a burn pit and an incinerator. SKC Deployable Vapor samplers and SKC Deployable Particulate samplers were used to collect both breathing zone sampling and ambient air samples for 24 hours beginning with the start of each work shift at multiple sites at the airfield (Blasch et al., 2016)
|
From page 477... ...
Using untargeted assays to assess thousands of chemical signatures at a time in such biological samples as urine or plasma can help identify candidate chemical exposures that may play a role in transgenerational inheritance. This approach would be the current state of the art, and it is expected that methods for both the assay and its associated bioinformatics will change and improve dramatically in the coming years, as this is an area of rapid scientific advancement.
|
From page 478... ...
FEASIBILITY The Volume 11 committee concludes that new large-scale HMRPs and epidemiologic studies designed specifically to address the question of whether descendants of deployed veterans are at increased risk of adverse health effects compared with descendants of nondeployed veterans will be an ambitious undertaking. While it will be possible to generate valuable information for veterans and their descendants from this effort, several important outstanding issues need to be addressed to optimize the timing of future investments.
|
From page 479... ...
As a result of these considerations, among many others, the committee proposes that a more practical and expedient approach to examining generational health effects may be to leverage ongoing veterans' health research programs, such as the Million Veteran Program and the Millennium Cohort Study. Such an approach would greatly benefit from past investments and take advantage of existing infrastructure to address some of the critical issues identified in this report.
|
From page 480... ...
Although the scientific evidence is not yet sufficient to predict with confidence which exposures are most likely to result in genetic or epigenetic disturbances in a veteran's somatic or germ cells that can compromise reproductive or generational health outcomes, progress is being made, and the mechanisms of generational inheritance are being explored. Thus, targeted epidemiologic studies combined with research using experimental models of epigenetic inheritance should be developed and promoted. Such programs can take advantage of the existing research infrastructure to establish whether adverse effects occur in the children of male and female veterans and whether these outcomes are related to their military service and, particularly, to their deployments.
|
From page 481... ...
2016a. Gulf War and health, volume 10: Update of health effects of serving in the Gulf War, 2016.
|
From page 482... ...
2018. Human and animal evidence of potential transgenerational inheritance of health effects: An evidence map and state-of-the-science evaluation.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.