Gulf War and Health Volume 11: Generational Health Effects of Serving in the Gulf War (2018) / Chapter Skim
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4 Deployment-Related Exposures
4 Deployment-Related Exposures
Pages 63-100
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From page 63... ...
The following sections review previous National Academies' reports, authoritative reviews, and new literature identified by the Volume 11 committee on deployment exposures and associated reproductive and developmental effects. DEPLOYMENT The committee uses the term "deployment" to refer to a military assignment or assignments leading to the collective and complex set of chemical, biological, radiological, and physiological exposures and psychological impacts that may be encountered in theater.
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From page 64... ...
. Those reports found that there was inadequate/insufficient evidence for any reproductive or developmental effects (including birth defects, adverse pregnancy outcomes, fertility problems, or genitourinary conditions)
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From page 65... ...
Adverse Pregnancy Outcomes The Volume 11 committee identified a systematic review of the impacts of active-duty military service on the reproductive health of female service members and male and female veterans from around the world, although most of the 46 studies cited in the review were of U.S. women (Lawrence-Wood et al., 2016)
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From page 66... ...
Nor was there an association between birth defects and paternal exposures to the burn pits. The association between adverse birth outcomes among U.S.
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From page 67... ...
The Volume 11 committee concludes that there is inadequate/insufficient evidence to determine whether an association exists between deployment and reproductive effects in men or women, or with adverse pregnancy outcomes. Developmental Effects The Volume 11 committee identified two studies of developmental effects and deployment exposures.
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From page 68... ...
. The analyses centered on the mechanisms and effects of acetylcholinesterase inhibition and neurologic outcomes, and reproductive effects were reported in animal studies.
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From page 69... ...
The Volume 11 committee concludes that there is inadequate/insufficient evidence to deter mine whether an association exists between exposure to sarin/cyclosarin and reproductive or developmental effects. Sulfur Mustard Sulfur mustard, also known as a mustard gas agent, was used in World War I
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From page 70... ...
or testosterone. Testicular effects were evaluated in infertile male Iranian service members who had been exposed to mustard gas in the 1985–1988 Iran–Iraq war (Safarinejad, 2001)
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. Adverse Pregnancy Outcomes A cross-sectional study evaluated adverse birth outcomes in Iraqi civilians after the Gulf War (Arnetz et al., 2013)
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The Volume 11 committee concludes that there is limited/suggestive evidence of an association between exposure to sulfur mustard and reproductive effects in men. The Volume 11 committee also concludes that there is inadequate/insufficient evidence of an association between exposure to sulfur mustard and reproductive effects in women, or with adverse pregnancy outcomes.
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(2004) 115 couples, 88 with 1 partner and 27 250-kg bombs containing 7.5% rate of infertility was observed among couples with both partners exposed to mustard liquid mustard gas released who were married at the time of exposure.
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Adverse Pregnancy Outcomes Arnetz et al.
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From page 75... ...
Congenital transmission of leishmaniasis from pregnant mother to child has been documented, with transplacental transmission being suspected. In addition to the damage done by direct infection of the child, animal studies suggest that the mother's immune response may also be responsible for adverse birth outcomes (Berger et al., 2017)
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From page 76... ...
The Volume 11 committee concludes that there is inadequate/insufficient evidence to deter mine whether an association exists between exposure to leishmaniasis and reproductive or developmental effects. The Volume 11 committee also concludes that there is sufficient evidence of an association between leishmaniasis infection during pregnancy and adverse pregnancy outcomes.
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Grosso do Sul, Brazil, from January 2004 to December 2005. 5 cases of pregnant women treated for VL.
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Reproductive Effects Reproductive Effects in Women The Volume 11 committee identified several studies on anthrax vaccine published after Volume 1, including three epidemiologic investigations in military populations, a review of adverse events following
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Infant health outcomes (preterm birth, low birth weight, major birth defects, and male sex of infant) were similar between the AVA-unexposed group (N=125)
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. Developmental Effects A retrospective cohort was used to evaluate the association between birth defects and anthrax vaccination in the first trimester among all infants born to U.S.
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. One study found that female soldiers who received the anthrax vaccine were not at increased risk for adverse pregnancy outcomes (Wiesen and Littell, 2002)
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weeks gestational age. birth defects, etc.)
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. 33,675 infants born to women Women who were vaccinated before pregnancy or in late who received the vaccine pregnancy did not have an increased risk of their infants being outside of their first trimester; born with birth defects when compared with women who had 663 of those were exposed in not been vaccinated.
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From page 84... ...
committee released a review of the available toxicologic, radiologic, epidemiologic, and toxicokinetic data on DU to help describe the risk of health effects to exposed military personnel. That committee found that long-term surveillance of DU-exposed Gulf War veterans had yielded no evidence of reproductive-system dysfunction in males, abnormalities
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From page 85... ...
recommended that on the basis of available reproductive toxicity and developmental toxicity data, samples of blood, urine, or semen of DU-exposed military personnel should be collected for the measurement of uranium content and signs of abnormal reproductive function in men and women. In addition, the reporting of spontaneous abortions and congenital anomalies should be continued.
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(2008) conducted a study with a total of 101 female mice exposed to DU through contaminated drinking water for 49 days.
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Data published since those reviews show no evidence of reproductive or developmental effects in veterans, although the studies are of male veterans only. Studies in animal models have shown mixed results, with some evidence for male and female reproductive effects and genotoxicity in parents and offspring.
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NOTE: DU=depleted uranium.
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From page 89... ...
There are ample data pertaining to the use of PB in therapeutic settings, and many studies have examined PB to determine its possible role in causing Gulf War illness. However, few studies have reported on the long-term effects of PB, particularly its reproductive and developmental effects.
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The committee's literature search identified 11 epidemiologic studies and 8 animal studies on the reproductive or developmental effects of chromium exposure. The studies used by the committee to reach its conclusions on Cr6 are summarized in Table 4-5 at the end of this section.
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From page 91... ...
. Adverse Pregnancy Outcomes The Volume 11 committee identified several recent publications and one older one that assessed both pregnancy outcomes and development effects following exposure to chromium.
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From page 92... ...
The authors reported that one study showed weak associations between chromium exposures and musculoskeletal defects, neuroblastoma, DNA damage, and lymphocyte damage but found no associations with birth weight, gestational age, birth length, autism spectrum disorder, birth defects, or adverse pregnancy outcomes.
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From page 93... ...
exposed to contaminated community drinking water in Massachusetts with those in children born to 1,177 unexposed women in 1977–1980, they found that congenital anomalies were not significantly associated with chromium levels in drinking water (median concentration=0.5 μg/L) (OR=0.8, 95% CI includes 1)
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From page 94... ...
Animal studies have exhibited long-term effects on female reproductive organs following in utero and continuous exposure. Although several studies showed no association between Cr6 exposure and adverse pregnancy outcomes, one study of a community with a plant that used Cr6 showed significant effects of prenatal exposure on both birth weight and duration of gestation (Remy et al.
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From page 95... ...
; perinatal jaundice (RR=1.13) ; rest of Mendocino birth defects; low birth weight (RR=1.14)
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From page 96... ...
(2014) 201 pregnant women living in Cord blood Oxidative damage in neonates measured by 8‑OHdG associated e‑waste recycling region, Guiyu concentrations of with Cr (β=0.086 ng/mL, 95% CI 0.014–0.158 ng/mL)
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1993. Quality of community drinking water and the occurrence of late adverse pregnancy outcomes.
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2012. The reproductive effects in rats after chronic oral exposure to low-dose depleted uranium.
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2017. Major birth defects after vaccination reported to the Vaccine Adverse Event Reporting System (VAERS)
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2008. Birth defects among infants born to women who received anthrax vaccine in pregnancy.
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