To determine whether the descendants of the Persian Gulf War and post-9/11 veterans are affected by health effects caused by toxic substances on service members during their deployment, a new report from the National Academies of Science, Engineering and Medicine recommends the creation of a health monitoring and research program HMRP). The committee, which conducted the study and wrote the report, evaluated the available data on the health effects of reproductive, developing and generating health related to the effects that could have occurred during the Gulf War and the conflicts after 9/11. Despite the growing database of people and animals regarding the reproductive and developmental effects of many toxicants of concern, there is a lack of information about the specific effects of veterans on their children, grandchildren and great-grandchildren.
In 1990-1991, nearly 700,000 US troops were deployed in the Gulf region in the midst of Operation Desert Shield and Operation Desert Storm. The US armed forces participated in further conflicts in the Middle East after the terrorist attacks of September 11, 2001 with troops stationed in Afghanistan and in Iraq and around it. In any war, deployed service members may be exposed to potentially dangerous agents and situations – some deliberately and others unknowingly, the report says. These can include chemicals used in everyday civilian life, such as pesticides and solvents, as well as chemical and biological agents, compulsory vaccines, smoke from burn pits and oil fires, dust, high ambient temperatures and heat stress and depleted Uranus.
Since information on the specific effects of veterans for many toxicants was insignificant or absent, the committee relied on studies that examined labor or residential cohorts that were exposed to some of the same toxicants as the Gulf War and after 9/11 veterans The committee was unable to determine how relevant the impact in these studies, not related to veterans, is to those experienced by veterans in terms of magnitude of impact, duration, often you, mixtures and co-exposure. The ability to summarize the associations found in such studies for veterans is also limited by differences in the characteristics of the population, such as gender, age, ethnicity, and lifestyle. Therefore, such impacts should be studied specifically for active service members and veterans to confirm that associations are valid for these populations.
The committee has reached more than 50 findings in five categories of associations between effects on deployment and reproductive effects, adverse pregnancy outcomes or developmental effects. No toxicant had sufficient evidence of a causal relationship between exposure and reproduction or development, and no toxicant had limited / suggestive signs of no association between exposure and reproductive or developmental manifestations. Among the findings, the committee found sufficient evidence of a link between the prenatal effects of organophosphate pesticides and neurological effects; prenatal exposure to particulate matter and adverse pregnancy outcomes, such as low birth weight and preterm delivery; and prenatal exposure to benzene and childhood leukemia. In addition, the committee found limited / impressive evidence of a link between sulfur mustard and reproductive effects in men and between prenatal particulate matter and pregnancy-induced hypertensive disorders, as well as respiratory or neurological effects in children.
The HMRP will collaborate between a number of governmental and non-governmental organizations. The report describes the recommended framework for developing HMRP, including the following priorities, which will be critical to the implementation of a useful HMRP:
- Collection, storage and maintenance of integrated basic and longitudinal data and biospecifications of veterans, their partners and their descendants;
- Detailed characterization and impact assessment during and after deployment; and
- The development, assessment, standardization and interoperability of biomarkers of exposure, susceptibility and biological effects.
“Addressing the priorities outlined in this report will require significant resources, long-term commitments from defense departments and veterans and other government organizations, and significant participation from past, present and future veterans and their families,” said committee chairman Kenneth S. Ramos. Deputy Vice President for Precision Health Sciences, Professor of Medicine and Executive Director of the Center for Applied Genetics and Genomic Medicine at the University of Arizona. “However, the results that arise from studying the effects of generations will eventually be rewarded with new knowledge about the veterans' exposure, their reproductive health, and the health of their children and grandchildren. It is important to note that the new insights gained from these investments will be related to the health of all Americans now and for future generations. ”
There are many considerations that need to be addressed in order to implement large-scale HMRP, such as financial and human resources, the availability and experience of qualified personnel, the time required to complete a project, access to well-prepared data, maintenance of confidential data on human health, investigations, including parents and children, as well as the implementation of appropriate health strategies and risks for communication between organizations and eterans and their families. Given these considerations, a practical approach to exploring the health effects of generations is to use current veteran health research programs, such as the Millionth Veterans Program and the Millennium Cohort Study, the report says.
The report states that the costs of designing and conducting an HMRP for any veteran cohort will be significant, as evidenced by the costs of similar programs, such as the National Children's Study of the National Institute of Health and the All-Russian Research Program. However, the costs of some of the basic technologies, for example, sequencing of entire genomes, have drastically decreased, and the results of research on a health monitoring program can lead to significant cost savings for the nation.
The study was funded by the US Department of Veterans Affairs. The National Academies of Science, Engineering and Medicine are private non-profit organizations that provide independent, objective analysis and counseling of the country for solving complex problems and informing government policy decisions related to science, technology and medicine. They operate in accordance with the charter of the 1863 Congress of the National Academy of Sciences, signed by President Lincoln.