Long-term health effects of chemical warfare agents on children following a single heavy exposure

Abstract

In the 1980s, villages in the Kurdistan region of Iraq were exposed to chemical weapons (CWs), which killed and injured thousands of civilians. There has been no clinical assessment of the long-term effects of CWs exposure on those injured. We report the first such evaluation of CW effects on long-term health of children. Patients from the CW-exposed areas were interviewed to assess previous and current clinical history and underwent clinical examination. The status of organs known to be targets of CWs, including skin, eyes, respiratory and neuromuscular systems, was assessed. Children of similar age and social background, but with no history of CW exposure, were selected as a control population. Results showed that 70% of children in the CWs group had chronic health problems in contrast to 3.3% in the unexposed group (p < 0.0001). Fifty-five per cent of the CWexposed group had long-term visual impairment but none in the unexposed population. Thirty-six per cent of the CW-exposed group had chronic dermatological conditions compared with 0.8% of the unexposed group (p < 0.0001), 31% of the CWs group had neurological sequelae compared with 0.4% of the unexposed group (p < 0.0001) and 51% of the CWs group had long-term respiratory problems compared with 1.5% of the unexposed group (p < 0.0001). Respiratory complaints including asthma, chronic bronchitis and bronchiectasis were particularly common. Our study suggests that CWs used were probably a combination of sulphur mustard and organophosphate nerve agents. Results also indicate that the prevalence of acute and chronic health problems following exposure to CW agents appear to be higher in children compared with reported data in adults.

Acetylcholinesterase: The “Hub” for Neurodegenerative Diseases and Chemical Weapons Convention

“…Cholinesterases are found in two isoforms, AChE (EC 3.1.1.7) and butyrylcholinesterase (BChE), EC 3.1.1.8. Compounds that can inhibit cholinesterases may impact the body positively or negatively and, therefore, be either explored as method of warfare or therapeutically [51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67].…”

Acute and long‐term consequences of exposure to organophosphate nerve agents in humans

“…Additional clinical neurologic signs that were found in the subjects included ataxia (31%), paralysis (4%), fasciculations (7%), confusion (38%), dysarthria (22%), headaches (43%), and coma (38%). 49 People exposed to OP pesticides also exhibit long-term effects. Sheep farmers exposed to low-level OP pesticides demonstrated significant cognitive impairment on working, verbal, and visual memory testing, response speed, fine motor control, mental flexibility, and strategy making.…”

“…Twenty percent of subjects had convulsions while ninety percent exhibited signs of anxiety/restlessness/muscular cramps. Additional clinical neurologic signs that were found in the subjects included ataxia (31%), paralysis (4%), fasciculations (7%), confusion (38%), dysarthria (22%), headaches (43%) and coma (38%) 49 .…”

Gendered lived experiences of marriage and family following exposure to chemical warfare agents: content analysis of qualitative interviews with survivors in Halabja, Kurdistan-Iraq

“…CWAs such as SM were used on a large scale. [5][6][7][8] As one of the main targets, the town of Halabja, was bombarded by a cocktail of chemicals on 16 March 1988, and almost 5000 people, including many children, died that day as a result. 9 Today, around 6000 CWA-exposed persons with multiple health complaints live in the Kurdistan Region of Iraq (KRI).…”