Military small arms fire in association with acute decrements in lung function

Borander, Anne Katrine; Voie, Øyvind Albert; Longva, Kjetil Sager; Danielsen, Tor Erik; Grahnstedt, Svein; Sandvik, Leiv; Kongerud, Johny; Sikkeland, Liv Ingunn Bjoner

doi:10.1136/oemed-2016-104207

Cited by 13 publications

(11 citation statements)

References 21 publications

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“…Our finding that gunshot smoke particles emitted from pistols in the breathing zone of the shooter resemble particles emitted during welding, corroborating previous findings (Antonini, 2003;Grabinski et al, 2017;Wingfors et al, 2014). Military soldiers that inhaled gunshot smoke particle fumes from Pb-free military small arms ammunitio (dominated by oxides of Mn, Fe, Cu, and Zn) developed neutrophilic inflammation within 24 h in both upper airways and blood circulation, along with reduced lung function and impaired alveolar-vascular barrier integrity (Borander et al, 2017;Sikkeland et al, 2018;Voie et al, 2014). proteins in plasma than Pb-containing ammunition (Borander et al, 2017;Sikkeland et al, 2018).…”

Section: Particle-induced Effects On Primary Endothelial Huvec Cellssupporting

confidence: 90%

“…Military soldiers that inhaled gunshot smoke particle fumes from Pb-free military small arms ammunitio (dominated by oxides of Mn, Fe, Cu, and Zn) developed neutrophilic inflammation within 24 h in both upper airways and blood circulation, along with reduced lung function and impaired alveolar-vascular barrier integrity (Borander et al, 2017;Sikkeland et al, 2018;Voie et al, 2014). proteins in plasma than Pb-containing ammunition (Borander et al, 2017;Sikkeland et al, 2018). Furthermore, gunshot smoke particles from small arms decreased cell viability and induced oxidative stress and immune activation in exposed alveolar epithelial (A549) cells, and these toxic responses significantly correlated with the Cu and Zn content in the samples (Bergström et al, 2015).…”

Section: Particle-induced Effects On Primary Endothelial Huvec Cellsmentioning

confidence: 99%

“…Work environment assessment of indoor shooting ranges shows that intense firearm training presents similar exposure characteristics to those observed during welding (Grabinski et al, 2017;Norwegian Defence Research Establishment et al, 2009). Inhalation exposures to metal fumes from military small arms also elicit general systemic symptoms and respiratory effects in shooters typical of metal fume fever (Borander et al, 2017;Sikkeland et al, 2018;Voie et al, 2014).…”

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confidence: 99%

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Characterization of toxicological effects of complex nano‐sized metal particles using in vitro human cell and whole blood model systems

Elfsmark

Ekstrand‐Hammarström

Forsgren

et al. 2021

J of Applied Toxicology

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Metal oxide fumes form at high temperatures, for instance, during welding or firing ammunition. Inhalation exposure to high levels of airborne metal oxide particles can cause metal fume fever, cardiovascular effects, and lung damage in humans, but the associated underlying pathological mechanisms are still not fully understood. Using human alveolar epithelial cells, vascular endothelial cells, and whole blood model systems, we aimed to elucidate the short-term effects of well-characterized metal particles emitted while firing pistol ammunition. Human lung epithelial cells exposed to gunshot smoke particles (0.1-50 μg/ml) produced reactive oxygen species (ROS) and pro-inflammatory cytokines (interleukin 8 (IL-8), granulocyte-macrophage colony-stimulating factor (GM-CSF)) that activate and recruit immune cells. Particles comprising high copper (Cu) and zinc (Zn) content activated human endothelial cells via a non-ROS-mediated mechanism that triggered immune activation (IL-8, GM-CSF), leukocyte adhesion to the endothelium (soluble intercellular adhesion molecule 1 (sICAM-1)), and secretion of regulators of the acute-phase protein synthesis (interleukin 6 (IL-6)). In human whole blood, metal oxides in gunshot smoke demonstrated intrinsic properties that activated platelets (release of soluble cluster of differentiation 40 ligand (sCD40L), platelet-derived growth factor B-chain homodimer(PDGF-BB), and vascular endothelial growth factor A (VEGF-A)) and blood coagulation and induced concomitant release of pro-inflammatory cytokines from blood leukocytes that further orchestrate thrombogenesis. The model systems applied provide useful tools for health risk assessment of particle exposures, but more studies are needed to further elucidate the mechanisms of metal fume fever and to evaluate the potential risk of long-term cardiovascular diseases.

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Section: Particle-induced Effects On Primary Endothelial Huvec Cellssupporting

confidence: 90%

Section: Particle-induced Effects On Primary Endothelial Huvec Cellsmentioning

confidence: 99%

mentioning

confidence: 99%

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Characterization of toxicological effects of complex nano‐sized metal particles using in vitro human cell and whole blood model systems

Elfsmark

Ekstrand‐Hammarström

Forsgren

et al. 2021

J of Applied Toxicology

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“…For example, in a comparison of harder steel core ammunition, which results in larger abrasion of the bullet and more metal fragments in the smoke, to Pb core ammunition, the steel core produced more Cu and Zn than the Pb core ammunition when fired in the same rifle. This suggests that exposure to metals from firing ammunition is more affected by barrel design than bullet type 20 . It has been reported that smoke particle sizes (a major peak at 1-4 µm) were largely unchanged from firing different ammunitions 10,18,19 .…”

Section: Discussionmentioning

confidence: 99%

Chemistry and lung toxicity of particulate matter emitted from firearms

Kim

Vance

Aurell

et al. 2022

Sci Rep

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Smoke emissions produced by firearms contain hazardous chemicals, but little is known if their properties change depending on firearm and ammunition type and whether such changes affect toxicity outcomes. Pulmonary toxicity was assessed in mice exposed by oropharyngeal aspiration to six different types of smoke-related particulate matter (PM) samples; (1) handgun PM, (2) rifle PM, (3) copper (Cu) particles (a surrogate for Cu in the rifle PM) with and without the Cu chelator penicillamine, (4) water-soluble components of the rifle PM, (5) soluble components with removal of metal ions, and (6) insoluble components of the rifle PM. Gun firing smoke PM was in the respirable size range but the chemical composition varied with high levels of Pb in the handgun and Cu in the rifle smoke. The handgun PM did not induce appreciable lung toxicity at 4 and 24 h post-exposure while the rifle PM significantly increased lung inflammation and reduced lung function. The same levels of pure Cu particles alone and the soluble components from the rifle fire PM increased neutrophil numbers but did not cause appreciable cellular damage or lung function changes when compared to the negative (saline) control. Penicillamine treated rifle PM or Cu, slightly reduced lung inflammation and injury but did not improve the lung function decrements. Chelation of the soluble metal ions from the rifle fire PM neutralized the lung toxicity while the insoluble components induced the lung toxicity to the same degree as the rifle PM. The results show that different firearm types can generate contrasting chemical spectra in their emissions and that the rifle PM effects were mostly driven by water-insoluble components containing high levels of Cu. These findings provide better knowledge of hazardous substances in gun firing smoke and their potential toxicological profile.

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“…R175H, R248G -fs*-mutation type: insertion-frameshift; *-mutation type: nonsense mutation; the protein coding sequence ends at a translation termination codon (stop codon); del-mutation type: deletion; ins-mutation type: insertion & Koch), soldiers got flu-like symptoms. Further investigations have revealed that exposure to gunshot fumes may induce health effects such as fever, coughing, inflammations reactions, and reduced lung capacity (Voie et al 2014, Borander et al 2017. Moreover, the high levels of carbon monoxide in the fume lead to increased levels of carboxyhemoglobin in the blood.…”

Section: Discussionmentioning

confidence: 99%

Ultrasensitive analysis of genetic instability related to chemical exposure

Domoradzki

Grochowski²,

Jaśkiewicz

et al. 2021

J Appl Genetics

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Our concerns have been raised about whether prolonged exposure to ammunition-related chemicals could correlate with genomic instability predisposing to lung carcinogenesis. The group of professional soldiers engaged in routine ammunition analysis and its explosive properties testing. To assess the presence of an innate genetic profile, DNA isolated from swabs was analyzed with LungCarta and HS Lung Panels and MassARRAY Analyzer 4 mass spectrometry. The presence of new somatic single nucleotide polymorphisms (SNPs) was detected with liquid biopsy technique and circulating cell-free DNA (ccfDNA) isolation, which was further analyzed with UltraSeek Lung Panel. Both genetic profiles obtained for each individual were compared. Genetic analysis revealed that in professional soldiers with long-term exposure to ammunition-related toxic chemicals, new SNPs in genes related to lung carcinogenesis are present. The preliminary data indicate that using modern molecular techniques could be a valuable tool for monitoring the genome instability in context of occupational risk of harmful volatile toxic compounds and improving personnel safety. The analyzed group will be further enlarged, and follow-up studies will be continued.

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Military small arms fire in association with acute decrements in lung function

Abstract: Exposure to fumes from military weapons might be a respiratory hazard for soldiers who do live-fire training regularly or are in a closed combat environment.

Cited by 13 publications

References 21 publications

Characterization of toxicological effects of complex nano‐sized metal particles using in vitro human cell and whole blood model systems

Characterization of toxicological effects of complex nano‐sized metal particles using in vitro human cell and whole blood model systems

Chemistry and lung toxicity of particulate matter emitted from firearms

Ultrasensitive analysis of genetic instability related to chemical exposure

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