Desert storm: the pulmonary legacies of Afghanistan and Iraq.


For more on concerns about US military research into burn pit exposures see Lancet Oncol News 2010; 11: 316. 1016/S1470-2045(10)70078-4 US military bases in both Iraq and Afghanistan, has been smoke from open-air military trash burn pits. Emissions from the pits included formal dehyde, arsenic, benzene, and asbestos, among other things. During the past decade, more than 50 openair military burn pits were in use in Iraq and more than 30 in Afghanistan. Burn pits produced particulate matter at sizes “associated with stroke, myocardial infarction, and asthma exacerbation”, Szema notes. The largest burn pit, at Balad, Iraq, was closed and replaced by three closed incinerators in 2009. “The 10-acre Balad burn pit that operated from 2002 to 2009, was shut down literally the day after our Senate testimony”, Szema notes. “I was told that in Iraq, they shut everything down by December 2012. But in Afghanistan, it’s still the wild, wild west.” Results from US military studies have shown low to moderate and acceptable risks associated with exposures to the burn pits’ emissions, although a few military researchers have raised concerns about that work, questioning the placement of air sampling stations or the small volumes of serum used in laboratory analyses of dioxin levels in exposed soldiers. The US Institute of Medicine of the National Academies of Science concluded in 2011 that it can be challenging to characterise waste disposal practices at many military there’s wide heterogeneity of disease.” Some exposures were localised, such as a fi re in a sulfur mine in 2003 in Iraq, which was a common exposure among many soldiers who later developed constrictive bronchiolitis. Shock waves from ubiquitous roadside bomb blasts were clearly another factor. “The same improvised explosive device that causes traumatic brain injury may subject the thoracic cage to shear stress and lung injury”, Szema notes. During and after combat, soldiers are more likely to initiate or reinitiate tobacco smoking, potentially exacerbating pulmonary illnesses. But Szema is quick to say that on the basis of histology and pathology, and multivariate statistical analyses, it seems clear that tobacco is not a factor in IAWLI. “The pathology has been bronchio litis and vascular remodelling and may also include detection of metals and minerals in the lungs, including titanium and calcium”, Szema notes. Iraqi dust contains titanium and other heavy metals, and microbes, he and researchers such as US Navy Captain Mark Lyles (Naval War College, Newport, RI, USA) have reported, prompting calls by Lyles for deployed military personnel to be issued N95 masks. Dust particles themselves are a factor, as well. Sandstorms produce sharp-edged particles smaller than 2·5 μm (PM2·5) at densities as high as 1000 parts per m3 every 24 h, according to Szema—much higher than levels deemed safe (<150 pcm) by the US Environmental Protection Agency. “A lung sample from one patient sunk to the bottom of the formalin cup, it was so heavy” with titanium, Szema explains. His team also showed that Iraqi dust suppresses pulmonary regulatory T cells in mice, he adds. Afghanistan’s high altitudes can cause high-altitude pulmonary oedema and related diseases, Szema notes. Another exposure for soldiers, contractors, and civilians living near Desert storm: the pulmonary legacies of Afghanistan and Iraq

DOI: 10.1016/S2213-2600(13)70032-8

Cite this paper

@article{Furlow2013DesertST, title={Desert storm: the pulmonary legacies of Afghanistan and Iraq.}, author={Bryant Furlow}, journal={The Lancet. Respiratory medicine}, year={2013}, volume={1 1}, pages={15-6} }