Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations (2020) / Chapter Skim
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2 Airborne Hazards in Southwest Asia
2 Airborne Hazards in Southwest Asia
Pages 23-42
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From page 23... ...
. The Statement of Task charges the committee to "comprehensively review, evaluate, and summarize the available scientific and medical literature regarding the respiratory health effects of exposure to airborne hazards encountered during service in the Southwest Asia theater of military operations." Exposures from the regional environment in Southwest Asia -- and those that occur specifically from military operations -- are thus the most relevant to the committee's charge.
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Factors That May Lead to Increased Vulnerability to Airborne Hazards • temperature extremes • stress • noise
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In 2009, three incinerators were operational at Joint Base Balad and burned about 10 tons of waste per day in the pit; the burn pit ceased operation on October 1, 2009. A 2010 Army Institute of Public Health study of burn pits in Iraq and Afghanistan reported that large bases burned waste that consisted generally of 5–6% plastics, 6–7% wood, 3–4% miscellaneous noncombustibles, 1–2% metals, and 81–84% combustible materials.
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Thus, the available monitoring data provide information on exposures to the major types of constituents from burn pit emissions, but they lack information on other chemicals that were likely present as well as on the exposure variability among burn pits and over time (IOM, 2011; NASEM, 2017a)
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. Taken together, these toxicity studies provide some evidence that exposure to burn pits may have different toxicologic effects than exposure to other airborne hazards in Southwest Asia.
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Military personnel serving in the theater could thus have been exposed to the uncombusted fuels, the combustion products from the burning of those fuels, or a combination of uncombusted and combusted materials. No studies evaluating fuel exposures or their associated combustion byproducts in theater were identified, although, based on the reported widespread use, these are likely a significant source of exposures to airborne hazards in theater (Masiol et al., 2016a)
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. REGIONAL ENVIRONMENTAL EXPOSURES The Southwest Asia regional climate is hot and arid, which exposes military personnel to intense heat and sunlight during the day, while nights are cool.
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. Particulate Matter Particulate matter is characterized by its physical size and chemical properties and includes total suspended particles (TSP)
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using airport visual range surrounding Joint measurement calibrated and Base Balad and aerosol optical depth Baghdad, Iraq Masri et al. Compared daily airport visual 104 sites in Iraq, 2000–2012 42.8 (22.7)
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Air Force 14th Weather Squadron sites located in a 17,000-km2 region in Iraq that includes Joint Base Balad were used to predict PM2.5. The authors coupled visibility measurements with aerosol optical depth observed by satellite to create a visibility prediction model, and then, using the previously defined calibration between visibility and PM2.5 (Masri et al., 2017b)
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From page 33... ...
. These studies provide biologic plausibility for the claim that exposures to airborne hazards in Southwest Asia have the potential to influence the health of military personnel, although clearly the World Trade Center exposure was much more intense and over a shorter time period.
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A previous National Academies committee found that several infections endemic to Southwest Asia could have long-term adverse outcomes, including brucellosis, Campylobacter infection, leishmaniasis, malaria, Q fever, salmonellosis, and shigellosis. Of these, only brucellosis was found to be associated with a respiratory health outcome: respiratory system infections (IOM, 2007)
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Two of the studies reviewed by the committee used intratracheal administration as the exposure method, which is of low relevance to human exposures. Additionally, the doses used in the studies may be higher than those experienced by military personnel in theater.
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While a number of papers considered by the committee mention military occupational exposures among the many airborne hazards experienced by deployed personnel, the committee did not identify any studies that specifically examined these exposures and adverse respiratory health outcomes. EXPOSURE TRACKING BY THE DEPARTMENT OF DEFENSE DoD and the Department of Veterans Affairs are working on a number of information management and technology efforts to support linking exposure and health effects information.
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Therefore, it is highly plausible that combined psychosocial and environmental exposures may interact to increase or amplify the risks of adverse respiratory health outcomes. Noise Chronic environmental noise is associated with a wide variety of adverse health effects, including sleep disturbance, annoyance, noise-induced hearing loss, cardiovascular disease, endocrine effects, and diabetes (Hammer
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Some of the studies considered in these chapters examine the potential association between a particular exposure -- burn pit emissions, for example -- and a health effect or outcome. However, the committee is mindful of the fact that everyone who was deployed to the theater was potentially exposed to a broad range of airborne hazards, whether these were explicitly considered in an epidemiologic analysis or not.
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2011. Long-term health consequences of exposure to burn pits in Iraq and Afghanistan.
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Air Force Research Laboratory. Presentation to the Committee on the Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations.
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2005. The World Trade Center residents' respiratory health study: New-onset respiratory symptoms and pulmonary function.
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2018. Airborne hazards concerns: Information for veterans.
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