Conference on Health and Environmental Consequences of Depleted Uranium used by U.S. and British forces in the 1991 Gulf War

Hotel Al-Rashid, Baghdad, Iraq

December 2-3, 1998






















Documents Collected by Damacio Lopez

Research Director, Re-Visioning New Mexico

Health Consequences of D. U. weapons used by U.S. and British Forces

Abstract:

A case control study of cancer cases in military troops and its relation to Depleted Uranium used by U.S. and British forces.

The study was a statistically and clinically descriptive study of cancer cases in Iraq. These studies involved Iraqi military personnel in the southern region of Iraq following the Gulf War.

1425 cases were selected retrospectively, which were diagnosed with different types of cancer in military and civilian hospitals. The study included cases of males who had participated in the war in the southern region of Iraq. The cases included only males between the ages of 19 and 50.

The study includes tabulation of cancer cases in this age group to see whether there is a positive association or odds ratio between those cases and D.U. used by the U.S. and British forces.

It is estimated that about 630,000 pounds of depleted uranium contaminated huge areas including targets and the surrounding environment.

The study shows increasing registration of different types of cancer cases and change in the epidemiological pattern of there occurrence with time among military personnel who were in the southern region of Iraq during the war. There is a significant correlation and association between these cases and D.U. exposure. This is illustrated by odds ratio of lymphomas and leukemias were 5.6 and 4.8 respectively.

Introduction:

In the war against Iraq in 1991 allied forces used 630,000 pounds of depleted uranium. Consequently, there are adverse health effects on human beings and the environment in Iraq and probably in the neighboring countries such as Kuwait and Saudi Arabia.

Military personnel and their families were exposed to depleted uranium weapons, which have a radiological and chemically toxic effect secondary to the their explosions. In addition, it is a source of contamination of the environment.

The central committee that was established in Iraq did a series of epidemiological investigations and field attachment surveys on the ill effects of depleted uranium weapons on human beings and the environment.

The result of this investigation is that both military personnel and their families who have been exposed to depleted uranium have experienced radiological and chemically toxic effects. Health problems may also exist in Kuwait, as a result of the huge contaminated area. It is estimated that approximately 14 acres, which are being used as a collection point of contaminated and destroyed vehicles and tanks. In addition, huge unknown quantities of D.U. munitions were buried in the ground in this area. (Dan Fahey, 1998).

There is also a probability of pollution in Saudi Arabia. Under the command of the New Jersey Company of American National Army, King Khalid Military City and King Abdul Aziz Air Force Base were used as collecting points for contaminated and destroyed vehicles and tanks.

Objectives:

  • Epidemiological and clinical studies of different types of cancer cases that are statistically associated with exposure to ionizing radiation from depleted uranium.
  • Description of cancer cases in terms of geographical distribution and time.
  • Determination of statistical significance.


 

Material and Method:

A case control study of different types of cancer cases observed in military troops who participated in the war in the southern region of Iraq in 1991. To determine relative risk (odds ratio) of these cases, military personnel with cancer was compared to cases free from cancer in order to study the factor incriminated.

The sample of cancer cases selected includes lymphomas, leukemias, lung CA, bone CA, gastrointestinal cancers, brain CA, and liver CA.

The cases studied are those which are registered retrospectively from military and civilian hospitals in the age group (19-50 years) who were in service at that time. The cases were identified clearly from the case sheets and the addresses of their residence which were fixed since 1991 up to 1997. 1425 people, whose residences were known, were asked if they were exposed to an explosion.

Sample comparative groups were identified and selected from military patients free of cancer who were admitted to the military hospitals from the same age group and sex. Their addresses were fixed from the case sheets and they were asked whether they were exposed to an explosion while in field operation.

Method of selection of sample cases was done through study of all cancer cases that were diagnosed and registered from 1991-1997.

Size of sample: It includes all recorded cancer cases that were diagnosed and registered in the civilian and military hospitals.

Data collection: It included case history, clinical exam, laboratory investigation, radiological finding and results of histopathological findings through sample form attached in the appendix A.

Direct interviews were done with control group. Each were asked about exposure to explosion.

Analysis of sample forms was done manually.

Presentation of data in form of tables and histograms.

Results:

Table (1):

Different types of cancer cases that were registered from 1991 through 1997 of military participants exposed to depleted uranium.

Cancer cases

Years

Total

 

1991

%

1992

1993

1994

1995

1996

1997

%

 

Lymphomas

10

34.5

16

70

85

80

106

82

29.4

449

Leukemias

10

34.5

28

45

53

65

70

40

14.3

311

Lung CA

4

13.8

6

39

40

41

40

40

14.3

210

Brain CA

1

3.4

2

20

30

35

40

34

12.2

162

Gastrointestinal CA

2

6.9

6

13

15

10

10

10

3.6

66

Testicular CA

-

-

1

5

10

12

15

15

5.4

58

Bone CA

2

6.9

3

5

10

10

12

15

5.4

57

Pancreatic CA

-

-

-

-

3

10

12

15

5.4

40

Salivary gland CA

-

-

-

-

-

7

11

15

5.4

36

Liver CA

-

-

-

-

5

 

11

13

4.6

36

Total

29

100%

62

197

251

280

327

279

100%

1425

Shows an increase in registration of different types of cancer cases from 1991 through 1997 in those who were exposed to explosions in the battle field including lymphomas, leukemias, lung cancer, and brain cancer.

Table (2):

Different cancer cases that were registered from 1991 through 1997 in military participants not exposed to the causative agent under study (D.U.)

Cancer cases

Years

Total

 

1991

%

1992

1993

1994

1995

1996

1997

%

 

Lung

2

66.7

6

7

15

11

23

14

35.9

78

Gastrointestinal

-

-

10

11

17

14

13

-

-

65

Leukemias

1

33.3

4

7

11

7

12

6

15.4

48

Lymphomas

-

-

2

8

11

9

8

6

15.4

44

Liver

-

-

1

6

8

10

5

-

-

30

Bone

-

-

-

2

12

7

3

3

7.7

27

Brain

-

-

-

-

2

4

7

10

25.6

23

Total

3

100%

23

41

76

62

71

39

100%

315

Shows an increase in registration of different types of cancer cases starting in the year 1992 for those military personnel who were not exposed to an explosion in the field in comparison with 1991, especially in relation to lung cancer, gastrointestinal cancer, leukemias, and lymphomas.

Table (3):

Relative Risk is estimated by calculating odds ratio of different types of cancer cases.

Types of Cancer

Exposed

Unexposed

Odds ratio

 

cases

control

cases

control

R.R.

1. Lymphomas

449

643

44

351

5.6

2. Leukemias

311

573

48

429

4.8

3. Brain CA

162

183

23

114

4.5

4. Liver CA

36

46

36

97

2.5

5. Bone CA

57

91

27

87

2

6. Gastrointestinal CA

66

125

65

177

1.4

7. Lung CA

210

627

78

357

1.4

10. Total cancer cases

1425

2894

315

1112

1.7

Shows the odds ratio which is "the degree of association between the factor under study and cancer cases."

Statistically, it is significant in relation to lymphomas, leukemia, lung , brain, gastrointestinal, bone, and liver cancers.

Graph 1: Different types of cancer cases which were registered from year 1991-1997 for those exposed and unexposed to D.U.

Shows an increase in registration of different types of cancer cases from the year 1992 to those exposed and unexposed.

Graph 2: Different types of cancer cases that were registered from the year 1991-1997 to military participants and were exposed to a D.U. explosion.

Shows an increase in registration of different types of cancer cases from the year 1992 to those exposed and unexposed.

Graph 3: Total number of different types of cancer cases which were registered from the year 1991-1997 of military personnel who participated but not exposed to an explosion.

Shows an increase in registration of cancer cases in military personnel who participated but were not exposed to an explosion of military origin and subsequent rise from year 1992.

Graph 4: Lymphoma cases in military participants exposed to a D.U. explosion in the years 1991-1997.

H.L.=58.4%, N.H.L.=40.6%

Shows an increase in registration of lymphoma cases in those military

participants exposed to a D.U. explosion in the field in years following 1992.

Graph 5: Leukemia cases in military participants who were exposed to a D.U. explosion for the years 1991-1997.

Shows an increase in registration of leukemia cases in military personnel exposed to a D.U. explosion in the field in the years following 1992.

Graph 5: Leukemia cases in military participants who were exposed to a D.U. explosion for the years 1991-1997.

Shows an increase in registration of leukemia cases to military personnel exposed to a D.U. explosion in the field in the years following 1992.

Graph 6: Lung cancer cases in military personnel exposed to a D.U. explosion for the years 1991-1997.

Shows a subsequent increase in registration of lung cancer cases in military personnel exposed to a D.U. explosion.

Graph 7: Brain cancer cases in military participants exposed to a D.U. explosion in the years 1991-1997.

Shows an increase in registration of brain cancer to those exposed to a D.U. explosion in the years following 1992.

Graph 8: Gastrointestinal cancer cases in military participants exposed to a D.U. explosion in the years 1991-1997.

Rectum=21%

Colon=54%

Stomach and intestine=25%

Shows an increase in registration of gastrointestinal cancer to those military participants exposed to a D.U. explosion in the years following 1992.

Graph 9: Bone cancer cases in military participants exposed to a D.U. explosion in the years 1991-1997.

Shows an increase in registration of bone cancer cases of those military participants exposed to a D.U. explosion in the field in the years following 1992.

Graph 10: Testicular cancer cases in military participants exposed to a D.U. explosion in the years 1991-1997.

Shows an increase in registration of testicular cancer cases of those military personnel exposed to a D.U. explosion in the field in the years following 1992.

Graph 11

Shows an increase in registration of pancreatic cancer cases in military participants exposed to D.U. in the field.

Graph 12: Salivary glands cancer cases in military participants exposed to a D.U. explosion in the years 1991-1997.

Shows an increase in registration of salivary glands cancer in military participants exposed to a D.U. explosion in the field in subsequent years after service.

Graph 13: Liver cancer cases in military participants exposed to a D.U. explosion in the years 1991-1997.

Shows an increase in registration of liver cancer in military participants exposed to a D.U. explosion in the field in subsequent years.

Graph 14: Percentage of different types of cancer cases in military participants exposed to a D.U. explosion.

Graph 15: Percentage of still birth, congenital anomalies and secondary infertility in families of military participants exposed to D.U.

Graph 16: Lung cancer cases in military participants who were not exposed to a D.U. explosion in the years 1991-1997.

Shows an increase in registration of lung cancer cases.

Graph 17: Gastrointestinal cancer cases in military participants not exposed to a D.U. explosion in the years 1991-1997.

Shows an increase in registration of gastrointestinal cancer cases in military participants not exposed to a D.U. explosion in the field.

Graph 18: Leukemia cases in military participants not exposed to a D.U. explosion in the years 1991-1997.

Shows an increase in registration of leukemia cases in military participants not exposed to a D.U. explosion in the field if the years following 1993.

Graph 19: Lymphoma cases in military participants not exposed to a D.U. explosion in the years 1991-1997.

N.H.L.=63.64%, H.L.=36.36%

Shows an increase in registration of lymphoma cases in military participants not exposed to a D.U. explosion in the field in subsequent years.

Graph 20: Liver cancer cases in military participants not exposed to a D.U. explosion in the years 1991-1997.

Shows an increase in registration of liver cancer cases in military participants not exposed to a D.U. explosion in the field in the years following 1993.

Graph 21: Bone cancer cases in military participants not exposed to D.U. in the years following 1991-1997.

Shows an increase in registration of bone cancer cases in military participants not exposed to a D.U. explosion in the field in the years following 1993.

Graph 22: Brain cancer cases in military participants not exposed to a D.U. explosion in the years 1991-1997.

Shows an increase in registration of brain cancer cases in military participants not exposed to a D.U. explosion in the years following 1994.

Graph 23: Percentage of different types of cancer cases in military participants not exposed to a D.U. explosion.

Discussion:

The tables and graphs indicate there is change in the pattern of different types of cancer cases in military personnel who were involved in the southern region of Iraq during the war with U.S. and British

forces in 1991.

The sample cases were from military personnel who participated and were exposed to explosions of D.U. weapon in the south of Iraq, Rumaila north, Rumaila south, strategic pipeline near pump station (Border of Saudi Arabia), and the road between Safwan and Kuwait at which attacks on tanks and vehicles continued 2 days after withdrawal of Iraqi troops.

U.S. and British forces dropped about 630,000 pounds of depleted uranium against Iraqi vehicles and tanks, and it is estimated that approximately 5000-6000 rounds of 120 mm and about 940,000 bullets of 30mm.

From review of literature, these weapons have ill effect on both human and environment.

It seems clear from tables and graphs that there is increasing registration of different types of cancer cases from years 1993 and 1994, especially lymphomas, leukemias, in addition to lung CA, bone CA, brain CA, Gastrointestinal cancers and liver CA.

The personnel under risk of exposure to an explosion (population at risk) were tanks crews, armored vehicles, artillery, air force defense, and those personnel who were engaged in administrative support to the fighting troops.

Table (1):- There is relative decline in the percentage of lymphoma in 1997 in comparison with 1991. It represents about 34.5% in the year 1991, but represents 29.4% in 1997. Also, there is a decline in the percentage of leukemias and bone cancer in 1997 in comparison with 1991. This may be due to increase in registration of other types of cancer.

Table (2):- Shows increase in the registration of different types of cancer cases from the years 1993-1994 to those participated, but not exposed, which is probably similar to the pattern in the general population. Also there is a decline in the percentage of registration in 1997 in comparison to 1991 concerning lung CA, leukemias and probably this is due to the increase registration of other cancers such as gastrointestinal cancer, leukemias, lymphomas, bone CA, and brain CA, which were not registered in 1991.

The end result of the exploded weapon could be as dust, fumes, aerosol, or ashes that contain uranium oxide particles. These particles could be transmitted by air or carried with winds and can be airborne for miles before dropping to the ground (Dan Fahey 98).

This can raise the probability of different types of cancer cases occurrences to those exposed to field explosion and front units, in tank crews, armored vehicles, air force defense, artillery, those personnel who were in administrative units, and in maintenance of destroyed vehicles or evacuation.

Table (2) also shows increase in registration of cancer cases in those who participated were but not exposed. This probably can be due to environmental pollution, which might be similar to the pattern of cases in the general population.

Dust of D.U., as a result of it's explosion, can fall on the ground and personnel can inhale it or it enters the body through GIT. In addition, some of the bullets that miss their targets fall on the ground and could be considered as environmental pollutant that can contaminate food and surface water sources and ground water.

Its effect on environment depends on the type of soil and the degree of solubility of uranium oxide particles. (Dan Fahey 98).

Table (3):- shows statistically significant odds ratio of different types of cancer cases to those involved and exposed to an explosion in the battlefield. From an epidemiological point of view, it is interpreted that there is a positive association between the explosion (exposure to D.U.) and cancer cases.

Odds ratio was very high in lymphomas which was 5.6, followed by 4.8 in cases of leukemias, and 4.5 in brain CA.

In fact, the odds ratios of other cancer cases in relation to exposure to an explosion (the factor under study) also have statistically significant values as shown by Table (3), but in a lesser degree such as in cases of lung, gastrointestinal, liver, and bone cancers.

The probability of this association as shown from odds ratio could be related to the causative agent (D.U.).

D.U. contains alpha particles, the insoluble part of these particles represent about 83.52%. This quantity, once entered the body of the exposed person, will stay there and consequently ionize body organs and tissues surrounding it, causing different types of cancer. (Dan Fahey 98).

The soluble part of alpha particles, which represent 48%, is transmitted to the human body by absorption and through blood circulation. Only about 60% will be excreted by urine and stool within a few weeks. The residual 20% will be deposited in the bones and the other 10% will be distributed to the other body organs, especially the liver, causing ionization of the tissues of the organs and disturbance of their function. This, consequently, may cause different types of cancer cases (Los Alamos National Laboratories 1996).

The soluble part of alpha particles inside the body of human being has a chemically toxic effect on DNA of reproductive cells which causes congenital anomalies and destructive effects on reproductive mechanisms resulting in primary and secondary sterility (Dan Fahey 98).

The mechanism of cause and effect needs further laboratory and experimental studies of those exposed to the causative agent through examination of its effect on chromosomes.

It is stated by U.S. Army Environmental Institute Report 1995 and Department of Veterans Affairs 1997, that "D.U. has an effect on changes of the shape of chromosomes in terms of increase in sister chromatid exchange" and that was proven through lymphocyte culture of two groups of people working in uranium manufacturing in U.S. The end result of the study shows that the group of workers exposed to soluble type of uranium have a statistically significant rise in chromosomal aberration and sister chromatid exchange in comparison with group of workers exposed to soluble and insoluble type of uranium.

The probability is that D.U. has a chemically toxic and radiological effect due to the alpha particles it contains: consequently causing infertility, congenital anomalies, low birth weight of babies of fathers and mothers exposed to D.U.

This may explain the 222 cases of congenital anomalies and stillbirths related to military personnel who were exposed to the explosions in the southern region of Iraq as shown in Graph 15.

Graph (1):- represents subsequent rise in registration of total cancer cases in those exposed and not exposed.

Graph (2):- shows subsequent rise in registration of different types of cancer cases in those who participated and were exposed to explosion from the years 1991 up to 1997.