Abstracts from The Cold Weather Operations Conference 2021.

A common effort for both military and civil healthcare is to achieve knowledge-based health care in cold weather injuries and fatal accidents in harsh arctic environment. The Cold Weather Operations Conference in November 2021, having more than 300 participants from 20 countries, was addressing the prevention and treatment of injuries and trauma care in cold weather conditions and the challenges for military prehospital casualty care. The intention of the programme was to stimulate further research and systematic knowledge-based clinical work. The abstracts from the conference present cold weather research and clinical experience relevant for readers of the International Journal of Circumpolar Health.

Toxic effects of gunshot fumes from different ammunitions for small arms on lung cells exposed at the air liquid interface.

Concerns have been raised as to whether gunshot fumes induce prolonged reduced lung capacity or even cancer due to inhalation. Gunshot fumes from three different types of ammunition calibre 5.56 mm × 45 NATO were investigated. SS109 has a soft lead (Pb) core, while NM255 and NM229 have a harder steel core. Emissions from ammunitions were characterized with respect to particle number- and mass-size, and mass distribution, heavy metal content, and different gases. Lung epithelial cells were exposed to the fumes at the air liquid interface to elucidate cytotoxicity and genotoxicity. Irrespectively of ammunition type, the largest mass fraction of generated particulate matter (PM) had a size between 1 and 3 µm. The highest number of particles generated was in the size range of 30 nm. Fumes from NM255 and NM229 induced cytotoxic effects of which the emission from NM229 induced the highest effect. Fumes from NM229 induced a dose-related increase in DNA-damage. Significant effects were only achieved at the highest exposure level, which led to approximately 40% reduced cell viability after 24 h. The effect probably relates to the mass of emitted particles where the size may be of importance, in addition to emission of Cu and Zn. A complex mixture of chemical substances and PM may increase the toxicity of the fumes and should encourage measures to reduce exposure.

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

OBJECTIVE: After introduction of unleaded ammunition, Norwegian Armed Forces received reports of acute respiratory symptoms in soldiers after exposure to fumes from firing the standard weapon, HK416. The aim of the present study was to examine lung function before and after exposure to fumes from HK416 in a double-blinded standardised study design using three different types of ammunition. METHODS: Fifty-four healthy, non-smoking male volunteers (19-62 years) fired the weapons for 60 min with either leaded, unleaded or 'modified' unleaded ammunition. Gaseous and particulate emissions were monitored. Spirometry and exhaled nitric oxide (eNO) were performed within 14 days before (T0), shortly after (T1) and 24 hours after (T2) shooting. Methacholine provocation and diffusing capacity of carbon monoxide (DLCO) were carried out at T0 and T2. RESULTS: The mean forced expiratory volume in 1 s on a group level was significantly reduced both at T1 and T2 compared with T0, with means and 95% CI of 226 mL (158 to 294 mL) and 285 mL (218 to 351 mL), respectively. The same significant pattern was seen for DLCO, forced vital capacity and eNO. The methacholine test indicated a slight increase in bronchial hyper-reactivity. However, there were no significant differences between types of ammunition used. CONCLUSION: 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.

Environmental risk assessment of white phosphorus from the use of munitions - a probabilistic approach.

White phosphorus (P(4)) is a highly toxic compound used in various pyrotechnic products. Ammunitions containing P(4) are widely used in military training areas where the unburned products of P(4) contaminate soil and local ponds. Traditional risk assessment methods presuppose a homogeneous spatial distribution of pollutants. The distribution of P(4) in military training areas is heterogeneous, which reduces the probability of potential receptors being exposed to the P(4) by ingestion, for example. The current approach to assess the environmental risk from the use of P(4) suggests a Bayesian network (Bn) as a risk assessment tool. The probabilistic reasoning supported by a Bn allows us to take into account the heterogeneous distribution of P(4). Furthermore, one can combine empirical data and expert knowledge, which allows the inclusion of all kinds of data that are relevant to the problem. The current work includes an example of the use of the Bn as a risk assessment tool where the risk for P(4) poisoning in humans and grazing animals at a military shooting range in Northern Norway was calculated. P(4) was detected in several craters on the range at concentrations up to 5.7g/kg. The risk to human health was considered acceptable under the current land use. The risk for grazing animals such as sheep, however, was higher, suggesting that precautionary measures may be advisable.

Effects of methyl mercury in combination with polychlorinated biphenyls and brominated flame retardants on the uptake of glutamate in rat brain synaptosomes: a mathematical approach for the study of mixtures.

Regulatory limit values for toxicants are in general determined by the toxicology of the single compounds. However, little is known about their combined effects. Methyl mercury (MeHg), polychlorinated biphenyls (PCBs), and brominated flame retardants (BFRs) are dominant contaminants in the environment and food. MeHg is a well known neurotoxicant, especially affecting the developing brain. There is increasing evidence that PCB and BFRs also have neurotoxic effects. An enhanced effect of these toxicants, due to either synergistic or additive effects, would be considered as a risk for the fetal development. Here we studied the combinatorial effects of MeHg in combination with PCB or BFR on the reuptake of glutamate in synaptosomes. To provide the optimal conclusion regarding type of interaction, we have analyzed the data using two mathematical models, the Löewe model of additivity and Bliss' model of independent action. Binary and ternary mixtures in different proportions were made. The toxicants had primarily additive effects, as shown with both models, although tendencies towards synergism were observed. MeHg was by far the most potent inhibitor of uptake with an EC(50) value of 0.33 microM. A reconstituted mixture from a relevant fish sample was made in order to elucidate which chemical was responsible for the observed effect. Some interaction was experienced between PCB and MeHg, but in general MeHg seemed to explain the observed effect. We also show that mixture effects should not be assessed by effect addition.

Effects of polychlorinated biphenyls on the neutrophil NADPH oxidase system.

Polychlorinated biphenyls (PCBs) are reported to induce the formation of reactive oxygen species (ROS) in human neutrophil granulocytes through the activation of the NADPH oxidase. The purpose of the present study is to elucidate the cellular mechanisms responsible for the activation of the NADPH oxidase after exposure to PCB. We have previously shown that PCB activates human neutrophil granulocytes through a calcium dependent activation of phospholipase D and/or phospholipase C, followed by the activation of protein kinase C. In the present study, pharmacological characterization of Aroclor (A) 1242-induced respiratory burst in human neutrophils was conducted by the use of enzymatic inhibitors. Pre-incubation with U0126, SB203580, SP600125, cyclosporin A and FK506 attenuated the A 1242-induced respiratory burst, measured by DCF-fluorescence, and luminol-amplified chemiluminescence. Our results show that the Erk1/2 kinases and p38MAPK/JNK are involved in ROS formation in neutrophils exposed to A 1242.

Why biota still accumulate high levels of PCB after removal of PCB contaminated sediments in a Norwegian fjord.

Accumulation of polychlorinated biphenyls (PCBs) in blue mussels (Mytilus edulis) and semipermeable membrane devices (SPMDs) was still high after the removal of PCB contaminated sediments from a Norwegian fjord by dredging. The accumulation of low chlorinated PCB congeners with a low octanol water-partitioning coefficient (K(ow)) in blue mussels and SPMDs was higher than for the highly chlorinated congeners with a high K(ow). The accumulation of low chlorinated congeners was also higher in a lightly contaminated area compared to a highly contaminated area. That dredging the contaminated sediments was unsuccessful in lowering PCB levels in the biota may be for the following reasons: (1) Due to the low solubility of PCBs in the water it is possible that a decrease in the sediment concentration of PCB would leave the water concentrations of PCB unchanged. (2) Removal of the fine organic sediments may also play an important role, since a seabed with coarse inorganic material has a lesser ability to bind PCB. (3) The dredging may whirl up fine contaminated particles that eventually settles on the seabed producing a thin contaminated sediment layer that determine the water concentration. (4) Bioaccumulation in blue mussels and in the SPMDs occurs mostly from PCB dissolved in the water column. Since the water concentration of PCB is unchanged by the dredging, the accumulation in SPMDs and mussels is the same as before dredging. Further monitoring need to be carried out to report the long-term effect of the dredging.