Long-term health complications of chemical weapon exposure: a study on Halabja chemical attack survivors (Iraqi Kurds).

OBJECTIVE: In 1988, the Iraqi government used a range of chemical weapons (CWs) against the Iraqi Kurds of Halabja. Here, we aim to investigate the long-term health consequences in exposed survivors as they are not sufficiently studied. MATERIALS AND METHODS: This was a retrospective study conducted from November 2019 to May 2020 assessing the health status of all exposed Halabja chemical attack survivors compared to non-exposed people from the same area. RESULTS AND DISCUSSION: Two hundred thirty survivors and 240 non-exposed participants were enrolled in this study, with control participants matched to age, gender, and occupation. Among the survivors, females were more prevalent. The respiratory system was the most common single exposure route (83, 36.1%), with 138 (60%) of the survivors being exposed by multiple routes. The vast majority (88.7%) of survivors had activities of daily living (ADL) impairment. There was female predominance in mild and moderate cases, with more males in severe cases (p < 0.01). Respiratory and cardiac diseases were significantly more common in the survivors compared to the controls (p < 0.001). Survivors with multiple CW exposure routes had significantly higher rates of ADL impairment (p < 0.001) and cardiac disease, respiratory diseases, and miscarriage (p < 0.01), than those with a single exposure route. CONCLUSION: In this study comparing CW survivors with a local control population, a single, high-dose exposure to CWs was associated with significant increases in chronic respiratory and cardiac conditions, in addition to high rates of ADL impairment. Similar studies are needed in other, more recent CW survivor cohorts.

Assessment of potentially toxic elements in vegetables cultivated in urban and peri-urban sites in the Kurdistan region of Iraq and implications for human health.

Vegetable fields in and around urban areas in the Kurdistan region of Iraq may have higher than background concentrations of potentially toxic elements (PTEs) from contamination sources including municipal waste disposal and wastewater used for irrigation. The purpose of this study was to assess PTE concentrations in soils and the edible parts of field-grown vegetables to quantify potential health risks to the local population. In this survey, 174 soils and 26 different vegetable and fruit types were sampled from 15 areas around Sulaymaniyah and Halabja cities. Sampling was undertaken from fields in urban, peri-urban and rural locations including sites close to areas of waste disposal. The soils are calcareous (pH 7.67-8.21) and classified as silty loam, sandy or silty clay with organic matter content between 6.62 and 11.4%. Concentrations of PTEs were typically higher in waste disposal areas compared with urban, peri-urban and rural areas. Pollution load indices suggested that agricultural soils near waste disposal sites were contaminated with some trace elements. Potentially toxic element concentrations in vegetables were highly variable. Higher total concentrations of PTEs were measured in vegetables from the waste areas with decreasing concentrations in urban, peri-urban and rural areas. Risks to human health were assessed using hazard quotients (HQ). Vegetable consumption poses no risk for adults, whereas children might be exposed to Ni, As and Cd. Although HQs suggest elevated risk for children from consumption of some vegetables, these risks are likely to be lower when realistic dietary consumption levels are considered.