Birth defects in Iraq and the plausibility of environmental exposure A review.docVIP

Al-Hadithietal.ConflictandHealth2012,6:3 /content/6/1/3 REVIEW OpenAccess BirthdefectsinIraqandtheplausibilityof environmentalexposure:Areview TariqSAl-Hadithi1,JawadKAl-Diwan2,AbubakirMSaleh1andNazarPShabila1* Abstract AnincreasedprevalenceofbirthdefectswasallegedlyreportedinIraqinthepost1991GulfWarperiod,whichwas largelyattributedtoexposuretodepleteduraniumusedinthewar.Thishasencouragedfurtherresearchonthis particulartopic.ThispaperreviewsthepublishedliteratureandprovidedevidenceconcerningbirthdefectsinIraq toelucidatepossibleenvironmentalexposure.Inadditiontopublishedresearch,thisreviewusedsomedirect observationofbirthdefectsdatafromAl-RamadiMaternityandPaediatricHospitalinAl-AnbarGovernorateinIraq from1stJuly2000through30thJune2002.Inadditiontodepleteduraniumotherwar-relatedenvironmentalfactors havebeenstudiedandlinkeddirectlyorindirectlywiththeincreasingprevalenceofbirthdefects.However,the reviewedstudiesandtheavailableresearchevidencedonotprovideaclearincreaseinbirthdefectsandaclear indicationofapossibleenvironmentalexposureincludingdepleteduraniumalthoughthecountryhasbeenfacing severalenvironmentalchallengessince1980. Introduction screening for birth defects, particularly for high risk Birthdefectsarestilltheleadingcauseofperinatalmor- population[5]. talityandchildhooddisabilityindevelopedcountries[1]. Workers allegedly reported a high prevalence of birth In contrast, in some developing countries where infant defects in Basrah (south of Iraq) in the post 1991 Gulf mortality remainsveryhigh, theleading causesof death War period, which was attributed to exposure to are related to malnutrition and infection [2]. However, depleted uranium (DU) used in the war [6,7]. This pro- birth defects in the developing world are largely under- videdimpetusforfurtherresearchinthisparticularfield reported by deficiencies in diagnostic capabilities and in Iraq. This paper reviews the published literature and lackofreliabilityofmedic