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Trembley JH, Barach P, Tomáška JM, Poole JT, Ginex PK, Miller RF, Lindheimer JB, Szema AM, Gandy K, Siddharthan T, Kirkness JP, Nixon JP, Torres RL, Klein MA, Nurkiewicz TR, Butterick TA. Current understanding of the impact of United States military airborne hazards and burn pit exposures on respiratory health. Part Fibre Toxicol 2024; 21:43. [PMID: 39434148 PMCID: PMC11492460 DOI: 10.1186/s12989-024-00606-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 10/08/2024] [Indexed: 10/23/2024] Open
Abstract
Millions of United States (U.S.) troops deployed to the Middle East and Southwest Asia were exposed to toxic airborne hazards and/or open-air burn pits. Burn pit emissions contain particulate matter combined with toxic gasses and heavy metals. Ongoing research has demonstrated that exposures to the airborne hazards from military burn pits have profound and lasting health and wellness consequences. Research on the long-term health consequences of exposure to open burn pits has been limited. Work continues to understand the scope of the health impacts and the underlying pathobiology following exposures and to establish care standards. The U.S. Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act was signed into law August 2022. This act expands the benefits and services to U.S. Veterans exposed to toxicants, requires the Veterans Health Administration to provide toxic exposure screening, and supports increased research, education, and treatment due to toxic occupational exposures. This review highlights the state of the science related to military burn pit exposures research with an emphasis on pulmonary health. Clinical data demonstrate areas of reduced or delayed pulmonary ventilation and lung pathologies such as small airways scarring, diffuse collagen deposition and focal areas of ossification. Identification and characterization of foreign matter deposition in lung tissues are reported, including particulate matter, silica, titanium oxides, and polycyclic aromatic hydrocarbons. These data are consistent with toxic exposures and with the symptoms reported by post-deployment Veterans despite near-normal non-invasive pulmonary evaluations. On-going work toward new methods for non-invasive pulmonary diagnoses and disease monitoring are described. We propose various studies and databases as resources for clinical and health outcomes research. Pre-clinical research using different burn pit modeling approaches are summarized, including oropharyngeal aspiration, intranasal inhalation, and whole-body exposure chamber inhalation. These studies focus on the impacts of specific toxic substances as well as the effects of short-term and sustained insults over time on the pulmonary systems.
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Affiliation(s)
- Janeen H Trembley
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Paul Barach
- Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Jedidah T Poole
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Pamela K Ginex
- School of Nursing, Stony Brook University, Stony Brook, NY, USA
| | - Robert F Miller
- Department of Medicine, Vanderbilt University, Nashville, TN, USA
| | | | - Anthony M Szema
- Three Village Allergy and Asthma, PLLC, South Setauket, NY, USA
- Department of Occupational Medicine, Epidemiology, and Prevention, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Division of Allergy and Immunology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Division of Pulmonary and Critical Care, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | | | - Trishul Siddharthan
- Division of Pulmonary and Critical Care Medicine, University of Miami, Miami, FL, USA
| | | | - Joshua P Nixon
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
- Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | | | - Mark A Klein
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Timothy R Nurkiewicz
- Department of Physiology, Pharmacology and Toxicology, West Virginia University School of Medicine, Morgantown, WV, USA
- Center for Inhalation Toxicology (iTOX), West Virginia University School of Medicine, Morgantown, WV, USA
| | - Tammy A Butterick
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA.
- Department of Food Science and Nutrition, University of Minnesota, St Paul, MN, USA.
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, USA.
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Ghosh A, Rogers KL, Gallant SC, Kim YH, Rager JE, Gilmour MI, Randell SH, Jaspers I. Effects of simulated smoke condensate generated from combustion of selected military burn pit contents on human airway epithelial cells. Part Fibre Toxicol 2024; 21:41. [PMID: 39380034 PMCID: PMC11460082 DOI: 10.1186/s12989-024-00604-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 09/29/2024] [Indexed: 10/10/2024] Open
Abstract
BACKGROUND Exposure to military burn pit smoke during deployment is associated with different respiratory and non-respiratory diseases. However, information linking smoke exposure to human pulmonary health is lacking. This study examined the effects of simulated burn pit smoke condensates on human airway epithelial cells (HAECs) from twelve donors (smokers/non-smokers, biological female/male) cultured at an air-liquid interface and exposed to condensates from three simulated burn pit waste materials (cardboard, plywood, and plastic) incinerated at two combustion conditions: smoldering and flaming. Cellular gene expression was analyzed using bulk RNA sequencing, and basolateral media cytokine levels were assessed using multiplex immunoassay. RESULTS Flaming smoke condensates caused more significant differentially expressed genes (DEGs) with plywood flaming smoke being the most potent in altering gene expression and modulating cytokine release. Cardboard and plywood flaming condensates primarily activated detoxification pathways, whereas plastic flaming affected genes related to anti-microbial and inflammatory responses. Correlation analysis between smoke condensate chemicals and gene expression to understand the underlying mechanism revealed crucial role of oxygenated polycyclic aromatic hydrocarbons (PAHs) and aluminum, molybdenum, and silicon elements; IL6 expression was positively correlated with most PAHs. Stratification of data based on HAEC donor demographics suggests that these affect gene expression changes. Enrichment analysis indicated similarity with several deployment-related presumptive and reported diseases, including asthma, emphysema, and cancer of different organs. CONCLUSIONS This study highlights that simulated burn pit smoke exposure of HAECs causes gene expression changes indicative of deployment-related diseases with more pronounced effects seen in smokers and females. Future studies are needed to further characterize how sex and smoking status affect deployment-related diseases.
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Affiliation(s)
- Arunava Ghosh
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, School of Medicine, 104 Mason Farm Road, Chapel Hill, NC, 27599-7310, USA
| | - Keith L Rogers
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, 116 Manning Drive, Chapel Hill, NC, 27599-7310, USA
| | - Samuel C Gallant
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Yong Ho Kim
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC, 27711, USA
| | - Julia E Rager
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, School of Medicine, 104 Mason Farm Road, Chapel Hill, NC, 27599-7310, USA
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, 116 Manning Drive, Chapel Hill, NC, 27599-7310, USA
- Department of Environmental Sciences and Engineering (ESE), Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - M Ian Gilmour
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC, 27711, USA
| | - Scott H Randell
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Ilona Jaspers
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, School of Medicine, 104 Mason Farm Road, Chapel Hill, NC, 27599-7310, USA.
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, 116 Manning Drive, Chapel Hill, NC, 27599-7310, USA.
- Department of Environmental Sciences and Engineering (ESE), Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
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Ghosh A, Payton A, Gallant SC, Rogers KL, Mascenik T, Hickman E, Love CA, Schichlein KD, Smyth TR, Kim YH, Rager JE, Gilmour MI, Randell SH, Jaspers I. Burn Pit Smoke Condensate-Mediated Toxicity in Human Airway Epithelial Cells. Chem Res Toxicol 2024; 37:791-803. [PMID: 38652897 PMCID: PMC11251002 DOI: 10.1021/acs.chemrestox.4c00064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Burn pits are a method of open-air waste management that was common during military operations in Iraq, Afghanistan, and other regions in Southwest Asia. Veterans returning from deployment have reported respiratory symptoms, potentially from exposure to burn pit smoke, yet comprehensive assessment of such exposure on pulmonary health is lacking. We have previously shown that exposure to condensates from burn pit smoke emissions causes inflammation and cytotoxicity in mice. In this study, we explored the effects of burn pit smoke condensates on human airway epithelial cells (HAECs) to understand their impact on cellular targets in the human lung. HAECs were cultured at the air-liquid interface (ALI) and exposed to burn pit waste smoke condensates (plywood, cardboard, plastic, mixed, and mixed with diesel) generated under smoldering and flaming conditions. Cytotoxicity was evaluated by measuring transepithelial electrical resistance (TEER) and lactate dehydrogenase (LDH) release; toxicity scores (TSs) were quantified for each exposure. Pro-inflammatory cytokine release and modulation of gene expression were examined for cardboard and plastic condensate exposures. Burn pit smoke condensates generated under flaming conditions affected cell viability, with flaming mixed waste and plywood exhibiting the highest toxicity scores. Cardboard and plastic smoke condensates modulated cytokine secretion, with GM-CSF and IL-1β altered in more than one exposure group. Gene expression of detoxifying enzymes (ALDH1A3, ALDH3A1, CYP1A1, CYP1B1, NQO1, etc.), mucins (MUC5AC, MUC5B), and cytokines was affected by several smoke condensates. Particularly, expression of IL6 was elevated following exposure to all burn pit smoke condensates, and polycyclic aromatic hydrocarbon acenaphthene was positively associated with the IL-6 level in the basolateral media of HAECs. These observations demonstrate that exposure to smoke condensates of materials present in burn pits adversely affects HAECs and that aberrant cytokine secretion and altered gene expression profiles following burn pit material smoke exposure could contribute to the development of airway disease.
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Affiliation(s)
- Arunava Ghosh
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Alexis Payton
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
- Department of Environmental Sciences and Engineering (ESE), Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Samuel C. Gallant
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Keith L. Rogers
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, 116 Manning Drive, Chapel Hill, NC 27599-7310 USA
| | - Teresa Mascenik
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Elise Hickman
- Department of Environmental Sciences and Engineering (ESE), Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, 116 Manning Drive, Chapel Hill, NC 27599-7310 USA
| | - Charlotte A. Love
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Kevin D. Schichlein
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Timothy R. Smyth
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Yong Ho Kim
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - Julia E. Rager
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
- Department of Environmental Sciences and Engineering (ESE), Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, 116 Manning Drive, Chapel Hill, NC 27599-7310 USA
| | - M. Ian Gilmour
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA
| | - Scott H. Randell
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Ilona Jaspers
- Center for Environmental Medicine, Asthma, and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
- Department of Environmental Sciences and Engineering (ESE), Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina at Chapel Hill, 116 Manning Drive, Chapel Hill, NC 27599-7310 USA
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
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Smoot J, Padilla S, Kim YH, Hunter D, Tennant A, Hill B, Lowery M, Knapp BR, Oshiro W, Hazari MS, Hays MD, Preston WT, Jaspers I, Gilmour MI, Farraj AK. Burn pit-related smoke causes developmental and behavioral toxicity in zebrafish: Influence of material type and emissions chemistry. Heliyon 2024; 10:e29675. [PMID: 38681659 PMCID: PMC11053193 DOI: 10.1016/j.heliyon.2024.e29675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/11/2024] [Accepted: 04/12/2024] [Indexed: 05/01/2024] Open
Abstract
Combustion of mixed materials during open air burning of refuse or structural fires in the wildland urban interface produces emissions that worsen air quality, contaminate rivers and streams, and cause poor health outcomes including developmental effects. The zebrafish, a freshwater fish, is a useful model for quickly screening the toxicological and developmental effects of agents in such species and elicits biological responses that are often analogous and predictive of responses in mammals. The purpose of this study was to compare the developmental toxicity of smoke derived from the burning of 5 different burn pit-related material types (plywood, cardboard, plastic, a mixture of the three, and the mixture plus diesel fuel as an accelerant) in zebrafish larvae. Larvae were exposed to organic extracts of increasing concentrations of each smoke 6-to-8-hr post fertilization and assessed for morphological and behavioral toxicity at 5 days post fertilization. To examine chemical and biological determinants of toxicity, responses were related to emissions concentrations of polycyclic hydrocarbons (PAH). Emissions from plastic and the mixture containing plastic caused the most pronounced developmental effects, including mortality, impaired swim bladder inflation, pericardial edema, spinal curvature, tail kinks, and/or craniofacial deformities, although all extracts caused concentration-dependent effects. Plywood, by contrast, altered locomotor responsiveness to light changes to the greatest extent. Some morphological and behavioral responses correlated strongly with smoke extract levels of PAHs including 9-fluorenone. Overall, the findings suggest that material type and emissions chemistry impact the severity of zebrafish developmental toxicity responses to burn pit-related smoke.
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Affiliation(s)
- Jacob Smoot
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | | | - Yong Ho Kim
- US Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Deborah Hunter
- US Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Alan Tennant
- US Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Bridgett Hill
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Morgan Lowery
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Bridget R. Knapp
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Wendy Oshiro
- US Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Mehdi S. Hazari
- US Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Michael D. Hays
- US Environmental Protection Agency, Research Triangle Park, NC, USA
| | | | | | - M. Ian Gilmour
- US Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Aimen K. Farraj
- US Environmental Protection Agency, Research Triangle Park, NC, USA
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Wang X, Doherty TA, James C. Military burn pit exposure and airway disease: Implications for our Veteran population. Ann Allergy Asthma Immunol 2023; 131:720-725. [PMID: 37343826 PMCID: PMC10728339 DOI: 10.1016/j.anai.2023.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/07/2023] [Accepted: 06/09/2023] [Indexed: 06/23/2023]
Abstract
Millions of veterans have been exposed to burn pit smoke during combat deployments throughout the last three decades. Toxic compounds present in burn pit fumes that may cause or exacerbate upper and lower airway diseases include dioxins, polyaromatic hydrocarbons, and particulate matter, among others. There have been several observational studies evaluating the potential role of burn pit exposure in the development of a multitude chronic health conditions, and the veterans Administration has established the Airborne Hazards and Open Burn Pit Registry in 2014. However, specific causality of airway disease from burn pits has been difficult to prove, and there are multiple barriers toward etiologic research. Preclinical models have demonstrated airway dysfunction and inflammation but modeling human exposures remains challenging. Here, we review the current literature on the potential impact of burn pit exposure on chronic airway disease.
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Affiliation(s)
- Xinyu Wang
- Section of Allergy and Immunology, Department of Medicine, University of California San Diego, La Jolla, California; Veterans Affairs San Diego Health Care System, La Jolla, California
| | - Taylor A Doherty
- Section of Allergy and Immunology, Department of Medicine, University of California San Diego, La Jolla, California; Veterans Affairs San Diego Health Care System, La Jolla, California.
| | - Christine James
- Section of Allergy and Immunology, Department of Medicine, University of California San Diego, La Jolla, California; Veterans Affairs San Diego Health Care System, La Jolla, California
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