It Takes Time to Unravel the Ecology of War in Gaza, Palestine: Long-Term Changes in Maternal, Newborn and Toddlers' Heavy Metal Loads, and Infant and Toddler Developmental Milestones in the Aftermath of the 2014 Military Attacks

Toxic chemical exposures among civilians in armed conflicts: the need for research equity, justice, and accountability

OBJECTIVE

Armed conflicts result in the release of toxic chemicals into the surrounding environment and civilians are commonly exposed to these toxicants. This paper reviews the evidence on civilian exposure to toxic chemicals, including but not limited to inhaled toxic substances, in post-World War II armed conflicts, and proposes a framework for the implementation of long-term surveillance programs for these populations.

MATERIALS AND METHODS

Four databases of peer-reviewed health articles were searched for all English-language articles with a primary focus on toxic chemical exposures among civilians in armed conflicts since World War II. The review was supplemented substantially by the gray literature.

RESULTS

In the 66 articles that met the inclusion criteria, the authors categorized the chemical toxicants to which civilians have been exposed in modern armed conflicts as ubiquitous (e.g. smoke, dust, and munitions components present in all conflicts) or particular agents (e.g. specific chemical agents used in a few conflicts). While most studies focused on particular agents, the vast majority of civilians are in fact exposed to ubiquitous agents both in the acute conflict phase and through persistent environmental exposures after the cessation of hostilities.

DISCUSSION/CONCLUSION

There is a dearth of research concerning civilian exposures to toxic chemicals during armed conflicts. In line with principles of equity, justice, and accountability, robust research and surveillance programs are urgently needed to document exposures and provide ongoing assessments and any necessary treatment for these long-ignored populations, most of whom live in the Global South.

Multiple exposures to heavy metals and changes in steroid hormones production in 4-year-old children

BACKGROUND

Prenatal exposure to multiple heavy metals can interfere with early neurodevelopment, lead to changes in sex hormone concentrations in children, and affect female reproductive health. To date, the influence of prenatal exposure to heavy metals on the endocrine system of children in Chinese electronic waste (e-waste) recycling areas has not been elucidated.

METHODS

Four weeks after delivery, 10 mL of human milk was collected for analysis of three heavy metals (lead (Pb), cadmium (Cd), and mercury (Hg)) via inductively coupled plasma mass spectrometry (ICP-MS). Four serum steroid hormones, including progesterone, testosterone, androstenedione (A-dione), and dehydroepiandrosterone (DHEA), were analyzed in 4-year-old children (25 boys and 17 girls). A multiple linear regression (MLR) model was implemented to investigate the association between each individual metal and serum steroid hormone. The exposure-response relationships were explored by generalized additive models (GAMs). Additionally, a Bayesian kernel machine regression (BKMR) model was used to assess the effects of multiple heavy metal exposures on each steroid hormone.

RESULTS

The MLR results show a significant positive association between a natural log unit increase in Hg and DHEA levels after adjusting for confounders (β = 65.50, 95% confidence interval (CI) = 4.37, 126.62). According to the GAM, the univariate exposure-response relationship of Hg on DHEA was almost linear. However, this association was attenuated based on the multiple metal MLR and BKMR results after accounting for multiple heavy metal exposures.

SIGNIFICANCE

Prenatal Hg exposure may affect sex hormones in children by affecting DHEA levels.

IMPACT STATEMENT

Prenatal maternal exposure to Hg may have long-term effects on the next generation. Hence, regulatory measures to reduce Hg exposure and long-term monitoring of children's health in e-waste areas are needed.

The mental health consequences on children of the war in Ukraine: A commentary

The news from Ukraine is currently full of heart-wrenching stories accompanied by graphic images of civilian casualties and massacres that are telecast world-wide on a daily basis. It is hard to fathom the magnitude of the devastation and disruption to regular lives and everyday routines that war brings with it, the witnessing of countless deaths, the associated trauma of living in perpetual fear, and the daily experience of many families and orphans who are crowded into basement bomb shelters now for months on end. These issues make us contemplate the mental health consequences, among other lasting effects, of this costly war in Ukraine, and wars in other countries not so widely featured in Western news. Despite people of all ages being affected by war, children are especially vulnerable. This commentary outlines some of the epidemiology of the consequences of war, the mental health sequelae specifically, and the complexity of providing culturally and contextually relevant interventions that meet the needs of children.

Russian-Ukrainian war impacts the total environment

The Russian-Ukrainian war triggered a tsunami that dramatically impacted the world economy, geopolitics, and food security. Due to the extreme humanitarian situation, the effects on the environment have been overlooked. However, due to the intense fighting, the impacts will be dramatic and produce an environmental disaster. The war is already affecting areas beyond Ukraine (explosions in Russia and Moldova territory). This discussion paper aims to shed light on the potential effect of this vast conflict on the ecosystems and their services. Although the war is still ongoing, there is evidence of severe air pollution and greenhouse gas emissions resulting from the intense fights. Also, warfare activities were conducted in the vicinity of the Zaporizhzhia nuclear power plant (the biggest in Europe) and Chernobyl, increasing the fear of radiation leaks. The biodiversity is being drastically affected due to intense deforestation and habitat destruction with potential implications for wildlife. Bombing, trench and tunnel excavations will likely negatively impact soil degradation and landscape morphology. This assumes particular importance since Ukraine has some of the most fertile soils globally (Chernozem), affecting food production. Water availability and quality are likely to be affected due to infrastructure destruction and the transport of pollutants to water reserves. The ecosystem services supplied will likely be strongly damaged since deforestation will decrease the capacity of the ecosystems to regulate air pollution or climate. Soil degradation will hamper food production, and landscape aesthetics, cultural heritage and social cohesion destruction drastically affects cultural services. Finally, the impacts on human health are already tremendous. However, it can be even higher due to exposure to high levels of contamination and sanitary conditions degradation. The war is still ongoing, and there is considerable uncertainty regarding the impacts. However, we may expect a dramatic effect on the total environment.

Human (in)security and psychological well-being in Palestinian children living amidst military violence: A qualitative participatory research using interactive maps

BACKGROUND

Research has widely evidenced the effects of war and political violence on the functioning of children, with a great accord in diagnosing children's psychological burdens related to their exposure to violence. Yet, within this literature, the influence of the chronic sense of insecurity on their psychological functioning during and after hostilities remains unexplored.

METHODS

The present study aimed at exploring interrelated relationships between the perceived insecurity and the children's psychological well-being and their adjustment to trauma. Based on drawings and walk-along interviews with 75 Palestinian children, residents of both the West Bank and Gaza Strip, we offer an analysis of human security-related risks and protective factors that contribute to either promoting or undermining the child's psychological functioning in a context characterized by chronic instability and political violence.

RESULTS

A complex network of sources of security and insecurity emerged from the narratives depicting an ecological portrait encompassing the determinants of children's mental health and psychological functioning. The TCA led to the identification of eight main themes: school and associativism; social relations and house as a source of security/insecurity; military occupation as a source of insecurity; national and political identity as a source of safety; mosque and spirituality as a source of safety/unsafety; environment as a source of security/insecurity; and mental health.

DISCUSSION

An approach encompassing human security as an explicative model can help in exhaustively portraying the complexity of the Palestinian children's suffering and their competence in adjusting to their traumatic reality. The study draws attention to social, political, environmental and economic determinants of children psychological well-being.

Environmental and health hazards of military metal pollution

An increasing body of literature has demonstrated that armed conflicts and military activity may contribute to environmental pollution with metals, although the existing data are inconsistent. Therefore, in this paper, we discuss potential sources of military-related metal emissions, environmental metal contamination, as well as routes of metal exposure and their health hazards in relation to military activities. Emission of metals into the environment upon military activity occurs from weapon residues containing high levels of particles containing lead (Pb; leaded ammunition), copper (Cu; unleaded), and depleted uranium (DU). As a consequence, military activity results in soil contamination with Pb and Cu, as well as other metals including Cd, Sb, Cr, Ni, Zn, with subsequent metal translocation to water, thus increasing the risk of human exposure. Biomonitoring studies have demonstrated increased accumulation of metals in plants, invertebrates, and vertebrate species (fish, birds, mammals). Correspondingly, military activity is associated with human metal exposure that results from inhalation or ingestion of released particles, as well as injuries with subsequent metal release from embedded fragments. It is also notable that local metal accumulation following military injury may occur even without detectable fragments. Nonetheless, data on health effects of military-related metal exposures have yet to be systematized. The existing data demonstrate adverse neurological, cardiovascular, and reproductive outcomes in exposed military personnel. Moreover, military-related metal exposures also result in adverse neurodevelopmental outcome in children living within adulterated territories. Experimental in vivo and in vitro studies also demonstrated toxic effects of specific metals as well as widely used metal alloys, although laboratory data report much wider spectrum of adverse effects as compared to epidemiological studies. Therefore, further epidemiological, biomonitoring and laboratory studies are required to better characterize military-related metal exposures and their underlying mechanisms of their adverse toxic effects.

(Ascorb)ing Pb Neurotoxicity in the Developing Brain

Lead (Pb) neurotoxicity is a major concern, particularly in children. Developmental exposure to Pb can alter neurodevelopmental trajectory and has permanent neuropathological consequences, including an increased vulnerability to further stressors. Ascorbic acid is among most researched antioxidant nutrients and has a special role in maintaining redox homeostasis in physiological and physio-pathological brain states. Furthermore, because of its capacity to chelate metal ions, ascorbic acid may particularly serve as a potent therapeutic agent in Pb poisoning. The present review first discusses the major consequences of Pb exposure in children and then proceeds to present evidence from human and animal studies for ascorbic acid as an efficient ameliorative supplemental nutrient in Pb poisoning, with a particular focus on developmental Pb neurotoxicity. In doing so, it is hoped that there is a revitalization for further research on understanding the brain functions of this essential, safe, and readily available vitamin in physiological states, as well to justify and establish it as an effective neuroprotective and modulatory factor in the pathologies of the nervous system, including developmental neuropathologies.