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Long Term Risks to Neonatal Health from Exposure to War—9 Years Long Survey of Reproductive Health and Contamination by Weapon-Delivered Heavy Metals in Gaza, Palestine

Author

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  • Paola Manduca

    (Department of Research, NWRG-onlus, 16123 Genoa, Italy)

  • Nabil Al Baraquni

    (Department of Medicine, Islamic University of Gaza, Gaza 79702, Palestine)

  • Stefano Parodi

    (Department of Epidemiology and Biostatistic Unit, IRCCS Istituto Giannina Gaslini, 16100 Genoa, Italy)

Abstract

Introduction : High levels of environmental contaminants with long term effects and teratogenic and carcinogenic potential, such as heavy metals, were introduced by weaponry in war areas in the last decades. Poorer reproductive health and increases in non-communicable diseases were reported after wars and are the suspected long term effects of contamination by stable war remnants. Although potentially affecting millions of people, this is still an understudied issue of public health. Background : Gaza, Palestine since 2006 has been an object of repeated severe military attacks that left heavy metals remnants in the environment, in wound tissues and that were assumed by the population. Retrospective studies showed a progressive increase in birth defects since the 2006 attacks. In 2011 we started surveillance at birth alongside analysis of the heavy metals load carried by pregnant women and their babies. Methods : We used protocols for birth registration which also document the extent of exposures to attacks, war remnants and to other environmental risks that allow comparison of 3 data sets—2011, 2016 and 2018–2019 (4000–6000 women in each set). By ICP/MS analysis we determined the content of 23 metals in mothers’ hair. Appropriate statistical analysis was performed. Results : Comparison of data in birth registers showed a major increase in the prevalence in birth defects and preterm babies between 2011 and 2016, respectively from 1.1 to 1.8% and from 1.1 to 7.9%, values remaining stable in 2019. Negative outcomes at birth in 2016 up to 2019 were associated with exposure of the mothers to the attacks in 2014 and/or to hot spots of heavy metals contamination. Metal loads since the attacks in 2014 were consistently high until 2018–2019 for barium, arsenic, cobalt, cadmium, chrome, vanadium and uranium, pointing to these metals as potential inducers for the increased prevalence of negative health outcomes at birth since 2016. Conclusions : Bodily accumulation of metals following exposure whilst residing in attacked buildings predispose women to negative birth outcomes. We do not know if the metals act in synergy. Trial for mitigation of the documented negative effects of high metal load on reproductive health, and ensuing perinatal deaths, could now be done in Gaza, based on this documentary record. High load of heavy metals may explain recent increases in non-communicable diseases and cancers at all ages in Gaza. Modern war’s legacy of diseases and deaths extends in time to populations and demands monitoring.

Suggested Citation

  • Paola Manduca & Nabil Al Baraquni & Stefano Parodi, 2020. "Long Term Risks to Neonatal Health from Exposure to War—9 Years Long Survey of Reproductive Health and Contamination by Weapon-Delivered Heavy Metals in Gaza, Palestine," IJERPH, MDPI, vol. 17(7), pages 1-20, April.
  • Handle: RePEc:gam:jijerp:v:17:y:2020:i:7:p:2538-:d:342681
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    References listed on IDEAS

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    1. Awny Naim & Hedaya Al Dalies & Mohammed El Balawi & Eman Salem & Kholud Al Meziny & Raneem Al Shawwa & Roberto Minutolo & Paola Manduca, 2012. "Birth Defects in Gaza: Prevalence, Types, Familiarity and Correlation with Environmental Factors," IJERPH, MDPI, vol. 9(5), pages 1-16, May.
    2. Paola Manduca & Awny Naim & Simona Signoriello, 2014. "Specific Association of Teratogen and Toxicant Metals in Hair of Newborns with Congenital Birth Defects or Developmentally Premature Birth in a Cohort of Couples with Documented Parental Exposure to M," IJERPH, MDPI, vol. 11(5), pages 1-16, May.
    3. Mauro Cristaldi & Cristiano Foschi & Germana Szpunar & Carlo Brini & Fiorenzo Marinelli & Lucio Triolo, 2013. "Toxic Emissions from a Military Test Site in the Territory of Sardinia, Italy," IJERPH, MDPI, vol. 10(4), pages 1-16, April.
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    Cited by:

    1. Cristina Canova & Anna Cantarutti, 2020. "Population-Based Birth Cohort Studies in Epidemiology," IJERPH, MDPI, vol. 17(15), pages 1-6, July.

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