Long Term Risks to Neonatal Health From Exposure to War

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

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 increase in not 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 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 progressive increase in birth defects since the 2006 attacks. In 2011 we started surveillance at birth alongside with analysis of 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 set, 2011, 2016 and 2018-19 [4.000- 6.000 women in each set]. By ICP/MS analysis was determined the content in mothers hair of 23 metals. Appropriate statistical analysis was performed. Results- Comparison of data in birth registers showed a major increase of 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 to exposure of the mothers to the attacks in 2014 and/or to hot spot of heavy metals contamination. Metal loads since the attacks in 2014, were consistently high till 2018-19 for barium, arsenic, cobalt, cadmium, chrome, vanadium, uranium, pointing to these metals as potential inducers for the increased prevalence of negative health outcomes at birth since 2016. Conclusion- 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 not communicable diseases and cancers at all ages in Gaza. Modern wars legacy of diseases and deaths extends in time to populations and demands monitoring.

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