Talabani J M, Ali A I, Kadir A M, Rashid R, Samin F, Greenwood D, Hay Awm
1 Paediatric Department, Good Hope Hospital, Heart of England NHS Foundation Trust, Sutton Coldfield, UK.
2 Sulaimanyah Children's Hospital, Sulaimanyah, Iraq.
Hum Exp Toxicol. 2018 Aug;37(8):836-847. doi: 10.1177/0960327117734620. Epub 2017 Oct 25.
In the 1980s, villages in the Kurdistan region of Iraq were exposed to chemical weapons (CWs), which killed and injured thousands of civilians. There has been no clinical assessment of the long-term effects of CWs exposure on those injured. We report the first such evaluation of CW effects on long-term health of children. Patients from the CW-exposed areas were interviewed to assess previous and current clinical history and underwent clinical examination. The status of organs known to be targets of CWs, including skin, eyes, respiratory and neuromuscular systems, was assessed. Children of similar age and social background, but with no history of CW exposure, were selected as a control population. Results showed that 70% of children in the CWs group had chronic health problems in contrast to 3.3% in the unexposed group ( p < 0.0001). Fifty-five per cent of the CW-exposed group had long-term visual impairment but none in the unexposed population. Thirty-six per cent of the CW-exposed group had chronic dermatological conditions compared with 0.8% of the unexposed group ( p < 0.0001), 31% of the CWs group had neurological sequelae compared with 0.4% of the unexposed group ( p < 0.0001) and 51% of the CWs group had long-term respiratory problems compared with 1.5% of the unexposed group ( p < 0.0001). Respiratory complaints including asthma, chronic bronchitis and bronchiectasis were particularly common. Our study suggests that CWs used were probably a combination of sulphur mustard and organophosphate nerve agents. Results also indicate that the prevalence of acute and chronic health problems following exposure to CW agents appear to be higher in children compared with reported data in adults.
20世纪80年代，伊拉克库尔德地区的村庄遭受了化学武器袭击，数千名平民伤亡。至今尚未对化学武器暴露对受伤者的长期影响进行临床评估。我们报告了首次对化学武器对儿童长期健康影响的此类评估。对来自化学武器暴露地区的患者进行了访谈，以评估既往和当前的临床病史，并进行了临床检查。评估了已知为化学武器攻击目标的器官状况，包括皮肤、眼睛、呼吸和神经肌肉系统。选择年龄和社会背景相似但无化学武器暴露史的儿童作为对照人群。结果显示，化学武器组70%的儿童有慢性健康问题，而未暴露组为3.3%（p<0.0001）。化学武器暴露组55%的儿童有长期视力损害，而未暴露人群中无人有此情况。化学武器暴露组36%的儿童有慢性皮肤病，而未暴露组为0.8%（p<0.0001）；化学武器组31%的儿童有神经后遗症，而未暴露组为0.4%（p<0.0001）；化学武器组51%的儿童有长期呼吸问题，而未暴露组为1.5%（p<0.0001）。包括哮喘、慢性支气管炎和支气管扩张在内的呼吸道疾病尤为常见。我们的研究表明，所使用的化学武器可能是芥子气和有机磷神经毒剂的混合物。结果还表明，与成人报告的数据相比，儿童接触化学武器制剂后急性和慢性健康问题的患病率似乎更高。
