The environmental risk factors of birth defects in Iraq

Abstract

BACKGROUND AND AIM: Ever since the war started in 2003, Iraqi doctors have reported an increase in the birth of children with congenital anomalies. According to them, the rise in incidence has been attributed to war-related heavy metal pollution e.g. from depleted uranium and white phosphorus. As the war impeded quality research, the current post-conflict situation has allowed renewed space for quality research. The aim of the study is to assess to what extent exposure to environmental pollution might be associated with the incidence of congenital anomalies in Iraq. METHODS: We conducted a case-control study in Fallujah, a heavily bombarded city, comparing 50 parents of children with birth defects and 50 parents of children without birth defects. We used a questionnaire to comprehensively document environmental exposure and history of residence of each couple. Further, we complemented the interviews with biomonitoring through hair analysis of parents on heavy metals using ICP-MS. In addition, we took soil samples of the city of Fallujah using grid sampling and compared this to a control city in northern Iraq which has been less bombarded. We used Stata to statistically assess the differences in case and control groups regarding exposure and heavy metal concentrations, correcting for confounders like age and socio-economic status. RESULTS: Comprehensive data analysis will take place in the summer 2022. Our preliminary results already point to a striking discrepancy between the occupation of the fathers of children children with congenital anomalies and the fathers of the control group. The fathers of the birth defects are more often construction workers, working on houses often damaged or levelled by war. CONCLUSIONS: Having a child with a congenital anomaly in Iraq might be associated with paternal environmental exposure, possibly through epigenetic pathways. KEYWORDS: Congenital anomalies, Military pollution, Teratogenicity, Epigenetics, Exposome