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BackgroundThe US military first deployed depleted uranium (DU) weapons in Iraq during the Gulf War in 1990 and in the 2003 invasion of Iraq. Research into the health impacts of DU has been mired in debate and controversy. Research funded by the US government has denied the health risks posed by DU to the Iraqi population, while opponents have claimed that DU is responsible for increased rates of birth defects and cancers in Iraq. Others assert that the public health impacts of DU weapons remain uncertain. This systematic review identified, appraised and synthesised all human observational studies assessing adverse health outcomes associated with DU exposure among the Iraqi population. To our knowledge, no systematic review has been conducted on the topic previously.MethodsWe searched 11 electronic databases for human observational studies published between 1990 and 2020 that measured association between exposure to weaponised uranium and health outcomes (including cancer, birth defects, immune system function and mortality) among the Iraqi population. We assessed risk of bias using the Navigation Guide’s risk of bias tool and rated certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluations approach (PROSPERO: CRD42018108225).ResultsOur searches identified 2601 records, of which 28 met our inclusion criteria. We identified five additional eligible reports from other sources. Two articles reported the results of multiple relevant studies; our final set included 33 articles reporting on 36 eligible studies. Most studies (n=30, 83%) reported a positive association between uranium exposure and adverse health outcomes. However, we found that the reviewed body of evidence suffers from a high risk of bias.ConclusionThe available evidence suggests possible associations between exposure to depleted uranium and adverse health outcomes among the Iraqi population. More primary research and the release of missing data are needed to design meaningful health and policy interventions in Iraq.
BackgroundThe US military first deployed depleted uranium (DU) weapons in Iraq during the Gulf War in 1990 and in the 2003 invasion of Iraq. Research into the health impacts of DU has been mired in debate and controversy. Research funded by the US government has denied the health risks posed by DU to the Iraqi population, while opponents have claimed that DU is responsible for increased rates of birth defects and cancers in Iraq. Others assert that the public health impacts of DU weapons remain uncertain. This systematic review identified, appraised and synthesised all human observational studies assessing adverse health outcomes associated with DU exposure among the Iraqi population. To our knowledge, no systematic review has been conducted on the topic previously.MethodsWe searched 11 electronic databases for human observational studies published between 1990 and 2020 that measured association between exposure to weaponised uranium and health outcomes (including cancer, birth defects, immune system function and mortality) among the Iraqi population. We assessed risk of bias using the Navigation Guide’s risk of bias tool and rated certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluations approach (PROSPERO: CRD42018108225).ResultsOur searches identified 2601 records, of which 28 met our inclusion criteria. We identified five additional eligible reports from other sources. Two articles reported the results of multiple relevant studies; our final set included 33 articles reporting on 36 eligible studies. Most studies (n=30, 83%) reported a positive association between uranium exposure and adverse health outcomes. However, we found that the reviewed body of evidence suffers from a high risk of bias.ConclusionThe available evidence suggests possible associations between exposure to depleted uranium and adverse health outcomes among the Iraqi population. More primary research and the release of missing data are needed to design meaningful health and policy interventions in Iraq.
This study aimed at determining the burden of cancer as a cause of death in Basrah over three selected years; namely 1989, 1997 and 2005. All death registries in Basrah city, Districts and sub districts were used as sources of information for data compiling. Every death recorded in the three years was checked for cause of death and all cases for which any type of cancer written as the cause of death were identified. Data related to age, sex, place of residence, type of cancer, place where death was certified and year of death were obtained. In addition, the numbers of total deaths due to all causes in each year were also recorded. The results indicate a total of 297 deaths in 1989, 499 deaths in 1997 and 649 deaths in 2005 could be attributed to cancer. Regarding sex distribution of deaths, slightly more deaths occurred in males (53.8%) than in females (46.2%) with significant rise of cancer in females in 2005. Cancer as a cause of death represents about 5% of all deaths with some degree of increase in 1997 and 2005 as compared to 1989, but no major change in the cancer specific death rates among different years. Geographically, the distribution shows significant but not substantial variation with years. The mean age of dead persons was similar in the three years. The leading cancer deaths were those of lung, urinary bladder, blood, breast, lymphomas and CNS. The overall risk of death is not much different in different years except for a slight increase in 1997 and 2005 in comparison to 1989. Most cancers show stable or slightly fluctuating level of risk of death with time. Slight rise in the risk of death may be noticed in cancers of CNS, blood (leukemia), Bones, lymphomas and Colon-rectum. The researchers suggest that the stable level of mortality could reflect some improvement in treatment based on early diagnosis of many cancers. A study covering at least ten years is highly recommended to establish more sound time trend in cancer mortality.
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