The Potential Effects of Burn Pit Exposure on the Respiratory Tract: A Systematic Review

Abstract

Introduction Burn pits (BPs) have been widely used by the U.S. military for waste disposal while in conflicts abroad. Significant adverse health effects are thought to be linked to BPs, but limited data exist examining the impact on the respiratory tract. The purpose of this systematic review is to characterize these effects on both the upper respiratory tract (URT) and lower respiratory tract (LRT). Materials and Methods A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines on articles published from January 1, 2001, through November 2020. PubMed, EMBASE, and Ovid MEDLINE databases were queried for studies examining the effect of BPs on the URT and LRT of service members. Results A total of 288 articles were identified, with nine meeting inclusion criteria. Eight of the nine articles assessed the LRT, one examined the URT alone, and two examined both the URT and LRT. Outcome measures were heterogeneous across all studies, precluding meta-analysis. Patient-reported LRT diagnoses appeared to increase as exposure to BPs increased. There are very limited data assessing the impact of BP exposure on the URT. No association between BP exposure and objective measures of LRT or URT disease was identified. Conclusion Service members deployed to combat zones seem to report a significant increase in respiratory diseases following exposure to BPs, although definitive conclusions are limited by multiple airborne exposures and varied reporting methods. Self-reported LRT diagnoses appear to be more prevalent. There is a paucity of data on the effects of BPs on the URT. Objective measures of disease do not appear to correlate with patient reports. Prospective, long-term, and outcome-based studies are necessary to examine the effects of BPs, and other airborne hazards related to deployment, on the URT and LRT of service members.

Hematological, cholesterolemic and clinical profile in exposed to outdoor air pollution linked to the incineration of biomedical waste in Benin

“…This limits the comparison of results with available data. However, airborne particles emitted during BMW incineration have also been found in other studies among air pollutants [15,[30][31][32].…”

“…In Algeria, respiratory diseases are very frequent among steel workers, especially in the most polluted units, as well as among the inhabitants of the housing estate surrounding the plant [23]. Similarly, in a meta-analysis, the diagnosis of upper respiratory disorders appeared to increase as the exposure of the subjects to waste combustion pits increased [15]. Other authors found that short-term air pollution from traffic or organic carbon led to an increase in respiratory infection symptoms and emergency room visits by children [24,25].…”

“…[10][11][12]. An exposure of low intensity and sustainable to dioxins and furans in human is responsible of a damage of the immune system and defects in the development of the nervous system, endocrine system and reproductive functions [13][14][15]. On the other side, these particles may disrupt the hormonal balance and therefore, lead to many health troubles, mainly development defects [16].…”

Chronic exposure to carbon black ultrafine particles reprograms macrophage metabolism and accelerates lung cancer

“…Exposure to ultrafine particles generated from incomplete combustion of organic matter (e.g., cigarette smoke, burn pit, forest fire, and other environmental pollutants) causes lung inflammation and emphysema ( 6 , 36 ). We show that nCB fosters early and more invasive lung cancer in mice, as summarized in Fig.…”

Burn Pit Exposure Is Associated With Increased Sinonasal Disease

“…A newly published systematic review has highlighted an association between burn pit exposure and subjective pulmonary symptoms but was unable to link exposure with objective pulmonary findings 13 . To date, most burn pit–related research has focused on pulmonary diseases, specifically asthma, bronchitis, and deployment-related distal lung disease 14–17 .…”