MJBU, VOL 17, No. 1&2, 1999

 

 

DEPLETED URANIUM AND HEALTH OF PEOPLE IN BASRAH: AN EPIDEMIOLOGICAL EVIDENCE.

 

A.     INCIDENCE AND PATTERN OF MALIGNANT DISEASES AMONG CHILDREN IN BASRAH WITH SPECIFIC REFERENCE TO LEUKAMIAS DURING THE PERIOD 1990-1998.

 

Alim A-H Yacoub, Imad Al-Sadoon, Genan G. Hassan & Muffid Al-Hemadi.

 

Alim A-H Yacoub, Imad Al-Sadoon, Genan G. Hassan & Muffid Al-Hemadi, College of Medicine, University of Basrah.

 

ABSTRACT

 

Analysis of recorded cases of malignant disease among children below 15 years of age in Basrah during the period extending from 1990 to 1997 was carried out. There is 60 % rise in the recorded cases of leukaemia among children below 15 years of age in 1997 compared to 1990 (24 in 1997 compared to 15 in 1990). The corresponding rise in all malignant cases for the same period for the same age group is about 120% (42 compared to 19). Brain tumours and lymphomas have also shown significant rise. These malignancies are well known to be causally related to exposure to ionizing radiation. The overall incidence rate of malignant cases among the same group ranged from 18.8 per 100,000 in shat-Al-Arab to 71.8 per 100,000 in Al-Hartha.. The highest figures were reported in Al-Hartha and Qurna 41.9 per 100,00. The overall incidence rate in Basrah in 1997 was7.22 per 100,000 compared to only 3.98 per 100,000 in 1990. There is a significant shift in the age distribution of lukaemia cases towards younger age group. In 1990 only 13% of cases among those below five years of age, compared to 41% of cases in 1997. Such a shift is highly suggestive of exposure to radiation. No significant shift in sex ratio of malignancies among such cases.

 

 

INTRODUCTION

 

In 1991 the American troops and their allies in their aggression against Iraq used weapons containing depleted uranium (U-238). This has been confirmed by detecting high radioactivity using Gamma spectrometric analysis of plant, water and soil samples taken from Basrah governorate, southern Iraq[1,2].

 

Papers published from the west did not deny this fact[3]. The relationship between exposure to ionising radiation and cacer has been documented in various studies in other parts of the world a part from the survivors of the atomic bombs in Hiroshima and Nagazaki such relationship have been proved among uranium miners[4], the employees of the Nuclear reactors in England and Canada[5,6] and those living in close proximity to Chernobyl

 

In the light of the above evidence the present study was carried out to test the hypothesis that their must be a rising incidence of cancer cases among Basrah population following 1991 military aggression. This paper reports the incidence and pattern of malignancies among children below 15 years of age in this governorate for the period from 1991 to 1997. In a separate paper the results among adults are  reported.

 

PATIENTS AND METHODS

 

All malignant cases among children below 15 years of age registered in the main Maternity and children Hospital in Basrah during the period from 1990 to 1997 were recorded. It is worth mentioning that this hospital serves as the referral hospital in the governorate for the management of such cases. Cases which were registered up to September 1998 were also analysed. Information as various clinical and demographic characteristics of such cases were collected by (JG). The incidence rate for each year was calculated by relating the number of registered cases to the estimated number of children below 15 years of age in Basrah for that year, while the incidence rate for a given geographical district was calculated by relating the number of cases registered in that district for a specific period to the estimated number of children below 15 years of age in that district. Census data were obtained from the Department of statistical section in Basrah Directorate of Health Services. Data for years 1991 and 1992 were not included because of their incompleteness. 

 

RESULTS

 

Table 1 and 2 show the numbers and types of registered malignant cases among children below 15 years of age in 1990 and for the period from 1993 up to December 1998. It can be seen that a remarkable rise in the incidence of cases was noticed from 1995 onwards. In 1997, 42 cases were registered compared to 19 in 1990  (a percentage rise of 120%). The corresponding increase for leukaemic cases was 60% (24 in 1997 vs. 15 in 1990). In spite of the small number of other tumours, a slight increase is recorded for lymphomas and brain tumours. Five cases of neuroblastomas were recorded in 1997 and 1998 while no such cancer was recorded in the preceding period.

 

The distribution of malignant diseases among children according to sex is shown in table 3. The preponderance of cases among males as compared to females is consistent for all types of cancers.

 

Table 4. Shows the incidence rate of malignant disease among children in various districts of Basrah for the period from 1993 to 1998. The highest incidence rates were recorded in Al-Hartha just north to Basrah City and in Al-Qurna district northern region of the Governorate (71.8 and 41.9 per 100,000 children respectively).

 

The annual incidence rates of malignant diseases among children in Basrah for the study period is shown in table 5. Consistent with table 1, a noticeable increase in such rate is recorded from 1995 onwards. The incidence rate in 1997 was 7.22 per 100,000 in 1990. The slightly lower figure in 1998 is because the cases registered up to September.

 

Table 6. shows the age distribution of leukaemic cases for each year of the study period. While in 1990 only 13% of cases were below five years of age (2 out of 15) in 1997 40% of such cases were in this age group (10 out of 24).

 

 

  Table 1. Incidence of malignant disease among children in Basrah

                for the period 1993-1998.

 

 

     Table 2. Distribution of malignant disease among children in

                   Basrah  in 1990.

 

 

 

Table 3.  Distribution  of  malignant  diseases   among children

               according to sex.

 

 

 

 

Table 4. Geographical distribution of prevalence of malignant diseases

               among  children 1993-1998.

 

 

 

 

 

 

 

 Table 5. Incidence rate of malignant diseases among children in

               Basrah from 1993-1998 compared to 1990.

 

 

 

 

Table 6. The distribution of leukaemia patients according to age.

 

 

 

 

 

 

 

DISCUSSION

 

The establishment of causal relationship between cancer among humans and certain risk factors is mostly based on epidemiological studies.

 

The findings presented in this study supports our hypothesis that increased incidence of malignant diseases among children in Basrah could be attributed to exposure to depleted uranium following the allies aggression on Iraq in 1991. It was shown that such increase is quite noticeable from 1995 onwards i.e. after a period of around four years which could be considered a sort of the incubation period. The changing age structure of such cases with a shift towards the younger age group further supports our hypothesis. In fact the pattern described is consistent with a “common source outbreak” which is in this case exposure to ionising radiation. It is most probable that carcinogenesis among children in Basrah is due to direct exposure to radiation rather than due to exposure of their parents to such radiation. Studies among offspring of parents working in nuclear reactors in Canada and in England did not support the hypothesis that their exist an association between childhood leukaemia and occupational exposure to ionising radiation[5,6]. The mechanism by which depleted uranium causes cancer is possibly through inducing chromosomal aberration[4], and by damaging cellular macromolecules including DNA.

 

Of course, other environmental factors and genetic predisposition can not be ruled out in initiation, promotion and progression of tumors but the evidence presented by our data point out clearly to the role of exposure to depleted uranium in developing cancer among children in Basrah.

 

 

 

 

REFERENCES

 

1.      Saleh M & Meqwar A. The effects of using depleted uranium by the allied forces on man and the biosphere in selected region of southern area of Iraq. A paper presented in the International symposium on using depleted uranium, Baghdad, 1998.

 

2. بهاء الدين معروف التلوث بالراديوم 226 الناجم عن استخدام القذائف الحاوية على اليورانيوم المنضب في المنطقة الجنوبية من العراق . بحث القي في الندوة العلمية الدولية حول استخدام الاسلحة المحرمة (اليورانيوم المنضب) واثره على البيئة والانسان في العراق –بغداد 1998.

 

3.      Haley R, Khrt T. and Hom.J. A series of papers published in Journal of American Medical Association 1997: 215-253.

4.      Taylor DM, Taylor SK. Environmental uranium and human health. Review of Environmental Health 1997; 12:147-157.

5.      McLaughlin JR., King WD, Anderson TW et al. Paternal radiation exposure and leukaemia in offspring. British Medical Journal 1993; 307: 959-966.

6.      McLaughlin JR., Clarke EA, Nishri ED and Anderson TW. Childhood leukaemia in the vicinity of Canadian nuclear facilities. Cancer-causes-control 1993; 4:51-58.

7.      Lyman GH. Risk factor for cancer. Primary Care 1992; 19:465-479.