Long-term health complications of chemical weapon exposure: a study on Halabja chemical attack survivors (Iraqi Kurds)

Abstract

Objective

In 1988, the Iraqi government used a range of chemical weapons (CWs) against the Iraqi Kurds of Halabja. Here, we aim to investigate the long-term health consequences in exposed survivors as they are not sufficiently studied.

Materials and methods

This was a retrospective study conducted from November 2019 to May 2020 assessing the health status of all exposed Halabja chemical attack survivors compared to non-exposed people from the same area.

Results and discussion

Two hundred thirty survivors and 240 non-exposed participants were enrolled in this study, with control participants matched to age, gender, and occupation. Among the survivors, females were more prevalent. The respiratory system was the most common single exposure route (83, 36.1%), with 138 (60%) of the survivors being exposed by multiple routes. The vast majority (88.7%) of survivors had activities of daily living (ADL) impairment. There was female predominance in mild and moderate cases, with more males in severe cases (p < 0.01). Respiratory and cardiac diseases were significantly more common in the survivors compared to the controls (p < 0.001). Survivors with multiple CW exposure routes had significantly higher rates of ADL impairment (p < 0.001) and cardiac disease, respiratory diseases, and miscarriage (p < 0.01), than those with a single exposure route.

Conclusion

In this study comparing CW survivors with a local control population, a single, high-dose exposure to CWs was associated with significant increases in chronic respiratory and cardiac conditions, in addition to high rates of ADL impairment. Similar studies are needed in other, more recent CW survivor cohorts.

Keywords:

• Chemical weapon
• Halabja
• Iraqi Kurds
• health complications
• sulfur mustard

Acknowledgements

We thank the Organization of Victims of Halabja Chemical Bombardment (OVHCB) for providing valuable help and support throughout the study.

Ethical approval

The study was approved by the ethical committee of the technical college of Health Sciences at the University of Human Development.

Patient consent (participation and publication)

Written and verbal informed consent were acquired from the participants.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Any data related to this study will be provided upon request.