The report recommends the creation of a health monitoring and research program on the Gulf War and post-9 September veterans

To help determine if the descendants of Gulf War veterans and veterans after September 11 are exposed to health risks resulting from the exposure of toxic service members during their deployment, a New report from the National Academies of Science, Engineering and Medicine recommends creating a Health Monitoring and Research Program (HMRP). The committee that conducted the study and drafted the report assessed the available evidence regarding the reproductive, developmental and generational health effects associated with the exposures that may have occurred during the Gulf War and the conflicts that occurred during the Gulf War. following the attacks of 11 September. There is more and more evidence in humans and animals about the reproductive and developmental effects of many toxins, but there is little information on the specific effects of the disease. Veterans exhibit on their children, grandchildren and great-grandchildren.

Nearly 700,000 American soldiers were deployed in the Persian Gulf region at the height of Operation Desert Shield and Operation Desert Storm in 1990-91. The US military has engaged in new conflicts in the Middle East following the terrorist attacks of September 11, 2001, with troops stationed in and around Afghanistan, as well as in Iraq. In any war, deployed service members may be exposed to agents and potentially dangerous situations – some intentionally or unknowingly, according to the report. These may include chemicals used in everyday civil life, such as pesticides and solvents, as well as chemical and biological agents, mandatory vaccines, smoke from burning pits and oil well fires, dust, high ambient temperatures and thermal stress, so uranium.

As there was little or no information on the specific effects of many toxic substances on veterans, the committee relied on studies of occupational or residential cohorts, who were exposed to certain of the same toxic substances as Gulf war veterans and post-9/11. . The committee was not able to determine the degree of relevance of the exposures in these studies with veterans compared to those of deployed veterans in terms of magnitude, duration, frequency, mixes and co-exhibitions. The ability to generalize the associations found in such studies to veterans is also limited by differences in the characteristics of the population such as gender, age, ethnicity and way of life. Therefore, such exposures should be specifically studied among active duty members and veterans to confirm that the associations are valid for these populations.

The committee has come up with more than 50 findings in five categories of association between exposure to deployment and reproductive effects, adverse pregnancy outcomes, or developmental effects. No toxic substance showed sufficient evidence of a causal relationship between exposure and reproductive or developmental effects, and no toxic substance exhibited limited / suggestive evidence of lack of linkage between exposure and effects on reproduction or development. Among the findings, the committee found sufficient evidence of a link between prenatal exposure to organophosphate pesticides and effects on neurodevelopment; prenatal exposure to particles and adverse consequences of pregnancy, such as low birth weight and preterm birth; and prenatal exposure to benzene and childhood leukemia. In addition, the committee found limited / evidenced evidence of an association between sulfur mustard and reproductive effects in men, between prenatal exposure to particulate matter and hypertensive disorders induced by pregnancy and the effects on the development of the respiratory system and neural development.

The HMRP would be a collaboration between several governmental and non-governmental organizations. The report outlines a recommended framework for the development of a HMRP, including the following priorities, which will be critical for the implementation of a useful HMRP:

• The collection, storage and maintenance of complete basic and longitudinal data as well as biological samples of veterans, their partners and their descendants;
• Detailed characterization and evaluation of exposure during and after deployment; and
• Development, evaluation, standardization and interoperability of biomarkers of exposure, susceptibility and biological effects.

"Meeting the priorities outlined in this report will require substantial resources, a long-term commitment from the Departments of Defense and Veterans Affairs and other government organizations, as well as a significant commitment from past, current veterans. and future and their families, "said Committee Chair Kenneth S. Ramos, Associate Vice President of Precision Health Sciences, Professor of Medicine and Executive Director of the Center for Applied Genetics and Genomic Medicine at the University of Ottawa. 39, University of Arizona. "However, results from the generational effects study will ultimately be rewarded with new insights into veterans' exposures, reproductive health, and the health of their children and grandchildren." It is important to note that new understanding arising from these investments will be relevant to the health of all Americans now and for future generations. "

Many considerations need to be taken into account to implement a large-scale HMRP, such as the costs in human and financial resources, the availability and expertise of properly trained staff, the time required for Project completion, quick access to well-organized data, maintenance. confidential data on human health, ethical considerations for investigations involving parents and children, and the implementation of appropriate health and risk communication strategies between and among organizations, veterans and their families. From these considerations, a hands-on approach to exploring the effects of generations on health should benefit from veterans' health research programs, such as the Million Veteran Program and the Millennium Cohort Study, the report says.

The cost of designing and setting up a PSSR for any cohort of veterans will be considerable, as evidenced by the cost of similar programs such as the National Child Health Study. National Institutes of Health and the All of Us research program, the report says. However, the costs of some of the underlying technologies – for example, whole genome sequencing – have dropped dramatically and the health monitoring program's research results could result in considerable cost savings for the country.

The study was sponsored by the US Department of Veterans Affairs. The National Academies of Science, Engineering and Medicine are private non-profit institutions that provide the nation with independent and objective analyzes and analyzes to solve complex problems and inform public policy decisions related to science, technology and medicine. They are governed by a charter of the 1863 Congress of the National Academy of Sciences, signed by President Lincoln.