Huge rise in birth defects in Falluja

From the Guardian:

Iraqi former battle zone sees abnormal clusters of infant tumours and deformities

Doctors in Iraq's war-ravaged enclave of Falluja are dealing with up to 15 times as many chronic deformities in infants and a spike in early life cancers that may be linked to toxic materials left over from the fighting.

The extraordinary rise in birth defects has crystallised over recent months as specialists working in Falluja's over-stretched health system have started compiling detailed clinical records of all babies born.

Neurologists and obstetricians in the city interviewed by the Guardian say the rise in birth defects – which include a baby born with two heads, babies with multiple tumours, and others with nervous system problems - are unprecedented and at present unexplainable.

A group of Iraqi and British officials, including the former Iraqi minister for women's affairs, Dr Nawal Majeed a-Sammarai, and the British doctors David Halpin and Chris Burns-Cox, have petitioned the UN general assembly to ask that an independent committee fully investigate the defects and help clean up toxic materials left over decades of war – including the six years since Saddam Hussein was ousted.

"We are seeing a very significant increase in central nervous system anomalies," said Falluja general hospital's director and senior specialist, Dr Ayman Qais. "Before 2003 [the start of the war] I was seeing sporadic numbers of deformities in babies. Now the frequency of deformities has increased dramatically."

The rise in frequency is stark – from two admissions a fortnight a year ago to two a day now. "Most are in the head and spinal cord, but there are also many deficiencies in lower limbs," he said. "There is also a very marked increase in the number of cases of less than two years [old] with brain tumours. This is now a focus area of multiple tumours."

After several years of speculation and anecdotal evidence, a picture of a highly disturbing phenomenon in one of Iraq's most battered areas has now taken shape. Previously all miscarried babies, including those with birth defects or infants who were not given ongoing care, were not listed as abnormal cases.

The Guardian asked a paediatrician, Samira Abdul Ghani, to keep precise records over a three-week period. Her records reveal that 37 babies with anomalies, many of them neural tube defects, were born during that period at Falluja general hospital alone.

Dr Bassam Allah, the head of the hospital's children's ward, this week urged international experts to take soil samples across Falluja and for scientists to mount an investigation into the causes of so many ailments, most of which he said had been "acquired" by mothers before or during pregnancy.

Other health officials are also starting to focus on possible reasons, chief among them potential chemical or radiation poisonings. Abnormal clusters of infant tumours have also been repeatedly cited in Basra and Najaf – areas that have in the past also been intense battle zones where modern munitions have been heavily used...

The anomalies are evident all through Falluja's newly opened general hospital and in centres for disabled people across the city. On 2 November alone, there were four cases of neuro-tube defects in the neo-natal ward and several more were in the intensive care ward and an outpatient clinic.

Falluja was the scene of the only two setpiece battles that followed the US-led invasion. Twice in 2004, US marines and infantry units were engaged in heavy fighting with Sunni militia groups who had aligned with former Ba'athists and Iraqi army elements.

The first battle was fought to find those responsible for the deaths of four Blackwater private security contractors working for the US. The city was bombarded heavily by American artillery and fighter jets. Controversial weaponry was used, including white phosphorus, which the US government admitted deploying.

Statistics on infant tumours are not considered as reliable as new data about nervous system anomalies, which are usually evident immediately after birth. Dr Abdul Wahid Salah, a neurosurgeon, said: "With neuro-tube defects, their heads are often larger than normal, they can have deficiencies in hearts and eyes and their lower limbs are often listless. There has been no orderly registration here in the period after the war and we have suffered from that. But [in relation to the rise in tumours] I can say with certainty that we have noticed a sharp rise in malignancy of the blood and this is not a congenital anomaly – it is an acquired disease."

Despite fully funding the construction of the new hospital, a well-equipped facility that opened in August, Iraq's health ministry remains largely disfunctional and unable to co-ordinate a response to the city's pressing needs.

The government's lack of capacity has led Falluja officials, who have historically been wary of foreign intervention, to ask for help from the international community. "Even in the scientific field, there has been a reluctance to reach out to the exterior countries," said Dr Salah. "But we have passed that point now. I am doing multiple surgeries every day. I have one assistant and I am obliged to do everything myself."

"It’s Time to Learn From Frogs"

By NICHOLAS D. KRISTOF - the New York Times

Some of the first eerie signs of a potential health catastrophe came as bizarre deformities in water animals, often in their sexual organs.

Frogs, salamanders and other amphibians began to sprout extra legs. In heavily polluted Lake Apopka, one of the largest lakes in Florida, male alligators developed stunted genitals.

In the Potomac watershed near Washington, male smallmouth bass have rapidly transformed into “intersex fish” that display female characteristics. This was discovered only in 2003, but the latest survey found that more than 80 percent of the male smallmouth bass in the Potomac are producing eggs.

Now scientists are connecting the dots with evidence of increasing abnormalities among humans, particularly large increases in numbers of genital deformities among newborn boys. For example, up to 7 percent of boys are now born with undescended testicles, although this often self-corrects over time. And up to 1 percent of boys in the United States are now born with hypospadias, in which the urethra exits the penis improperly, such as at the base rather than the tip.

Apprehension is growing among many scientists that the cause of all this may be a class of chemicals called endocrine disruptors. They are very widely used in agriculture, industry and consumer products. Some also enter the water supply when estrogens in human urine — compounded when a woman is on the pill — pass through sewage systems and then through water treatment plants.

These endocrine disruptors have complex effects on the human body, particularly during fetal development of males.

“A lot of these compounds act as weak estrogen, so that’s why developing males — whether smallmouth bass or humans — tend to be more sensitive,” said Robert Lawrence, a professor of environmental health sciences at the Johns Hopkins Bloomberg School of Public Health. “It’s scary, very scary.”

The scientific case is still far from proven, as chemical companies emphasize, and the uncertainties for humans are vast. But there is accumulating evidence that male sperm count is dropping and that genital abnormalities in newborn boys are increasing. Some studies show correlations between these abnormalities and mothers who have greater exposure to these chemicals during pregnancy, through everything from hair spray to the water they drink.

Endocrine disruptors also affect females. It is now well established that DES, a synthetic estrogen given to many pregnant women from the 1930s to the 1970s to prevent miscarriages, caused abnormalities in the children. They seemed fine at birth, but girls born to those women have been more likely to develop misshaped sexual organs and cancer.

...
Among some scientists, there is real apprehension at the new findings — nothing is more terrifying than reading The Journal of Pediatric Urology — but there hasn’t been much public notice or government action.

This month, the Endocrine Society, an organization of scientists specializing in this field, issued a landmark 50-page statement. It should be a wake-up call.

“We present the evidence that endocrine disruptors have effects on male and female reproduction, breast development and cancer, prostate cancer, neuroendocrinology, thyroid, metabolism and obesity, and cardiovascular endocrinology,” the society declared.

“The rise in the incidence in obesity,” it added, “matches the rise in the use and distribution of industrial chemicals that may be playing a role in generation of obesity.”

The Environmental Protection Agency is moving toward screening endocrine disrupting chemicals, but at a glacial pace. For now, these chemicals continue to be widely used in agricultural pesticides and industrial compounds. Everybody is exposed...

"China birth defects 'up sharply'"

From the BBC:

A senior family planning official in China has noted an alarming rise in the number of babies with birth defects, a Chinese media report says.

Jiang Fan, from China's National Population and Family Planning Commission, said environmental pollution was a cause of the increase.

The coal-mining heartland of Shanxi province had the biggest problem.

China has reported the trend before, and it was not clear if Mr Jiang was commenting on new or old statistics.

A 2007 commission report said the rate of defects had risen 40% since 2001, from 104.9 per 10,000 births to 145.5 in 2006.

Officials blame emissions from Shanxi's large coal and chemical industry for the problems there.

"The problem of birth defects is related to environmental pollution, especially in eight main coal zones," said An Huanxiao, the director of Shanxi provincial family planning agency.

Mr Jiang said a child was born with physical defects every 30 seconds because of the degrading environment.