Medical Monday: Setting the Record Straight on Sand

By:  Capt. Patrick Laraby, MD, MPH, MS, MBA, FACOEM

U.S. Navy Hospital Corpsman 3rd Class Nicolas Grey, with Combined Anti-Armor Team 2, pauses during a security halt during a patrol in the Nawa district of Helmand province, Afghanistan. (U.S Marine Corps photo by Lance Cpl. James Purschwitz/Released)

The Navy and Army Medical Departments have spent substantial time and resources researching the possibility that sand in the Middle East (specifically Iraq and Afghanistan) is harmful and to date have found no definitive basis to indicate that it is despite the claims by some military members outside the research community. (Could dust be the cause of war vets’ ailments?, USA Today, May 11, 2011).

The Defense Department routinely monitors the incidence of illnesses reported among its personnel, both those who have deployed to Iraq and Afghanistan and those who have not.  Neither the Armed Forces Health Surveillance Center nor the Naval Health Research Center, have identified any unexplained or unusual illnesses that can be linked to theories discussed in the article.

The military medical community takes our role in safeguarding the health and welfare of our deployed men and women very seriously and we actively work to identify and overcome any threat to their health and our military’s readiness.   As such, we have aggressively examined the concerns that Capt Mark Lyles,  and other have voiced regarding the blowing sand and dust and to date, his assumptions have not been supported by scientific research.

We have been aware of the Lyles’ theories since 2004 about the presence of bacteria, fungus, and metals in the soil and dust samples in the Middle East and these findings were not totally unexpected as these substances are naturally occurring in sand and soil around the world.  In a letter to the editor of USA Today last Friday, Army Colonel Lisa Zacher, a respected Pulmonary Medicine Physician and Consultant said:

“The United States Army Public Health Command has been conducting surveillance of increased airborne particulate matter since 2005 and concluded it had a similar composition to other desert regions.  Additional published peer-reviewed research by Army infectious disease experts have failed to demonstrate a connection between bacteria in the soil and infections in service members.”

During 2005 and 2006, the Army sampled the dust at 15 different locations in theater over the course of a year. In general, dust samples from these Middle East sites were found to be similar to dust and rocks from other desert regions of the world.  Most dusts contain mixtures of silicate minerals, carbonates, oxides, sulfates, and salts in various proportions, as reflected by their chemistry and mineralogy.  Differences among regions lie in the relative proportions of these minerals in soils.  This extensive data set was provided to the National Research Council (NRC) for them to assess whether the data indicated a health risk to our personnel.  After an exhaustive review, the NRC was unable to identify any health risks and indicated that they would need more data to determine whether there were any risks.

Based on several published studies, we have found some indications that there may be a slight increase in respiratory symptoms among those who have deployed  —  one study (Szema et. al, 2010)  indicated an incidence of asthma of 6.6% among deployers compared to 4.3% in non deployers.  Another study (Smith, et al 2009) indicated a 14% incidence of new onset asthma in deployers compared to 10% in those who did not deploy.  We are actively exploring causes for this and some current contributing factors including  increased use of tobacco products by service members during deployment, the fine particulates in the air and the dryer relative humidity in the Middle East.   What we are not seeing is any increased incidence of neurological conditions, cancer, depression, and heart disease that can in anyway be linked with the unsupported theories of Lyles.

While the USA Today article attempts to form a “cause and effect” relationship, there is no evidence on which to base such a relationship.  It is unfortunate that this article may inflict unnecessary stress on our already overworked service members and their families.  Force Health Protection is a top priority for all our brave men and women and this undoubtedly includes exposure to dust in war zones.

Despite the lack of scientific evidence supporting many of these claims, our research teams will continue their work until a full picture is understood in order to continue offering the best care for our deployed forces as protecting our men and women in uniform is our highest priority.

Captain Patrick Laraby is the Director of Occupational & Environmental Medicine Policy & Practice for the U.S. Navy Bureau of Medicine & Surgery in Washington DC.

 

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