PATERNAL EXPOSURES DURING THE FIRST GULF WAR

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(Date of issue: November 2016, Version: 1.1)

This is a UKTIS monograph for use by health care professionals. For case-specific advice please contact UKTIS on 0344 892 0909. To report an exposure please download and complete a pregnancy reporting form. Please encourage all women to complete an online reporting form.

Summary

There has been concern that male military personnel are at increased risk of adverse reproductive outcomes as a result of exposure to multiple compounds whilst serving in the first Persian Gulf War (1991).

Known exposures potentially encountered during the first Gulf War include: organophosphate pesticides, nerve agents such as sarin and cyclosarin, nerve agent antidotes such as pyridostigmine, pralidoxime and atropine, depleted uranium, vaccinations against biological agents such as anthrax and botulinum toxin, in addition to smoke from oil well fires.  However, not all deployed Gulf War veterans would have been exposed to each of the agents listed above and other unrecognised exposures may also have occurred.  This is one of the major limitations that should be taken into account when considering findings of studies which compare reproductive outcomes of deployed vs. non-deployed veterans.

The majority of the available data do not support an association between military deployment in the first Gulf War and an overall increased risk of congenital malformation in offspring.  Increased rates of specific malformations (including cardiac, urinary, musculoskeletal and genital) have been reported in the offspring of male Gulf War veterans in some but not other studies. 

Studies which investigated fertility of veterans have relied heavily on self-reporting of problems, with many failing to reach a definitive conclusion.  Data regarding risk of miscarriage are also conflicting.

Only one study was identified that investigated the risk of cancer in the offspring of male Gulf War veterans, with no association found.

Paternal exposure to drugs and/or chemicals is generally considered unlikely to   increase the risk of congenital malformation in the offspring, unless the exposure is a mutagen and therefore has the potential to induce a genetic change in the sperm. 

This document is regularly reviewed and updated. Only use full UKTIS monographs downloaded directly from TOXBASE.org to be sure you are using the most up-to-date version. The summaries of these monographs are openly available on UKTIS.org.

This is a summary of the full UKTIS monograph for health care professionals and should not be used in isolation. The full UKTIS monograph and access to any hyperlinked related documents is available to health care professionals at www.toxbase.org.

If you have a patient with exposure to a drug or chemical and require assistance in making a patient-specific risk assessment, please telephone UKTIS on 0344 892 0909 to discuss the case with a teratology specialist.

If you would like to report a pregnancy to UKTIS please click here to download our pregnancy reporting form. Please encourage all women to complete an online reporting form.

Disclaimer: Every effort has been made to ensure that this monograph was accurate and up-to-date at the time of writing, however it cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes of the measures recommended. The final decision regarding which treatment is used for an individual patient remains the clinical responsibility of the prescriber. This material may be freely reproduced for education and not for profit purposes within the UK National Health Service, however no linking to this website or reproduction by or for commercial organisations is permitted without the express written permission of this service. This document is regularly reviewed and updated. Only use UKTIS monographs downloaded directly from TOXBASE.org or UKTIS.org to ensure you are using the most up-to-date version.