(Autism Centre in Diyala, Iraq. Photo: Yalla Iraq)

Autism Spectrum Disorder (ASD) has increased significantly worldwide but in the Middle East ASD amongst children is causing real concern. Although the exact causes behind this disorder are still unknown, a range of evidence shows links to levels of toxic pollution, particularly in utero exposure to hazardous environmental pollutants.

In Iraq, munitions used in the Gulf Wars caused a massive amount of environmental pollution, with radiological and carcinogenic effects on the health of the population. These impact negatively on the human brain and contribute to the deterioration of mental health, with the World Health Organisation and UNICEF publishing reports indicating increased rates of brain damage, neuropathy and mortality rates in Iraq.

Airborne chemical exposure contributes to mental disorders, especially in vulnerable people like children as inhaled pollutants might be delivered directly to the brain via the olfactory bulb. These pollutants are associated with ASD in children because they have neurotoxic or immunotoxic properties leading to immune system disturbances, causing damage to nervous systems. Many signs and symptoms of neuropathy appear during the growth and development of the child, such as blurred vision, memory disturbances, sleep disorders, slurred speech and anger. As a consequence, environmental pollution is considered a cause of deterioration in speech and language among children with ASD.

Environmental pollutants could also damage the developing foetus. Exposure to heavy metals during pregnancy can cause reduced foetal growth, low birth weight and adverse effects on the nervous system. Bellinger and Garza argue that exposure to environmental pollutants during pregnancy leads to congenital deformities and damages the developing central nervous system. As a consequence, environmental pollution has a profound effect on brain development in the foetus and adversely affects later neuropsychological development in childhood. Thus there is a relationship between environmental pollution, the foetal brain and the later incidence of autism spectrum disorder.

The presence of immense levels of environmental pollutants in Iraq is not surprising. According to Savabieasfahani, 200 military camps, 141 forward operating bases and 69 combat outposts have existed in Iraq since the 2003 invasion. A vast amount of military waste has been disposed of via open-air burn-pits. Savabieasfahani examined the risk factors associated with environmental pollution by measuring metal levels using the Inductively Coupled Plasma Mass Spectrometry instrument, finding large amounts of toxic metals such as titanium, depleted uranium and magnesium, due to their heavy use during the Iran-Iraq war and the two Gulf Wars. Thus, participants had been exposed to varying types of environmental pollution resulting from bombing or living near military bases.

Furthermore, the United Nations Environment Program estimated around 1000 to 2000 metric tons of depleted uranium were used during the 2003 U.S. invasion. Again, the most vulnerable – pregnant women, foetuses and children – are severely affected by this pollution. Research by Dr. Souad Al-Azzawi and others points to a legacy of suffering, congenital malformations, high mortality and cancer rates that have not been fully acknowledged.

Blaurock-Busch examined specific environmental risk factors for the development of ASD. The study of exposure to heavy metals in the environment noted that arsenic concentrations were significantly higher in water. Cadmium concentrations were very high in food, while lead levels were also significantly higher among participants in hair and urine. This research found that hair mineral levels indicated long-term environmental exposure and urine analysis indicated recent exposure. Thus the degree of pollutants in the surrounding air, water and land had negative effects on human health.

Clearly, environmental pollution in the Middle East needs to be reduced quickly and efficiently. It is vital to increase the evidence base and to develop an appropriate public health response to this issue.

Special thanks to Fran Sutherland for editing the piece.