Polycyclic aromatic hydrocarbon exposure in battlefield and beyond: Implications for environmental- and human health

Polycyclic aromatic hydrocarbons (PAHs) are combustion pollutants that are released into the environment through natural events and anthropogenic activities. Exposures to PAHs occur in military personnel during garrison (non-combat) and active deployment (combat) environments. Exposures that occur at low levels during deployment could lead to health issues, post-deployment. A scoping review was conducted to address the pathways of exposure, and the adverse effects caused by PAHs in active-duty personnel and veterans. Out of 50,171 scientific publications screened from 5 databases, 296 studies were identified that focused on the relationship between exposure to PAHs from various point sources and debilitating health issues reported in veterans. The findings revealed that in combat conditions, PAHs are released into the environment through explosions caused by bombing, artillery fire, and missile attacks on military installations, petrochemical industries, oil well fires set by saboteurs, and burn pits used to incinerate ammunition waste and military base refuse. Significant exposure of troops to PAHs occurred during active combat in the Operation Desert Shield, Operation Desert Storm, and Operation Enduring Freedom campaigns launched against hostile forces. The PAH releases contaminated not only the affected service personnel and staff, but also the surrounding environment. The coastal environment, including its flora and fauna, were affected by oil tanker fires, petroleum storage tanks that caught fire during conflict and subsequent release of PAHs into the marine environment. The human health effects resulting from PAH exposures included severe lung-, kidney-, and reproductive dysfunctions, as well as an increased risk of cancer, mostly manifested in Veterans as part of the Gulf War Syndrome. The Exposome approach utilizing the omics-based biomarkers to characterize individual service member profile with wearable monitors (wrist bands and sensors) to characterize the external environment when combined with biomonitoring studies holds significant promise for treatment of troops during combat and post deployment.