Occupational exposures and environmental health hazards of military personnel

Background: Military personnels are frequently exposed to environmental pollutants that can cause a variety of diseases. Methods: This review analyzed publications regarding epidemiological and biomonitoring studies on occupationally-exposed military personnels. Results: The exposures include sulfur mustard, organ chlorines, combustion products, fuel vapors, and ionizing and exciting radiations. Important factors to be considered are the lengths and intensities of exposures, its proximity to the sources of environmental pollutants, as well as confounding factors (cigarette smoke, diet, photo-type, healthy warrior effect, etc.). Assessment of environmental and individual exposures to pollutants is crucial, although often omitted, because soldiers have often been evaluated based on reported health problems rather than on excessive exposure to pollutants. Biomarkers of exposures and effects are tools to explore relationships between exposures and diseases in military personnels. Another observation from this review is a major problem from the lack of suitable control groups. Conclusions: This review indicates that only studies which analyzed epidemiological and molecular biomarkers in both exposed and control groups would provide evidence-based conclusions on exposure and disease risk in military personnels.