The people of the Iraqi city of Fallujah are facing grave health problems as a result of a devastating 2004 assault by the US military, a new study claims.

According to Cancer, Infant Mortality and Birth Sex-Ratio in Fallujah, Iraq 2005–2009, Fallujah's citizens have suffered greater increases in cancer, leukemia and infant mortality than survivors of the atom bomb attack on Hiroshima.

A survey of 711 households in January and February of 2010, showed a fourfold increase in cancer since the US assault. And the types of cancer seen resemble those found in Hiroshima survivors. Rates of leukemia are 38 times higher, and rates of breast cancer 10 times higher, than in Egypt and Jordan.

The researchers also found a 12-fold increase in childhood cancer. Infant mortality is 80 per 1000 births compared with 19 in Egypt, 17 in Jordan and 9.7 in Kuwait.

One of the most striking findings was that in Fallujah, only 860 boys are born for every 1000 girls. The normal birth sex ratio is 1050 boys for every 1000 girls. Similar changes in the birth sex ratio were seen in Hiroshima. The birth sex ratio is a well-known indicator of genetic mutations. Genetic damage causes the proportion of boys born to fall because girls have two X-chromosomes and can afford to lose one.

"This is an extraordinary and alarming result" said Dr Chris Busby, visiting Professor at the University of Ulster, and one of the authors of the report.

One possible cause of genetic mutations is the use of depleted uranium weapons. US forces use shells tipped with depleted uranium to enhance their armor-piercing capability. When the shells hit their targets, tiny particles of uranium are dispersed in the area.

"To produce an effect like this, some very major mutagenic exposure must have occurred in 2004 when the attacks happened. We need urgently to find out what the agent was. Although many suspect uranium, we cannot be certain without further research and independent analysis of samples from the area," Professor Busby said.

Fallujah's troubles began in April 2003 when US troops shot dead 17 civilians who were protesting the conversion of a school into a military base. In March 2004 four military contractors from controversial security company Blackwater were lynched. A revenge attack by the US military in May 2004 failed, but in November 2004, US forces devastated the city, causing heavy casualties. The Americans were widely criticized for excessive use of force and for using white phosphorus weapons. The new study confirms earlier reports of increases in cancer, birth defects and infant mortality in Fallujah. In 2009, a group of British and Iraqi doctors wrote to the United Nations asking for an inquiry. In March 2010 the BBC's John Simpson reported seeing several paralyzed and deformed children, but said local people were "scared to speak" about the issue.

Malak Hamdan, one of the report's authors said: "We have been able to obtain proper scientific confirmation of all the anecdotal evidence of cancer and congenital birth defects. Maybe now the international community will wake up".

Cancer, Infant Mortality and Birth Sex-Ratio in Fallujah, Iraq 2005–2009, was published by the International Journal of Environmental Research and Public Health on July 6, 2010. To download a copy of the report click here.

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