Biologic monitoring and surveillance results for the department of veterans affairs' depleted uranium cohort: Lessons learned from sustained exposure over two decades

Abstract

Now more than 20 years since first exposure to DU, an aging cohort of military veterans continues to show no U-related health effects in known target organs of U toxicity. As tissue concentrations continue to accrue with exposure duration, critical tissue-specific U concentration thresholds may be reached, thus recommending on-going surveillance of this veteran cohort.

Longitudinal study of t‐cell somatic mutations conferring glycosylphosphatidylinositol‐anchor deficiency in gulf war I veterans exposed to depleted uranium

“…The mutagenicity studies have been repeated on several occasions over these years. In all genotoxicity studies, the results have been negative, thus providing some degree of comfort to the individuals exposed (McDiarmid et al, 2001;McDiarmid et al, 2004;McDiarmid et al, 2006;McDiarmid et al, 2007;McDiarmid et al, 2009;Bakhmutsky et al, 2011;McDiarmid et al, 2011;Squibb et al, 2012;Bakhmutsky et al, 2013;Albertini et al, 2015;McDiarmid et al, 2015;McDiarmid et al, 2017). background data on the Veterans.…”

Impulse oscillometry measurement of distal airways obstruction in depleted uranium‐exposed Gulf War veterans

“…Veterans were grouped into high versus low U exposure groups based on stratification at or above 0.1 mcg uU/g Cr, as per previous analyses in this cohort . This cut‐off point correlates generally with the presence or absence of DU‐containing fragments, and falls above the NHANES 95th percentile of 0.043 mcg/g Cr, but below levels characterizing U‐exposed industrial workers .…”

“…This cohort represents the largest group of Gulf War veterans documented to have inhalational exposure to DU, likely at high concentrations at the time of impact. Target organs of U toxicity include the lung, and while blast delivery, particulate size, and chemical composition of insoluble DU oxides yield potential for long term airway effects, spirometry has demonstrated no DU‐specific abnormalities . In the cohort overall, traditional lung function values are within clinically normal range …”

Occupational Exposures and Environmental Health Hazards of Military Personnel

“…Since 1991, Uranium (U) has been used for Depleted Uranium (DU) military ammunitions in different war theaters. Gulf War I US veterans exposed to DU after friendly fire incidents were included in surveillance programs to investigate long-term health and genotoxic effects, as described in several studies [ 126 , 127 , 128 , 129 , 130 ]. Seventy-four Gulf War I veterans have been visited every two years since 1993 to identify health changes in response to embedded metal fragments [ 126 ].…”

“…HPRT mutant frequencies were evaluated in 70 veterans of the cohort every 2 years (2001–2009) and no increase in mutation frequencies was detected even after 20 years since exposure ( p = 0.61) [ 128 ]. High uU concentrations persisted even after 20 years, indicating that U is still mobilized from embedded fragments, but no health effects were observed [ 129 ]. After 25 years since DU-exposure, 36 veterans belonging to the cohort have been monitored for uU concentrations and health outcomes [ 130 ].…”