Depleted uranium exposure and health effects in Gulf War veterans

Abstract

Health effects stemming from depleted uranium (DU) exposure in a cohort of Gulf War veterans who were in or on US Army vehicles hit by friendly fire involving DU munitions are being carefully monitored through the Baltimore Veterans Affairs (VA) DU Follow-Up Program initiated in 1993. DU exposure in this cohort has been directly measured using inductively coupled plasma-mass spectrometer (ICP-MS) isotopic analysis for DU in urine specimens. Soldiers with embedded DU fragments continue to excrete elevated concentrations of U in their urine, documenting ongoing systemic exposure to U released from their fragments. Biennial surveillance visits provide a detailed health assessment that includes basic clinical measures and surveillance for early changes in kidney function, an expected target organ for U. Tests also include measurements of genotoxicity and neuroendocrine, neurocognitive and reproductive function. With the exception of the elevated urine U excretion, no clinically significant expected U-related health effects have been identified to date. Subtle changes in renal function and genotoxicity markers in veterans with urine U concentrations greater than 0.1 mg K1 creatinine, however, indicate the need for continued surveillance of these DU-exposed veterans.

Measures of genotoxicity in Gulf war I veterans exposed to depleted uranium

“…This range is similar to that observed in past surveillance visits [McDiarmid et al, , 2004[McDiarmid et al, , 2009. Approximately 43% (n 5 15) of the individuals in this cohort of 35 subjects showed evidence of retained shrapnel when evaluated by an X-ray plain film skeletal survey [Hooper et al, 1999;Squibb and McDiarmid, 2006].…”

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

“…We note, however, that both the urine micro-albumin concentrations (with a statistical difference at P < 0.09) and Retinol Binding Protein (RBP) mean values are higher in the high uU group compared to the low uU group. Although the Mann-Whitney P-value for RBP shown here indicates a minimal statistical relationship between the low vs high uU groups, statistically high RBP urine concentrations have been seen in past surveillance visits [McDiarmid et al, 2001;Squibb and McDiarmid, 2006], suggesting that a U concentration threshold that decreases the ability of proximal tubules to reabsorb low molecular weight proteins prior to their excretion in urine is being approached.…”

Health Surveillance of Gulf War I Veterans Exposed to Depleted Uranium: Updating the Cohort

“…The principal finding from this DU Follow-up Program medical surveillance visit continues to be that urine U excretion is significantly higher in veterans with confirmed retention of metal fragments in soft tissue compared to either those DU-exposed veterans without fragments (Hooper et al 1999;McDiarmid et al 2000Squibb and McDiarmid 2006) or a comparison population of Gulf War deployed, but not DU-exposed veterans (McDiarmid et al 2000). Multiple smaller fragments remain in some veterans despite surgeries because the fragments are not .10 g g creatinine Ϫ1 (n ϭ 24).…”