Longitudinal Health Surveillance in a Cohort of Gulf War Veterans 18 Years After First Exposure to Depleted Uranium

Abstract

As part of a longitudinal surveillance program, 35 members of a larger dynamic cohort of 79 Gulf War I veterans exposed to depleted uranium (DU) during combat underwent clinical evaluation at the Baltimore Veterans Administration Medical Center. Health outcomes and biomonitoring results were obtained to assess effects of DU exposure and determine the need for additional medical intervention. Clinical evaluation included medical and exposure histories, physical examination, and laboratory studies including biomarkers of uranium (U) exposure. Urine collections were obtained for U analysis and to measure renal function parameters. Other laboratory measures included basic hematology and chemistry parameters, blood and plasma U concentrations, and markers of bone metabolism. Urine U (uU) excretion remained above normal in participants with embedded DU fragments, with urine U concentrations ranging from 0.006 to 1.88 μg U/g creatinine. Biomarkers of renal effects showed no apparent evidence of renal functional changes or cellular toxicity related to U body burden. No marked differences in markers of bone formation or bone resorption were observed; however, a statistically significant decrease in levels of serum intact parathyroid hormone and significant increases in urinary calcium and sodium excretion were seen in the high versus the low uU groups. Eighteen years after first exposure, members of this cohort with DU fragments continue to excrete elevated concentrations of uU. No significant evidence of clinically important changes was observed in kidney or bone, the two principal target organs of U. Continued surveillance is prudent, however, due to the ongoing mobilization of uranium from fragment depots.

Données nouvelles sur la néphrotoxicité de l’uranium

“…Par ailleurs, bien qu'une étude conclue en l'absence de contamination de l'organisme des militaires des suites de l'exposition aux obus (à tête d'uranium) durant les conflits du Golfe et des Balkans (Cazoulat et al, 2008) des études complémentaires ont montré la présence d'uranium dans les urines jusqu'à 18 ans après exposition à l'uranium (McDiarmid et al, 2011(McDiarmid et al, , 2000Squibb and McDiarmid, 2006). Le suivi des vétérans souligne une tendance non significative à des dysfonctionnements tubulaires rénaux attribuables à l'uranium (McDiarmid et al, 2009(McDiarmid et al, , 2006.…”

The Role of Chelation in the Treatment of Other Metal Poisonings

“…By comparison, a series of US soldiers who may have been exposed to DU by inhalation, ingestion, or wound contamination, but without embedded shrapnel, had mean urinary uranium concentrations of 0.066 μg/g creatinine, much lower than those with embedded DU shrapnel (median urinary uranium concentrations of 2.61 μg/g creatinine) [156]. Despite DU shrapnel persistence and long-term ongoing urinary elimination, renal dysfunction or cellular toxicity have been unimpressive [149].…”

“…Inhalation, the primary occupational exposure route, results in pulmonary retention lasting from weeks to years, depending upon the solubility of the uranium compound. DU shrapnel has been a concern, due to persistence and prolonged renal exposure via elimination [149]. Some accumulation occurs in skeletal, renal, and hepatic locations.…”

Depleted Uranium and Its Effects on Humans

“…Further scientific research performed in a population of veterans from the Gulf War (1991) showed that the inhalation of DU exposure did not induce long-term adverse pulmonary effects in the soldiers [53]. Likewise, no significant evidence of clinically important changes was observed in kidney or bone [54]. Based on the results of a study in which 35 veterans from the First Gulf War with embedded DU fragments and/or inhalation exposure participated, it is obvious that chronic exposure to DU did not induce chromosomal aberrations in the peripheral blood lymphocytes [55].…”