Surveillance of Depleted Uranium Exposed Gulf War Veterans: Health Effects Observed in an Enlarged ???Friendly Fire??? Cohort

Abstract

To determine clinical health effects in a small group of US Gulf War veterans (n = 50) who were victims of depleted uranium (DU) "friendly fire," we performed periodic medical surveillance examinations. We obtained urine uranium determinations, clinical laboratory values, reproductive health measures, neurocognitive assessments, and genotoxicity measures. DU-exposed Gulf War veterans with retained metal shrapnel fragments were excreting elevated levels of urine uranium 8 years after their first exposure (range, 0.018 to 39.1 micrograms/g creatinine for DU-exposed Gulf War veterans with retained fragments vs 0.002 to 0.231 microgram/g creatinine in DU exposed but without fragments). The persistence of the elevated urine uranium suggests ongoing mobilization from the DU fragments and results in chronic systemic exposure. Clinical laboratory outcomes, including renal functioning, were essentially normal. Neurocognitive measures showing subtle differences between high and low uranium exposure groups, seen previously, have since diminished. Sister chromatid exchange frequency, a measure of mutation in peripheral lymphocytes, was related to urine uranium level (6.35 sister chromatid exchanges/cell in the high uranium exposure group vs 5.52 sister chromatid exchanges/cell in the low uranium exposure group; P = 0.03). Observed health effects were related to subtle but biologically plausible perturbations in central nervous system function and a general measure of mutagen exposure. The findings related to uranium's chemical rather than radiologic toxicity. Observations in this group of veterans prompt speculation about the health effects of DU in other exposure scenarios.

Depleted uranium exposure and health effects in Gulf War veterans

“…This and subsequent work (McDiarmid et al 2000(McDiarmid et al , 2001(McDiarmid et al , 2004a(McDiarmid et al ,b, 2006 confirmed that urine U excretion is a good measure for quantifying systemic exposure to U in this cohort, as it serves as an indication of the extent to which U was being released to blood from embedded fragments and/or tissue stores of previously released, inhaled or ingested DU.…”

Gulf war depleted uranium risks

“…This finding, however, was disputed by the National Academy of Science, and the possible association of DU with prolactin levels was not found during a subsequent reassessment (McDiarmid et al, 2001). …”

“…These findings are consistent with medical records for US troops in the 1991 Gulf War (PAC, 2005) and Italian ground troops in the Balkan War (Italian Ministry of Defense, 2001). McDiarmid et al (2001), however, found an elevation in sister chromatid exchanges (SCE) for veterans with high DU concentrations in their urine relative to veterans with low DU concentrations. These observations are similar to observations for uranium workers showing an increase in SCE (Martin et al, 1991) with no statistically significant increase of cancers of any type (Waxweiler et al, 1983).…”

“…On another topic relating to reproductive health, McDiarmid et al (2001) reported that initial veteran test results for DU-exposed veterans suggested a possible linkage between high levels of the hormone prolactin with DU internalization. This finding, however, was disputed by the National Academy of Science, and the possible association of DU with prolactin levels was not found during a subsequent reassessment (McDiarmid et al, 2001).…”

“…Furthermore, excitability of neurons in the hippocampus was reduced for rats with significant internalized DU, although no behavioral differences were observed from a battery of behavioral tests. Among veterans, McDiarmid et al observed a statistically lower score in one type of neurocognitive test for veterans with high uranium concentrations in their urine; however, normal functioning was not affected and the measured effect appears to be declining (McDiarmid et al, 2001). Although significant cognitive impairment has not been observed in veterans or test animals, sufficient evidence has been found to suggest some neurotoxic effects associated with large quantities of internalized DU.…”