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Gulf War and Health: Updated Literature Review of Depleted Uranium
underwent a complete blood count and measurement of serum creatinine and urea, and urinary uranium. Thirteen study subjects provided spot urine samples for urinary-uranium analysis because timed and 24-hour urine samples were difficult to ascertain. Uranium concentration, expressed in micrograms per liter, was measured with laser fluorimetry. Air samples were collected to measure air uranium concentration. Linear regression was used in the analysis.
Mean urinary uranium concentration was 17.8 μg/L in the 13 participants who provided spot urine specimens; urinary uranium ranged from 8-29 μg/L. There was a correlation between urinary uranium and serum creatinine in the 13 specimens, and mean uranium excretion was more than 20 times the occupational-exposure decision level of 0.8 μg/L.
This section describes studies that examined the health outcomes related to exposure to depleted uranium as a result of military deployment; the studies are also summarized in Table 7-2. The literature focuses on veterans deployed to conflicts in the Balkans and the Persian Gulf region. This section begins with a case series of US Gulf War veterans involved in friendly-fire incidents who received fragments of depleted-uranium shrapnel. Next, it summarizes the cohort studies that examined the mortality experience and cancer outcome of UK Gulf War veterans, followed by studies that assessed cancer incidence primarily in European service personnel deployed to the Balkans. Finally, it summarizes a study on workers exposed to depleted uranium at the FFMPC in Ohio.
Baltimore Veterans Affairs Medical Center Studies
Since 1993, the Depleted Uranium Follow-up Program at the Baltimore Veterans Affairs Medical Center (Baltimore VAMC) has sought to provide clinical surveillance of Gulf War veterans exposed to depleted uranium through friendly-fire incidents. Depleted uranium was first used by US and other military during the first Gulf War as material for tank armor and in weaponry (McDiarmid et al., 2004). During the course of that conflict, soldiers in or on vehicles and tanks “were mistakenly fired on and struck by munitions containing DU [depleted uranium]” (McDiarmid et al., 2000) and are thought to have inhaled or ingested airborne depleted-uranium particles or to have experienced wound contamination by depleted uranium. In addition, some soldiers had multiple tiny fragments of depleted uranium scattered throughout muscle and soft tissue. As a result, the Department of Veterans Affairs established a medical surveillance system to determine health effects in depleted-uranium–exposed veterans, evaluate techniques to measure uranium, and assess possible surgical management of shrapnel (McDiarmid, 2007). The results of the surveillance program are detailed in a number of studies by researchers at the Baltimore VAMC.