the critical elements needed for an epidemiologic study of veterans who were exposed to DU while on active duty. Those might include veterans who
were exposed to smoke from fires resulting from the burning of vehicles containing DU munitions or fires at depots at which DU munitions were stored,
worked in environments containing DU dust or residue from DU munitions,
were within a structure or vehicle when it was struck by DU munitions,
climbed on or entered equipment or structures struck by DU munitions, or
were medical personnel who provided initial treatment to members of the armed forces who were exposed to DU.
The committee also will identify elements needed to study veterans’ children who were born after parental exposure to DU.
To approach its task, the committee first considered the necessary elements of a comprehensive epidemiologic study to assess exposure to DU and related health outcomes (Chapter 2). The committee then evaluated DOD’s available data and research efforts and identified limitations and data gaps in the databases (Chapter 3). Finally, it identified options for further study of potential health outcomes in DU-exposed military personnel and veterans (Chapter 4).
The elements of an epidemiologic study essential for assessing the relationship between exposure to DU and health outcomes include identification of a relevant study population of adequate size; a comprehensive assessment of uranium exposure in the population, including the use of biomarkers; an evaluation of long-term health outcomes; adequate followup time; use of reasonable methods for controlling confounding and minimizing bias; and appropriate statistical analyses.
The committee reviewed available datasets on health outcomes in DU-exposed military personnel and veterans and datasets on these populations that do not specifically assess DU exposure (they track health outcomes in general) but might be useful for future study. The datasets include the Depleted Uranium Medical Management Program, including the Depleted Uranium Follow-Up