Surveillance Results of Depleted Uranium–Exposed Gulf War I Veterans: Sixteen Years of Follow-Up

Abstract

As part of a longitudinal surveillance program, 35 members of a larger cohort of 77 Gulf War I veterans who were victims of depleted uranium (DU) “friendly fire” during combat underwent a 3-day clinical assessment at the Baltimore Veterans Administration Medical Center (VAMC). The assessment included a detailed medical history, exposure history, physical examination, and laboratory studies. Spot and 24-h urine collections were obtained for renal function parameters and for urine uranium (U) measures. Blood U measures were also performed. Urine U excretion was significantly associated with DU retained shrapnel burden (8.821 μg U/g creatinine [creat.] vs. 0.005 μg U/g creat., p = .04). Blood as a U sampling matrix revealed satisfactory results for measures of total U with a high correlation with urine U results (r = .84) when urine U concentrations were ≥0.1 μg/g creatinine. However, isotopic results in blood detected DU in only half of the subcohort who had isotopic signatures for DU detectable in urine. After stratifying the cohort based on urine U concentration, the high-U group showed a trend toward higher concentrations of urine β₂ microglobulin compared to the low-U group (81.7 v. 69.0 μg/g creat.; p = .11 respectively) and retinol binding protein (48.1 vs. 31.0 μg/g creat.; p = .07 respectively). Bone metabolism parameters showed only subtle differences between groups. Sixteen years after first exposure, this cohort continues to excrete elevated concentrations of urine U as a function of DU shrapnel burden. Although subtle trends emerge in renal proximal tubular function and bone formation, the cohort exhibits few clinically significant U-related health effects.

Acknowledgments

This clinical surveillance project is funded by the Veterans Administration. The authors also acknowledge the General Clinical Research Center at the University of Maryland Medical System, which provided the clinical staff and facilities with which to conduct this surveillance.

Notes

U.S. Department of Labor, Occupational Safety and Health Administration. 1978. 29 CFR 1910.1025 Lead standard.