VA Studies Effects of Depleted Uranium Exposure on Friendly Fire Victims
WASHINGTON, May 8, 2000 (GulfLINK) - Since 1993, Gulf War veterans with the highest exposure to depleted uranium have been monitored by the Department of Veterans Affairs. A recently released paper reports their findings.
The Depleted Uranium Follow-up Program was established in 1993 at the Veterans Affairs Medical Center in Baltimore, Md. That first year, doctors examined 33 veterans who had been exposed to depleted uranium, many with embedded shrapnel. Large shrapnel fragments had been removed, but surgeons judged that many were too small to be safely removed without doing more damage to the patient. At that time, doctors saw no association between depleted uranium levels and adverse health effects.
Four years later, in 1997, the group was re-evaluated and the results recently published. The article, Health Effects of Depleted Uranium on Exposed Gulf War Veterans, appears in the February 2000 edition of Academic Press' Environmental Research journal.
Melissa McDiarmid, M.D., M.P.H.,of the University of Maryland School of Medicine and lead physician on the project, says the government has a special responsibility toward the veterans she's studying. The veterans in the follow-up group were crewmembers of the 15 Bradley Fighting vehicles or the nine Abrams tanks that were mistakenly fired on and struck by munitions containing depleted uranium. McDiarmid points out that she and her coworkers are not experimenting on these veterans or doing medical research. Their role is best described as surveillance.
"Part of the ethical obligation that that unfortunate situation has created is to follow these folks forward vigilantly assessing them and watching them for any health effects that might accrue in the future as a result of their exposure," she said.
The program observes more than 60 veterans. About a quarter of them have depleted uranium fragments lodged in their bodies. The others were on or in vehicles struck by depleted uranium rounds, but do not have shrapnel injuries. They have had inhalation exposures, possible wound contamination or skin exposure.
The veterans in the follow-up program are regularly examined and their doctors alerted for any unusual test results. McDiarmid says those veterans who still retain depleted uranium fragments in their tissue do share a medical abnormality. Years after the war, they still have elevated uranium concentrations in their urine. This does concern her, but it is not the whole story.
The good news," she continued, "is that the usual big health indicators that we look at for the most part are normal in this group." The usual health indicators include organ function tests, blood tests and the normal range of medical checks most of us are familiar with from physical exams.
"This should not be interpreted as meaning the veterans in the program are in general good health. Most are suffering both the catastrophic physical and psychological effects of being in a friendly fire incident," said McDiarmid. "A number of these folks have very significant injuries. A number of them are amputees and suffer the results of serious traumatic injuries."
McDiarmid says her program looks closely at test results, hoping to see very early signs of problems before they actually cause a problem. In addition to physical examinations, they also have monitored these veterans' mental functioning. The participants were given neurocognitive assessments, which are a series of both handwritten and computerized tests. These tests measure many aspects of central brain function such as memory, learning, attention and reasoning. The media have focused on the results of these tests.
"There was a subtle, but nonetheless, statistically significant difference between the performance of those with high urine uranium level [greater than 0.05 micrograms of uranium per gram of creatinine] compared with those with normal levels," said McDiarmid. "Those with high urine uranium levels did slightly less well. However, that was only true on the computerized tests and not the old fashioned paper and pencil tests."
Additionally, she pointed out that most of the veterans in the program have families, go to work every day and function in their every day life. The results of these tests may not be clinically significant or have significant practical implications.
It is already known that other heavy metals may affect reproduction. Since uranium is a heavy metal, its effects on the reproductive health of veterans exposed to DU have been evaluated. So far, no problems related to the heavy metal character of DU have been found in those who are being followed.
"All the children that have been fathered by these men since they came home are normal. This is good news. However, we have gotten more sophisticated in our ability to track and assess normal reproductive function, and we will continue to follow indicators of reproductive function in the future," said McDiarmid.
Some have raised the fear that depleted uranium could cause genetic damage to those exposed to it. One laboratory study showed that depleted uranium could change cells on the genetic level. However, McDiarmid pointed out that this research was what scientists call "in vitro," meaning it was done in a laboratory, not in whole animals or people. Her own team tested the veterans for genetic damage in 1997 and saw no difference between those who had high urine uranium levels and those who had low levels. Still, to be on the safe side the tests were repeated in 1999 and will be analyzed shortly.
If there is even the possibility that fragments of depleted uranium imbedded in veterans' bodies might be harmful, one might ask why they aren't removed. McDiarmid says surgeons believe the process of removing the particles of DU is likely to be more harmful to the veterans than leaving them in place.
"A lot of these men have had multiple surgeries already," she said, "and we're talking about really tiny fragments. I liken them to paint splatter in size."
Rather than operating on these veterans again, the follow-up program continues to observe the Gulf War veterans who have had the greatest exposure to depleted uranium for any health effects related to the shrapnel. They also continue to search for other veterans who have been exposed to the substance and enroll them into the program. Speaking as a public health professional, McDiarmid feels the program's work should continue indefinitely.
"I think we're ethically obliged to follow these folks forward long into the future," she concluded.