Surveillance of Depleted Uranium-exposed Gulf War Veterans: More Evidence for Bone Effects. Issue 6 (June 2021)

• Record Type: Journal Article
• Authors: McDiarmid, Melissa A.; Gaitens, Joanna M.; Hines, Stella; Cloeren, Marianne; Breyer, Richard; Condon, Marian; Oliver, Marc; Roth, Tracy; Gucer, Patricia; Kaup, Bruce; Brown, Lawrence; Brown, Clayton H.; Dux, Moira; Glick, Danielle; Lewin-Smith, Michael R.; Strathmann, Frederick; Xu, Hanna; Velez-Quinones, Maria A.; Streeten, Elizabeth
• Is Part Of: Health physics. Volume 120:Issue 6(2021)
• Page Start: 671
• Page End: 682
• Publication Date: 2021-06
• Subjects: exposure, occupational -- health effects -- occupational safety -- toxicology; Biophysics -- Periodicals; Health Physics -- periodicals; Radiation Protection -- periodicals; Radiotherapy -- periodicals; Medische fysica; Electronic journals; 612.01448
• DOI: 10.1097/HP.0000000000001395
• Languages: English
• ISSNs: 0017-9078

Abstract

Abstract: Gulf War I veterans who were victims of depleted uranium (DU) "friendly-fire" incidents have undergone longitudinal health surveillance since 1994. During the spring of 2019, 36 members of the cohort were evaluated with a monitoring protocol including exposure assessment for total and isotopic uranium concentrations in urine and a comprehensive review of health outcomes, including measures of bone metabolism and bone mineral density (BMD) determination. Elevated urine U concentrations were observed in cohort members with retained depleted uranium (DU) shrapnel fragments. In addition, a measure of bone resorption, N-telopeptide, showed a statistically significant increase in those in the high DU subgroup, a finding consistent with a statistically significant decrease in bone mass also observed in this high DU subgroup compared to the low DU subgroup. After more than 25 y since first exposure to DU, an aging cohort of military veterans continues to show few U-related health effects in known target organs of U toxicity. The new finding of impaired BMD in the high DU subgroup has now been detected in two consecutive surveillance visits. While this is a biologically plausible uranium effect, it is not reflected in other measures of bone metabolism in the full cohort, which have largely been within normal limits. However, ongoing accrual of the U burden from fragment absorption over time and the effect of aging further impairing BMD suggest the need for future surveillance assessments of this cohort.