title: Health effects of depleted uranium on exposed Gulf War veterans.
abstract: A small group of Gulf War veterans possess retained fragments of depleted uranium (DU) shrapnel, the long-term health consequences of which are undetermined. We evaluated the clinical health effects of DU exposure in Gulf War veterans compared with nonexposed Gulf War veterans. History and follow-up medical examination were performed on 29 exposed veterans and 38 nonexposed veterans. Outcome measures employed were urinary uranium determinations, clinical laboratory values, and psychiatric and neurocognitive assessment. DU-exposed Gulf War veterans with retained metal shrapnel fragments are excreting elevated levels of urinary uranium 7 years after first exposure (range 0.01-30.7 microg/g creatinine vs 0.01- 0.05 microg/g creatinine in the nonexposed). The persistence of the elevated urine uranium suggests on-going mobilization from a storage depot which results in a chronic systemic exposure. Adverse effects in the kidney, a presumed target organ, are not present at this time, though other effects are observed. Neurocognitive examinations demonstrated a statistical relationship between urine uranium levels and lowered performance on computerized tests assessing performance efficiency. Elevated urinary uranium was statistically related to a high prolactin level (>1.6 ng/ml; P=0.04). More than 7 years after first exposure, DU-exposed Gulf War veterans with retained metal fragments continue to excrete elevated concentrations of urinary uranium. Effects related to this are subtle perturbations in the reproductive and central nervous systems.
authors.affiliation: Department of Veterans Affairs Medical Center, Baltimore, Maryland, USA. mmcdiarm@medicine.umaryland.edu
authors.forename: M A
authors.initials: MA
authors.lastname: McDiarmid
authors.forename: J P
authors.initials: JP
authors.lastname: Keogh
authors.forename: F J
authors.initials: FJ
authors.lastname: Hooper
authors.forename: K
authors.initials: K
authors.lastname: McPhaul
authors.forename: K
authors.initials: K
authors.lastname: Squibb
authors.forename: R
authors.initials: R
authors.lastname: Kane
authors.forename: R
authors.initials: R
authors.lastname: DiPino
authors.forename: M
authors.initials: M
authors.lastname: Kabat
authors.forename: B
authors.initials: B
authors.lastname: Kaup
authors.forename: L
authors.initials: L
authors.lastname: Anderson
authors.forename: D
authors.initials: D
authors.lastname: Hoover
authors.forename: L
authors.initials: L
authors.lastname: Brown
authors.forename: M
authors.initials: M
authors.lastname: Hamilton
authors.forename: D
authors.initials: D
authors.lastname: Jacobson-Kram
authors.forename: B
authors.initials: B
authors.lastname: Burrows
authors.forename: M
authors.initials: M
authors.lastname: Walsh
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D006403:Hematologic Tests; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008877:Middle East; D009460:Neurologic Examination; D016273:Occupational Exposure / Q000009:adverse effects*; D012661:Semen / Q000737:chemistry / Q000502:physiology; D014481:United States; D014501:Uranium / Q000009:adverse effects* / Q000652:urine; D014728:Veterans; D014857:Warfare; D014915:Whole-Body Counting; D014947:Wounds and Injuries / Q000150:complications*
chemical_list: D014501:Uranium