title: Teratogenicity of depleted uranium aerosols: a review from an epidemiological perspective.
abstract: BACKGROUND
  Depleted uranium is being used increasingly often as a component of munitions in military conflicts. Military personnel, civilians and the DU munitions producers are being exposed to the DU aerosols that are generated.
  
  
  METHODS
  We reviewed toxicological data on both natural and depleted uranium. We included peer reviewed studies and gray literature on birth malformations due to natural and depleted uranium. Our approach was to assess the "weight of evidence" with respect to teratogenicity of depleted uranium.
  
  
  RESULTS
  Animal studies firmly support the possibility that DU is a teratogen. While the detailed pathways by which environmental DU can be internalized and reach reproductive cells are not yet fully elucidated, again, the evidence supports plausibility. To date, human epidemiological data include case examples, disease registry records, a case-control study and prospective longitudinal studies.
  
  
  CONCLUSIONS
  The two most significant challenges to establishing a causal pathway between (human) parental DU exposure and the birth of offspring with defects are: i) distinguishing the role of DU from that of exposure to other potential teratogens; ii) documentation on the individual level of extent of parental DU exposure. Studies that use biomarkers, none yet reported, can help address the latter challenge. Thoughtful triangulation of the results of multiple studies (epidemiological and other) of DU teratogenicity contributes to disentangling the roles of various potentially teratogenic parental exposures. This paper is just such an endeavor.
  
  
  CONCLUSIONS
  In aggregate the human epidemiological evidence is consistent with increased risk of birth defects in offspring of persons exposed to DU.
authors.affiliation: University of Massachusetts School of Public Health and Health Sciences, Amherst, MA 01003, USA. rita@schoolph.umass.edu
authors.forename: Rita
authors.initials: R
authors.lastname: Hindin
authors.forename: Doug
authors.initials: D
authors.lastname: Brugge
authors.forename: Bindu
authors.initials: B
authors.lastname: Panikkar
mesh_terms: D000016:Abnormalities, Radiation-Induced / Q000453:epidemiology; D000336:Aerosols / Q000633:toxicity*; D000818:Animals; D004781:Environmental Exposure / Q000009:adverse effects*; D006801:Humans; D008889:Military Personnel; D008891:Military Science; D011848:Radioactive Pollutants / Q000633:toxicity*; D013723:Teratogens / Q000633:toxicity*; D014501:Uranium / Q000737:chemistry / Q000493:pharmacokinetics / Q000633:toxicity*; D014857:Warfare
chemical_list: D000336:Aerosols; D011848:Radioactive Pollutants; D013723:Teratogens; D014501:Uranium