Surveillance results of depleted uranium-exposed Gulf War I veterans: sixteen years of follow-up.
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 mug U/g creatinine [creat.] vs. 0.005 mug 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 mug/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 beta(2) microglobulin compared to the low-U group (81.7 v. 69.0 mug/g creat.; p = .11 respectively) and retinol binding protein (48.1 vs. 31.0 mug/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.
McDiarmid
M A
MA
Department of Medicine, University of Maryland, School of Medicine, Baltimore, Maryland, USA.
Engelhardt
S M
SM
Dorsey
C D
CD
Oliver
M
M
Gucer
P
P
Wilson
P D
PD
Kane
R
R
Cernich
A
A
Kaup
B
B
Anderson
L
L
Hoover
D
D
Brown
L
L
Albertini
R
R
Gudi
R
R
Squibb
K S
KS
D000328:Adult; D015142:Baltimore; D001862:Bone Resorption / Q000188:drug therapy / Q000652:urine; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism; D047830:Gulf War; D006801:Humans; D007687:Kidney Tubules, Proximal / Q000187:drug effects / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D016273:Occupational Exposure / Q000032:analysis*; D011159:Population Surveillance; D012098:Reproduction / Q000187:drug effects; D014501:Uranium / Q000032:analysis / Q000506:poisoning*; D014728:Veterans; D001613:beta 2-Microglobulin / Q000652:urine
D001613:beta 2-Microglobulin; D014501:Uranium