title: Health effects of occupational exposure to uranium: do physicochemical properties matter?
abstract: OBJECTIVE
  Physicochemical properties of uranium, including isotopic composition and solubility, are determinants of its toxicity. We reviewed epidemiological studies in civilian and military workers known to be exposed to uranium with different physicochemical properties to investigate its long-term effects, such as cancerous and circulatory diseases.
  
  
  METHODS
  We systematically searched the Pubmed and the Scopus databases to identify studies of uranium- processing workers (published between 1980 and 2013) and veterans of the wars in the Persian Gulf and the Balkans (published between 1991 and 2013) in which defined outcomes, such as lung, lymphohematopoietic, kidney cancers, and circulatory diseases were examined. RESULTS from these studies in terms of risk of each health outcome (mortality or incidence) and analyses of dose-response relationship were examined to present the impact of uranium physicochemical properties on the observed results.
  
  
  RESULTS
  Twenty-seven articles were reviewed. There is some evidence for increased lung cancer risk among uranium-processing workers. The evidence is less strong for lymphohematopoietic cancer. We found that most of the studies insufficiently assessed the physicochemical properties of uranium and some of them used proxies for the exposure assessment and risk estimation analyses. Studies of veterans of the wars in the Persian Gulf and the Balkans are uninformative in respect to internal uranium exposure.
  
  
  CONCLUSIONS
  Existing epidemiological data on the physicochemical properties of uranium and associated health outcomes are inconclusive. Further studies among certain groups of uranium-processing workers (uranium-enrichment and fuel-fabrication workers) could contribute to our knowledge of the health effects of uranium with respect to its physicochemical properties.
authors.affiliation: Institut de Radioprotection et de Sûreté Nucléaire, IRSN/PRP-HOM/SRBE/LEPID , BP 17, 92262 Fontenay-aux-Roses , France.
authors.forename: Sergey
authors.initials: S
authors.lastname: Zhivin
authors.forename: Dominique
authors.initials: D
authors.lastname: Laurier
authors.forename: Irina
authors.initials: I
authors.lastname: Guseva Canu
mesh_terms: D063368:Balkan Peninsula; D002318:Cardiovascular Diseases / Q000209:etiology; D047830:Gulf War; D006801:Humans; D008889:Military Personnel; D009381:Neoplasms, Radiation-Induced / Q000209:etiology; D009784:Occupational Diseases / Q000209:etiology; D016273:Occupational Exposure; D012306:Risk; D012995:Solubility; D013997:Time Factors; D016896:Treatment Outcome; D014501:Uranium / Q000009:adverse effects* / Q000737:chemistry*; D014728:Veterans
chemical_list: D014501:Uranium
keywords: Review; epidemiology; ionizing radiation; occupational; physicochemical; uranium