title: Biologic monitoring and surveillance results for the department of veterans affairs' depleted uranium cohort: Lessons learned from sustained exposure over two decades.
abstract: BACKGROUND
  A small group of Gulf War I veterans wounded in depleted uranium (DU) friendly fire incidents have been monitored in a clinical surveillance program at the Veterans Affairs Medical Center, Baltimore since 1994.
  
  
  METHODS
  An in-patient clinical surveillance protocol was performed on 35 members of the cohort, including exposure monitoring for total and isotopic uranium concentrations in urine and a comprehensive assessment of health outcomes.
  
  
  RESULTS
  Although urine U concentrations continue to be elevated in this group, illustrating on-going in situ mobilization of U from embedded fragments, no consistent U-related health effects have been observed.
  
  
  CONCLUSIONS
  Now more than 20 years since first exposure to DU, an aging cohort of military veterans continues to show no U-related health effects in known target organs of U toxicity. As tissue concentrations continue to accrue with exposure duration, critical tissue-specific U concentration thresholds may be reached, thus recommending on-going surveillance of this veteran cohort.
authors.affiliation: Department of Veterans Affairs Medical Center, Baltimore, Maryland.|Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: McDiarmid
authors.affiliation: Department of Veterans Affairs Medical Center, Baltimore, Maryland.|Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Joanna M
authors.initials: JM
authors.lastname: Gaitens
authors.affiliation: Department of Veterans Affairs Medical Center, Baltimore, Maryland.|Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Stella
authors.initials: S
authors.lastname: Hines
authors.affiliation: Department of Veterans Affairs Medical Center, Baltimore, Maryland.
authors.forename: Marian
authors.initials: M
authors.lastname: Condon
authors.affiliation: Department of Veterans Affairs Medical Center, Baltimore, Maryland.|Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Tracy
authors.initials: T
authors.lastname: Roth
authors.affiliation: Department of Veterans Affairs Medical Center, Baltimore, Maryland.|Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Marc
authors.initials: M
authors.lastname: Oliver
authors.affiliation: Department of Veterans Affairs Medical Center, Baltimore, Maryland.|Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Patricia
authors.initials: P
authors.lastname: Gucer
authors.affiliation: Department of Veterans Affairs Medical Center, Baltimore, Maryland.|Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Brown
authors.affiliation: Biophysical Toxicology, The Joint Pathology Center, Silver Spring, Maryland.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Centeno
authors.affiliation: Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Streeten
authors.affiliation: Department of Veterans Affairs Medical Center, Baltimore, Maryland.|Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Katherine S
authors.initials: KS
authors.lastname: Squibb
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis / Q000652:urine; D001842:Bone and Bones / Q000378:metabolism; D004784:Environmental Monitoring / Q000706:statistics & numerical data*; D047830:Gulf War; D006801:Humans; D007554:Isotopes / Q000633:toxicity / Q000652:urine; D007677:Kidney Function Tests; D008137:Longitudinal Studies; D008168:Lung / Q000528:radiation effects; D008670:Metals / Q000652:urine; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D014481:United States; D014493:United States Department of Veterans Affairs; D014501:Uranium / Q000633:toxicity / Q000652:urine*; D014728:Veterans / Q000706:statistics & numerical data*; D000067453:War Exposure / Q000009:adverse effects*
chemical_list: D015415:Biomarkers; D007554:Isotopes; D008670:Metals; D014501:Uranium
keywords: DU bio-monitoring; Uranium toxicity; alpha-emission; health surveillance