title: The U.S. Department of Veterans' Affairs depleted uranium exposed cohort at 25 Years: Longitudinal surveillance results.
abstract: BACKGROUND
  A small group of Gulf War I veterans wounded in depleted uranium (DU) friendly-fire incidents have been monitored for health changes in a clinical surveillance program at the Veterans Affairs Medical Center, Baltimore since 1994.
  
  
  METHODS
  During the spring of 2015, an in-patient clinical surveillance protocol was performed on 36 members of the cohort, including exposure monitoring for total and isotopic uranium concentrations in urine and a comprehensive assessment of health outcomes.
  
  
  RESULTS
  On-going mobilization of U from embedded fragments is evidenced by elevated urine U concentrations. The DU isotopic signature is observed principally in participants possessing embedded fragments. Those with only an inhalation exposure have lower urine U concentration and a natural isotopic signature.
  
  
  CONCLUSIONS
  At 25 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 U body burden continues to accrue from in-situ mobilization from metal fragment depots, and increases with exposure duration, critical tissue-specific U concentration thresholds may be reached, thus recommending on-going surveillance of this veteran cohort.
authors: Department of Veterans Affairs Medical Center Baltimore, Maryland, 10 N. Greene St., Baltimore, MD 21201, USA; Department of Medicine, University of Maryland School of Medicine, 655 W Baltimore S, Baltimore, MD 21201, USA.
authors: Melissa A
authors: MA
authors: McDiarmid
authors: Department of Veterans Affairs Medical Center Baltimore, Maryland, 10 N. Greene St., Baltimore, MD 21201, USA; Department of Medicine, University of Maryland School of Medicine, 655 W Baltimore S, Baltimore, MD 21201, USA.
authors: Joanna M
authors: JM
authors: Gaitens
authors: Department of Veterans Affairs Medical Center Baltimore, Maryland, 10 N. Greene St., Baltimore, MD 21201, USA; Department of Medicine, University of Maryland School of Medicine, 655 W Baltimore S, Baltimore, MD 21201, USA.
authors: Stella
authors: S
authors: Hines
authors: Department of Veterans Affairs Medical Center Baltimore, Maryland, 10 N. Greene St., Baltimore, MD 21201, USA. Electronic address: mcondon@medicine.umaryland.edu.
authors: Marian
authors: M
authors: Condon
authors: Department of Veterans Affairs Medical Center Baltimore, Maryland, 10 N. Greene St., Baltimore, MD 21201, USA; Department of Medicine, University of Maryland School of Medicine, 655 W Baltimore S, Baltimore, MD 21201, USA.
authors: Tracy
authors: T
authors: Roth
authors: Department of Veterans Affairs Medical Center Baltimore, Maryland, 10 N. Greene St., Baltimore, MD 21201, USA; Department of Medicine, University of Maryland School of Medicine, 655 W Baltimore S, Baltimore, MD 21201, USA.
authors: Marc
authors: M
authors: Oliver
authors: Department of Veterans Affairs Medical Center Baltimore, Maryland, 10 N. Greene St., Baltimore, MD 21201, USA; Department of Medicine, University of Maryland School of Medicine, 655 W Baltimore S, Baltimore, MD 21201, USA.
authors: Patricia
authors: P
authors: Gucer
authors: Department of Veterans Affairs Medical Center Baltimore, Maryland, 10 N. Greene St., Baltimore, MD 21201, USA; Department of Pathology, University of Maryland School of Medicine, 655 W Baltimore S, Baltimore, MD 21201, USA.
authors: Lawrence
authors: L
authors: Brown
authors: US Food and Drug Administration, Center for Devices and Radiological Health Office of Science and Engineering Laboratories, Silver Spring, MD 20993, USA.
authors: Jose A
authors: JA
authors: Centeno
authors: Department of Veterans Affairs Medical Center Baltimore, Maryland, 10 N. Greene St., Baltimore, MD 21201, USA.
authors: Moira
authors: M
authors: Dux
authors: Department of Veterans Affairs Medical Center Baltimore, Maryland, 10 N. Greene St., Baltimore, MD 21201, USA; Department of Medicine, University of Maryland School of Medicine, 655 W Baltimore S, Baltimore, MD 21201, USA.
authors: Katherine S
authors: KS
authors: Squibb
mesh_terms: D015142:Baltimore; D047830:Gulf War; D008137:Longitudinal Studies; D008889:Military Personnel / Q000706:statistics & numerical data*; D016273:Occupational Exposure; D014501:Uranium / Q000633:toxicity*; D014728:Veterans / Q000706:statistics & numerical data*
chemical_list: D014501:Uranium
keywords: DU bio-monitoring; Health surveillance; Uranium toxicity