Epidemiologic Studies of Veterans Exposed to Depleted Uranium Feasibility and Design Issues (2008) / Chapter Skim
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Pages 25-40
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From page 25... ...
The chapter discusses the committee's evaluation of the available datasets and their limitations. DEPLETED-URANIUM EXPOSURE IN THE MILITARY POPULATION DU munitions and armor were extensively used by the US military during the 1991 Gulf War, and military personnel were first exposed to DU as a result of friendly-fire incidents, cleanup and salvage operations, and proximity to burning DU-containing tanks and ammunition (DOD, 2000)
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From page 26... ...
A testing program for collecting urine to monitor for DU exposure is in place, and the Depleted Uranium Follow-Up Program provides continuing health monitoring of military personnel exposed to DU during the 1991 Gulf War and OIF. Several DOD policies provide guidance on identifying DU-exposed military personnel, quantifying and documenting exposures, analyzing embedded fragments, referring military personnel and veterans to the Depleted Uranium Follow-Up Program, and reporting and archiving bioassay results (DOD, 2003, 2004a,b, 2008c)
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From page 27... ...
Prospective cohort Registry Study population <100 male Gulf War veterans PDHA/reassessment: >900,000 >100,000 military >750,000 infants born in 1998 +3 male OIF personnel (as of OIF personnel, of whom personnel (active duty, 2004 to military families (those February 2008) 27,000 reported potential DU reserve)
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From page 28... ...
, Critical Elements Program DU Questionnaire (Form 2872) Millennium Cohort Study Birth and Infant Health Registry Work records Yes, veterans and military Yes, primary-care manager No Parental demographic, military (assignment and personnel with level I exposure may review work records to exposure data available from location)
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From page 29... ...
education, intelligence, education, marital status, smoking, marital status, military race or ethnicity, short rank, exposure to genetic and long-term service, toxicants, depression, use of deployment status, pay prescription psychotropic and grade, active-duty status, antidepressant drugs, recent service branch, occupation x-ray exposure Adequate followup Population followed since 1993 NA Population has been Data collected since 1998 period? followed since 2001 Study continues Study continues Study continues Analytic approach and Case series with longitudinal Retrospective analysis Longitudinal analysis Descriptive data analysis followup 29 continued
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From page 30... ...
Small number of subjects; lacks statistical power to detect effect Corroboration of Yes Yes Could be done if Could be done through linkage biomonitoring data with biomonitoring data were with other DOD databases work record or self- collected reported data? NOTE: DEERS = Defense Enrollment Eligibility Reporting System, DMDC = Defense Manpower Data Center, DOD = Department of Defense, DU = depleted uranium, ICD-9-CM = International Classification of Diseases, 9th edition, NA = not available, OIF = Operation Iraqi Freedom, PDHA = postdeployment health assessment.
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From page 31... ...
began offering DU medical screening to any other Gulf War veterans concerned about DU exposure. The screening included 30 questions about exposure and a 24-hour urine collection (Kilpatrick, 2008)
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From page 32... ...
However, the program does not constitute a comprehensive epidemiologic study of veterans exposed to DU in that the study population is small (so statistical power is low) and includes only those who were determined to have level I exposure.
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From page 33... ...
If a urine sample is high in uranium (total uranium concentration at least 50 ng/g of creatinine) or isotopic analysis indicates the presence of DU at 10% or more of total uranium and/or the person has embedded fragments or fragmenttype injuries, he or she is referred to the Depleted Uranium Follow-Up Program (see above)
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From page 34... ...
Millennium Cohort Study Launched in 2001, the Millennium Cohort Study is the largest prospective health study in military history. The study was established in response to a DOD recommendation for a long-term study of deployment-related exposure and an Institute of Medicine report (IOM, 1999)
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From page 35... ...
did not answer the question. Limitations The Millennium Cohort study population is not ideal for evaluating health effects related to DU exposure, because it was not designed to assess specifically this relatively rare exposure.
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From page 36... ...
Births and diagnoses are captured from inpatient and outpatient data by using the following databases: the Standard Inpatient Data Record, the Standard Ambulatory Data Record, and the Health Care Service Record. Demographic data and exposure data on military families are captured by using the Defense Enrollment Eligibility Reporting System and the Defense Manpower Data Center.
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From page 37... ...
Other MHS databases include the Defense Occupational and Environmental Health Readiness System, the DU testing archive (contains results of all urine testing for DU) , the Master Death File, the DOD Mortality Registry, and the Medical Evaluation Board database.
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From page 38... ...
Presentation to the IOM committee on Gulf War and health: Depleted uranium. Washington, DC: Department of Defense Center for Deployment Health Research, Naval Health Research Center.
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From page 39... ...
Presentation to the IOM committee on Gulf War and health: Depleted uranium. San Diego, CA: DOD Center for Deployment Health Research, Naval Health Research Center.
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