Health effects of depleted uranium on exposed Gulf War veterans

A small group of Gulf War veterans possess retained fragments of depleted u ranium (DU) shrapnel, the long-term health consequences of which are undete rmined. We evaluated the clinical health effects of DU exposure in Gulf War veterans compared with nonexposed Gulf War veterans. History and follow-up medical examination were performed on 29 exposed veterans and 38 nonexpose d veterans. Outcome measures employed were urinary uranium determinations, clinical laboratory values, and psychiatric and neurocognitive assessment. DU-exposed Gulf War veterans with retained metal shrapnel fragments are exc reting elevated levels of urinary uranium 7 years after first exposure (ran ge 0.01-30.7 mu g/g creatinine vs 0.01-0.05 mu g/g creatinine in the nonexp osed). The persistence of the elevated urine uranium suggests on-going mobi lization from a storage depot which results in a chronic systemic exposure. Adverse effects in the kidney, a presumed target organ, are not present at this time, though other effects are observed. Neurocognitive examinations demonstrated a statistical relationship between urine uranium levels and lo wered performance on computerized tests assessing performance efficiency. E levated urinary uranium was statistically related to a high prolactin level (> 1.6 ng/ml; P = 0.04). More than 7 years after first exposure, DU-expose d Gulf War veterans with retained metal fragments continue to excrete eleva ted concentrations of urinary uranium. Effects related to this are subtle p erturbations in the reproductive and central nervous systems. (C) 2000 Acad emic Press.