Gulf War Illnesses

The Persian Gulf War saw the first ever use of armor-piercing munitions and reinforced tank armor that relied on depleted uranium, a low-level radioactive heavy metal. Concerns have been raised about whether exposure to depleted uranium could have been a source of illness in returning Gulf War veterans. GAO found that the scientific understanding of the effects of depleted uranium on human health is still evolving. For example, an evaluation of 29 Gulf War veterans who had among the highest exposure to depleted uranium found that none of them showed any adverse kidney effects. However, most veterans with embedded fragments continued to have elevated uranium levels in their urine. Additional studies are underway to more fully understand the health effects of depleted uranium exposure and to better estimate the amount of exposure received by Gulf War veterans. Some Gulf War veterans have had difficulty fully participating in the medical screening program created to help ensure that veterans with higher than normal uranium levels are identified for appropriate monitoring and treatment. Some veterans had not been contacted by the Defense Department or the Department of Veterans Affairs to arrange an appointment at a medical facility, had not received the required urine test, and had been unable to understand the test results. The military has developed depleted uranium safety training, which instructs soldiers on how to identify and safely deal with depleted uranium contamination. However, GAO's review of general awareness training at 17 Army units found that the required training was not provided to all troops. Moreover, because neither the Army nor the Marine Corps monitor depleted uranium training for deployments, they were unable to say whether troops recently sent to Kosovo, where depleted uranium munitions were used, had received depleted uranium training.

GAO noted that: (1) the scientific understanding of depleted uranium's effect on health is still evolving; (2) because depleted uranium is a low-level radioactive heavy metal, the potential for health effects can come from radiation or chemical toxicity; (3) two recent studies cited the kidney as the organ that would show the first adverse health effects, noting animal studies show that very high doses of uranium may cause kidney failure; (4) however, both reviews observed that studies of uranium miners and mill workers have not shown increased kidney disease even though they were occupationally exposed to elevated levels of natural uranium; (5) the Department of Veterans Affairs (VA) is evaluating 51 Gulf War veterans considered to have the highest exposure to depleted uranium; (6) evaluations in 1997 of 29 of these veterans, many of whom have embedded fragments, indicate that, to date, none of these veterans show any evidence of adverse kidney effects associated with exposure to depleted uranium; (7) most depleted uranium-exposed veterans with embedded fragments continue to have elevated uranium levels in urine, which were related to lowered performance on computerized tests assessing problem-solving efficiency and to high levels of the prolactin hormone associated with reproductive health; (8) the clinical significance and long-term health consequences of these findings are undetermined; (9) some Gulf War veterans experienced problems in fully participating in the medical screening program established to ensure that veterans with higher than normal uranium levels are identified for appropriate monitoring and treatment; (10) the problems encountered by 19 of the 128 veterans interviewed included not being contacted by the Department of Defense (DOD) or VA to arrange an appointment at a medical facility, not receiving the required urine test designed to detect elevated uranium levels, and not being able to understand the test results; (11) DOD and VA subsequently corrected or planned to correct each administrative problem GAO identified; (12) the military services have developed depleted uranium safety training, which instructs servicemembers on how to identify and safely deal with depleted uranium contamination; (13) the services have begun efforts to provide general awareness depleted uranium training to servicemembers on a more widespread basis; and (14) however, GAO's review showed that the required training was not being provided to all troops for various reasons.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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