Public Health
Military Exposures & Your Health - Spring/Summer - Issue 16
In this issue:
- VA makes several cancers presumptive for service connection
- Now Recruiting: The Project IN-DEPTH study on Gulf War Illness
- Accomplishments from the Metal Exposures and Depleted Uranium Surveillance Center
VA makes several cancers presumtive for service connection
As a part of the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act, the Department of Veterans Affairs (VA) has made acute and chronic leukemias, multiple myelomas, myelodysplastic syndromes, myelofibrosis, urinary bladder, ureter, and related genitourinary cancers presumptive for service-connection for:
- Gulf War Veterans: Veterans who served in Somalia or the Southwest Asia theater of operations (which includes Iraq, Kuwait, Saudi Arabia, the neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Gulf of Aden, the Gulf of Oman, the Persian Gulf, the Arabian Sea, the Red Sea, and the airspace above these locations) during the Persian Gulf War on or after Aug. 2, 1990.
- Post-9/11 Veterans: Veterans who served in Afghanistan, Iraq, Djibouti, Egypt, Jordan, Lebanon, Syria, Yemen, or Uzbekistan and the airspace above these locations during the Gulf War on or after Sept. 11, 2001. This includes Veterans who served at the Karshi-Khanabad (K2) base in Uzbekistan after Sept. 11, 2001.
This step lowers the burden of proof for these Veterans, meaning that they do not need to prove that their service caused their condition to receive benefits for it. That is, VA automatically assumes service connection for the condition and provides benefits accordingly. Additionally, when a Veteran becomes service-connected for a health condition, it gives them access to free health care for that condition.
VA’s most recent assessment was of leukemias and multiple myelomas in fiscal year 2024, because the PACT Act did not establish these conditions as presumptive service-connected conditions. The presumptions for urinary bladder, ureter, and related genitourinary cancers went into effect January 2, 2025, and the presumptions for acute and chronic leukemias, multiple myelomas, and myelodysplastic syndromes, myelofibrosis went into effect January 10, 2025.
VA conducted a detailed review that entailed screening approximately 1 million scientific articles to identify the most relevant studies on all the conditions under consideration. Leading experts from the fields of oncology, hematology, occupational health, medicine, and epidemiology, conducted the scientific assessment.
VA encourages Veterans with these conditions to apply for benefits today and encourages eligible Veterans with previously denied claims to reapply. To apply for benefits, Veterans and survivors may visit VA.gov or call 1-800-MYVA411.
Now Recruiting: The Project IN-DEPTH study on Gulf War Illness
The Department of Veterans Affairs (VA) and National Institutes of Health (NIH) are recruiting Gulf War Veterans to participate in its Investigative Deep Phenotyping of Gulf War Veterans Health (Project IN-DEPTH) study. First launched in July 2022, Project IN-DEPTH’s purpose is to understand the biological causes of Gulf War Illness (GWI) and find new ways to diagnose and treat GWI.
GWI is a chronic, poorly understood condition that impacts approximately one-third of Veterans who served in the 1990-1991 Persian Gulf War. Symptoms may include fatigue, headaches, memory or cognitive difficulties, poor sleep, joint and muscle pain, digestive distress, and/or respiratory problems.
“Project IN-DEPTH is a unique study that truly goes deeper than any other study I’ve been involved with,” said a Veteran Advisor for Project IN-DEPTH. “For the first time since my GWI diagnosis, this study gives me hope that they will find real, tangible results that my fellow Gulf War Vets and I are looking for,” he said.
Project IN-DEPTH’s goal is to refer 75 Gulf War Veterans (50 with GWI and 25 healthy Persian Gulf War Veterans) to NIH for deep phenotyping, an approach to acquire more detailed knowledge about GWI to inform clinical care and provide treatments, beyond treating symptoms alone. In just over a 2-year period, the VA research team has reached out to more than 1,000 Veterans. To date, 27 Veterans have been determined eligible and referred to the NIH team.
If you are a Gulf War Veteran and are interested in participating in this study, contact the study team for more information by emailing VHAWAS.INDEPTH@va.gov.
Accomplishments from the Metal Exposures and Depleted Uranium Surveillance Center
The Metal Exposures and Depleted Uranium (MEDU) Surveillance Center, located at the Baltimore VA Medical Center, serves Veterans, service members, and providers as the trusted authority on the health outcomes of military exposure to depleted uranium (DU). MEDU provides urine uranium testing for any Veteran concerned about DU exposure.
DU is a by-product of uranium processing. It is 40% less radioactive than natural uranium. Due to its high density and other unique properties, the U.S. military has used DU for tank armor and projectiles. It was first used on a large scale during the Gulf War. Exposure to DU is most likely for service members who were in or on a vehicle struck by DU weapons. In these combat scenarios, very fine dust-like DU particles could be inhaled into the lungs, swallowed, or contaminate open wounds. DU shrapnel fragments may also become embedded in the body.
As of February 2025, over 10,000 Veterans concerned about DU exposure have submitted a urine sample to MEDU for testing. These samples are processed at the Baltimore VA laboratory and then sent to the Joint Pathology Center, a premier laboratory, for specialized urine uranium testing. To date, only 5 samples have tested positive for DU. In each of these cases, the Veteran was involved in a DU ‘friendly fire’ incident and was invited to be followed clinically by the MEDU Surveillance Center. Included in the more than 10,000 urine samples tested were samples from 465 Veterans deployed to Karshi-Khanabad (K2), none of which tested positive for DU. In addition, MEDU offers broader urine metal biomonitoring to assess fragment-related exposures to other metals. To date, MEDU has received over 2,500 urine samples from Veterans with other types of embedded fragments.
Learn more about MEDU and the services it offers at Depleted Uranium Information For Veterans and Embedded Fragments Information for Veterans.
