Health Care Providers
Information for Health Care Providers
Many Veterans see health care providers from VA as well as providers in the community outside of the VA system. Regardless of when and where you care for Veteran patients, it is important to understand how exposure to environmental hazards like open burn pits may impact their health and wellness.
Addressing Your Patient's Concerns About Depleted Uranium
Some Veterans are concerned about the possibility that they were exposed to Depleted Uranium (DU). They are looking to you for information and guidance. Read on to learn more about important information for health care providers regarding:
- DU and possible Health Risks from DU Exposure
- DU Exposure Screening and Surveillance offered through the MEDU Surveillance Center
- Resources available to help address Veterans’ and service members’ concerns.
What Are The Health Effects of Depleted Uranium?
The possibility of harmful health effects from exposure to DU is dependent on the burden of DU and its duration in the body. It also depends on the solubility of the DU present. The more soluble forms of DU primarily target the kidney, while the insoluble are more of an inhalation hazard to the lung. Clearance of both the soluble and insoluble fractions of DU should be cleared from the body within a year or two, with the exception of Veterans with retained metal fragments.
The MEDU Surveillance Center at the Baltimore VA Medical Center has been screening and monitoring Veterans for health problems associated with exposure to DU from “friendly fire” incidents with many possessing retained fragments since 1993. These Veterans have persistently elevated urine uranium levels.
After almost 30 years of follow-up the finding include:
- no abnormalities in kidney function;
- no link between elevated urine uranium and outcomes such as U-related cancers and birth defects;
- no evidence of abnormal PFTs or lung disease.
However, in three of the most recent evaluations of this group, there has been an indication that elevated urine uranium may be associated with lower bone mineral density (BMD). This makes biologic sense, as U is stored in bone, but requires further study.
Options for Veterans
Please encourage all Veterans who may have been exposed to environmental hazards during their military service to apply for VA health care and file a VA claim. Even if Veterans have other insurance or are not currently experiencing symptoms they believe are related to their exposures, taking these steps may give them access to care and services to meet their unique care needs.
Exposure Ed App
VA also offers Exposure Ed, an app that helps health care providers engage Veterans in discussions about their military exposures. Through this free app, providers can learn about exposures, quickly share information with Veterans, and search VA facilities and programs to help Veterans get the care they need.
To learn more, visit the VA Mobile Health site. The app is available for download on Android or Apple devices.
Depleted Uranium
Chemical used in tanks and in bullets that penetrate enemy armored vehicles
When a vehicle is hit and penetrated by a DU projectile, it splits into small shards and bursts into flames. The projectile fragmentation may fill the vehicle with flying metal fragments, particles, and dust.
Inhalation, oral, or dermal (wounds)
Southwest Asia, South-Central Asia, Western/Central Europe, Southeastern Europe
Gulf War, Operation Joint Endeavor (OJE), Operation Enduring Freedom (OEF) / Operation Freedom's Sentinel (OFS), Operation Iraqi Freedom (OIF) / Operation New Dawn (OND)
1990-1991, 1992-1995, 2001-present
The two primary health concerns related to DU exposure are radiation and heavy metal toxicity.
- Radiation - since DU is less radioactive than naturally occurring uranium, this should not be a significant source of concern.
- Heavy metal toxicity - The first organs of concern are the kidneys. Currently, there is no evidence of long-term health effects in Veterans as a result of embedded DU fragments.
The potential for health effects from internal exposure is related to the amount of DU that enters a person’s body. Inhaled DU particles are likely cleared from the lungs over several years. DU fragments may remain for many years. Other health effects being studied are the effects on the kidneys and on bone mineral density.
- Depleted Uranium Fact Sheet
- https://www.publichealth.va.gov/docs/depleted-uranium/du_factsheet.pdf
- https://www.publichealth.va.gov/exposures/depleted_uranium/index.asp.
- Depleted Uranium webpage
- https://health.mil/Military-Health-Topics/Health-Readiness/Environmental-Exposures/Depleted-Uranium .
- DoD Depleted Uranium (DU) Library
Get a Registry Evaluation
- Environmental Health Coordinator
- https://www.publichealth.va.gov/exposures/coordinators.asp
Contact your local https://www.publichealth.va.gov/exposures/coordinators.asp, https://www.oefoif.va.gov/map.asp, or VA Primary Care Team about getting a registry evaluation.
WRIISC Link
- War Related Illness and Injury Study Center (WRIISC)
- https://www.warrelatedillness.va.gov/WARRELATEDILLNESS/referral/index.asp
For evaluation for difficult-to-diagnose conditions, contact your local https://www.warrelatedillness.va.gov/WARRELATEDILLNESS/referral/index.asp.
Depleted Uranium Follow-Up Program
- https://www.publichealth.va.gov/exposures/depleted_uranium/followup_program.asp
"Depleted Uranium Follow-Up Program screens and monitors Veterans for health problems associated with exposure to depleted uranium (DU). The program is especially geared to Veterans who were on, in or near vehicles hit with 'friendly fire'; rescuers entering burning vehicles, and those near burning vehicles; salvaging damaged vehicles; or near fires involving DU munitions. VA requires active duty service in any of the conflicts listed below to qualify for the DU Follow-Up Program:
- 1990-1991 Gulf War
- Bosnia
- Operation Enduring Freedom
- Operation Iraqi Freedom
- Operation New Dawn
- For more information, visit: https://www.publichealth.va.gov/exposures/depleted_uranium/followup_program.asp
1990 2100 Gulf War, Operation Enduring Freedom (OEF) / Operation Freedom's Sentinel (OFS) Southwest Asia, South-Central Asia
