Gulf War I veterans who were victims of depleted uranium (DU) "friendly-fire" incidents have undergone longitudinal health surveillance since 1994. During the spring of 2019, 36 members of the cohort were evaluated with a monitoring protocol including exposure assessment for total and isotopic uranium concentrations in urine and a comprehensive review of health outcomes, including measures of bone metabolism and bone mineral density (BMD) determination. Elevated urine U concentrations were observed in cohort members with retained depleted uranium (DU) shrapnel fragments. In addition, a measure of bone resorption, N-telopeptide, showed a statistically significant increase in those in the high DU subgroup, a finding consistent with a statistically significant decrease in bone mass also observed in this high DU subgroup compared to the low DU subgroup. After more than 25 y since first exposure to DU, an aging cohort of military veterans continues to show few U-related health effects in known target organs of U toxicity. The new finding of impaired BMD in the high DU subgroup has now been detected in two consecutive surveillance visits. While this is a biologically plausible uranium effect, it is not reflected in other measures of bone metabolism in the full cohort, which have largely been within normal limits. However, ongoing accrual of the U burden from fragment absorption over time and the effect of aging further impairing BMD suggest the need for future surveillance assessments of this cohort.

中文翻译：

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对暴露于贫铀的海湾战争退伍军人的监测：骨骼效应的更多证据。

自 1994 年以来，作为贫铀 (DU)“友军火力”事件受害者的第一次海湾战争退伍军人一直在接受纵向健康监测。2019 年春季，该队列中的 36 名成员接受了监测方案评估，包括总体暴露评估和暴露评估。尿液中的同位素铀浓度以及对健康结果的全面审查，包括骨代谢测量和骨矿物质密度 (BMD) 测定。在保留贫铀（DU）弹片碎片的队列成员中观察到尿尿浓度升高。此外，骨吸收指标 N-端肽显示，高 DU 亚组中的骨量显着增加，这一发现与高 DU 亚组中观察到的骨量显着下降（与低 DU 亚组相比）一致。 。自首次接触铀以来已经过去 25 年多了，一群老年退伍军人在已知的铀毒性靶器官中仍然没有表现出与铀相关的健康影响。现在，在连续两次监测中发现了高 DU 亚组 BMD 受损的新发现。虽然这是一种生物学上合理的铀效应，但它并没有反映在整个队列的其他骨代谢指标中，这些指标基本上都在正常范围内。然而，随着时间的推移，碎片吸收造成的 U 负担不断增加，以及衰老的影响进一步损害 BMD，表明未来需要对该人群进行监测评估。