Significance of Dermatologic Findings in a Cohort of Depleted Uranium–Exposed Veterans of Iraqi Conflicts

BackgroundDepleted uranium (DU)–containing weapons have been used in military operations since 1991. There is interest in following veterans who were occupationally exposed to DU by either inhalation or retention of fragments. A cohort of DU-exposed Gulf War I veterans has been followed longitudinally at the Baltimore Veterans Administration Medical Center since 1993. ObjectiveThe aim was to monitor chronic dermatological findings associated with occupational DU exposure in the 2013 cohort. MethodsThirty-five veterans were evaluated. This study was reviewed and approved by the institutional review board and the Baltimore Veterans Administration Medical Center research service. Depleted uranium exposure was measured using creatinine-adjusted urine uranium concentrations (micrograms of uranium per gram of creatinine [&mgr;gU/gCrea]). Detailed medical histories, physical examinations, and exposure histories were performed. ResultsUsing a cutoff level of 0.1 &mgr;gU/gCrea, 11 veterans were placed in the high-uranium exposure group, whereas 23 veterans were placed in the low-uranium exposure group. Retained fragments were documented in 91% of the high-exposure group versus that in 13% of the low-exposure group (P < 0.001), and fragment-related scarring was significantly increased in the high-exposure group (P = 0.002). Other dermatological findings such as dermatitis were also assessed. ConclusionsFragment retainment and related scarring was significantly increased in veterans exposed to high levels of DU. Continuous monitoring of this cohort will yield interesting dermatological findings related to DU exposure.